To disclose or not to disclose patient information? That is a question which is frequently put to DDU dento-legal advisers, particularly when the information is requested by a Primary Care Organisation (PCO), NHS Business Services Authority (NHSBSA) or private funding scheme.
Of course, dental professionals recognise they have an ethical and legal duty to respect the confidentiality of patient information. The Data Protection Act 1998 is the most significant piece of legislation in this area.
It regulates the processing of information about individuals including the obtaining, use or disclosure of information and covers clinical records and recognises individuals’ rights to restrict the disclosure of information about them. A breach of the Act can result in civil or criminal proceedings. In most circumstances, a patient’s consent must be sought, preferably in writing, to disclose any information about them to others.
However NHS GDS dental records may need to be disclosed to a PCO for purposes such as verification or audit. These bodies have a statutory right to see NHS GDS records and the dentist is under a legal duty to comply. For example, the dental contract regulations has a section on the provision of, and access to, information which states: ‘Contractors must provide a) any information which is reasonably required by the Primary Care Trust for the purposes of or, in connection with, the contract; and b) any other information which is reasonably required in connection with the Primary Care Trust’s functions, and includes the contractor’s patient records.’*
Most people understand and accept that information must be shared within the dental team in order to provide their care. Also, while they may not realise it, NHS patients indicate their consent to relevant information being disclosed to the PCO and NHSBSA when they sign the patient declaration on a FP17 form.
Despite this, it is important that dental professionals explain and provide information to patients on the circumstances in which they might share information about them with others involved in their healthcare.
The DDU recommends that practitioners include information about the use of patient data and patients’ rights under the Data Protection Act in their practice information material. Patients should also be given the opportunity to withhold permission for sharing of information.
When asked to submit records or a report to a private dental funding scheme for any purpose, the patient’s expressed consent should be sought. Under the Access to Medical Reports Act 1988, you should check if they wish to see the report before it is sent.
* Section 35 of the National Health Service (General Dental Services Contracts) Regulations 2005.
Bryan Harvey is deputy head of the Dental Defence Union (DDU).