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Practice dilemma: Return address may breach confidentiality

With the rise in postal prices our practice has invested in a franking machine to save costs. It automatically puts our return address on all post. We are concerned this might be a breach of confidentiality, as it will be clear to anyone who sees the envelope that the person we have written to is a patient with our practice. Should we be worried?

You are right to be concerned, as even the fact that a patient is registered at a practice is confidential medical information and should not be disclosed without the consent of the patient. However, having the practice's address on an envelope may not equate to the recipient being registered at the practice. The practice may, for example, be writing to a supplier of goods or services.

It could also be argued that having a return address on the practice correspondence is in the public interest, because if the mail is undelivered or returned the practice can take steps to contact the patient in some other way. If, however, you believe circumstances exist which will result in your address on the envelope identifying the recipient as a patient, you may wish to consider taking alternative measures to omit your identity – for example, using a P.O. Box number or similar.

The GMC guidance on confidentiality recommends patients are made aware of how information about them will be used.

In line with this, the Medical Defence Union's advice is to inform patients of your practice's policy for communicating with them, explaining that it may be possible to identify correspondence sent by post because it will display a return address label. You may decide to tell patients through a notice in the waiting room, for example, or a note on prescriptions. If a patient objects to receiving correspondence in this way by post, you may need to remove any identifying labels or find another way of communicating with that patient.

Dr Naeem Nazem is a medicolegal adviser at the Medical Defence Union


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