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Online GMC Consultation February 2008 - Confidentiality: protecting and providing information

Published: 26th February 2008

Please see the GMC website: www.gmc-uk.org for more information on the consultation they are running.

1. Is maintaining confidentiality an important professional value for the medical profession, or is it simply a contractual and legal obligation?

It is a vitally important professional value without which patients will never trust us with enough information to make an adequate diagnosis for treatment purposes. Any legal and contractual issues follow.

2. Should the GMC be producing guidance, given that guidance is issued by a few different bodies (GMC, departments of health, Information Commissioner)?

Yes. The GMC is the primary professional body which sets standards and holds doctors accountable to them. The other agencies mentioned reflect secondary issues of law and contract.

3. What do you see as the most important confidentiality issues now and in the future which are relevant to doctors and the GMC?

The content of the consultation must remain sacrosanct. Identifying information should only be shared with others after fully informed consent has been given. The very rare exceptions to this must be clearly set out and enforced.

With the several recent high-profile examples of data NOT being protected, public confidence in the protection of the data they provide in medical contexts is likely to be low. This has implications for every doctor-patient interaction as well as for the NHS IT programme.

4. What have been the big organisational and legal changes in relation to confidentiality since 2000, when we last substantially reviewed our guidance?

The advance of IT, both locally in the practice or hospital and on planned national databases, makes the breach of accepted confidentiality processes more likely, or at least perceived to be more likely.

5. What do you think of the current form of the guidance - for example, should we be more or less specific or detailed in our advice, or about the same?

The current guidance is about the right length and has the right balance. We do not suggest any major changes. We are aware that some, for example in the epidemiology research communities, have thought it too restrictive, and whilst they might prefer less specific advice, for general medical purposes we believe it is about right. (There may be a case for further detailed advice regarding special situations.)

6. Would a web-based resource of examples or case studies, which could be kept up to date and amended as necessary, be helpful?

Yes. This might be a good way of dealing with the specific needs of doctors in specialised areas (see Answer to 5) and also a way of illustrating 'common cases' to more junior doctors.

7. Are there any major omissions in the current core guidance? If so, what are they?

We are not aware of any.

8. What is wrong with our existing core guidance? In particular, can you point to text which is confusing, inaccurate or inconsistent with the law or other relevant guidance? (Please be as specific as possible.)

We have no significant concerns.

9. Can you give examples of difficult decisions doctors have to make about confidentiality and the disclosure of information? (This should help us identify issues on which we can give practical advice in the guidance to replace the Frequently Asked Questions. Please do suggest solutions to the problems you identify.)

Nothing to contribute.

10. How might we make our confidentiality guidance more useful and accessible to patients and public?

Producing a simplified precis of the guidance to doctors, along the lines of 'What you can expect when you tell your doctor confidential personal information'.

Produce this in paper form, in necessary languages, and place it as accessibly as possible on websites.

11. How could we make our confidentiality guidance more useful to doctors?

With the rapid extension of IT and databases, a generation of medical students and junior doctors may arise who are initially too casual about confidentiality. The principles, the practice of maintaining confidentiality at all times, and the pitfalls need to be taught throughout medical school and reinforced regularly.

'Case reports' in GMC communications often stick in the mind and have a salutary effect.

For further information:

Steven Fouch (CMF Head of Communications) 020 7234 9668

Media Enquiries:

Alistair Thompson on 07970 162 225

About CMF:

Christian Medical Fellowship (CMF) was founded in 1949 and is an interdenominational organisation with over 5,000 doctors, 900medical and nursing students and 300 nurses and midwives as members in all branches of medicine, nursing and midwifery. A registered charity, it is linked to over 100 similar bodies in other countries throughout the world.

CMF exists to unite Christian healthcare professionals to pursue the highest ethical standards in Christian and professional life and to increase faith in Christ and acceptance of his ethical teaching.

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