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GPs should explain to patients consequences of refusing to share information, says GMC

GPs should explain to patients any potential consequences of refusing to share information for their direct care, new GMC guidance has said. 

The regulator has revamped its ‘Confidentiality’ guidance, which makes it clearer when doctors need to make disclosures in the public interest, when doctors can rely on implied consent to share information and acknowledging the roles of the families of patients.

The guidance comes into force on 25 April and includes a decision making flowchart to help doctors decide when it is appropriate to share personal information about patients.

There is a new requirement that doctors should explain to patients the potential consequences of refusing sharing information for direct care, although doctors still have to abide by the wishes of a patient who has capacity.

The guidance also includes a new statement on the role that those close to a patient can play, emphasising that confidentiality is ‘not a justification for refusing to listen to the views of those who are close to the patient’.

There is also a more clear outline of the legal requirements to disclose information, with a list of factors for doctors to take into account when to disclose information in the public interest.

Charlie Massey, GMC chief executive, said: ‘This refreshed, revised and restructured guidance on confidentiality will help doctors better understand their responsibilities when handling patient information in their everyday practice.

‘We know doctors want more support and guidance on some of the complexities of confidentiality, and so as well as the revised guidance we are also publishing some supporting explanatory notes. We will produce additional helpful materials for doctors when the guidance comes into effect in April.’

Dr Catherine Wills, MDU deputy head of advisory services explained to Pulse some of the main changes:

‘One change is to make a clearer distinction between disclosures that are permitted versus those that are required. This can cause confusion but in para 19 the GMC points out that if a disclosure is permitted but not required by law, the doctor must be satisfied that there is a legal basis for breaching confidentiality and that the other relevant requirements for disclosing information are met (ie it can be justified in the public interest).

‘The take home message from this is that if the police are quoting the law or you have been presented with a court order for disclosing information, best to check with your MDO so we can check the validity of the request, before you disclose the info.

‘There is an emphasis on the importance of sharing info for good care (para 26) and it is clear that it is reasonable to rely on implied consent for sharing with others who are providing care, as long as the patients has ready access to information about how their data will be used, their right to object and have not objected. But as para 29 says that, if a doctor suspects that a patient would be surprised about how the doctor is accessing or disclosing information, the doctor should ask for explicit consent first, if practicable. The example given is that of a doctor accessing a record from another healthcare provider in a shared record.

‘There is expanded guidance on involving family members, while respecting patient confidentiality. Para 35 and 100-101 explains how important family can be in care and that doctors should avoid misunderstandings or offence to families by having an early dialogue with patients to clarify who they are happy for the doctors to disclose to.’