The NHS Code of Practice on Confidentiality

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The NHS Code of Practice on Confidentiality

• A LEIGHS presentation
• Joy Wingfield, Professor of Pharmacy Law and
  Ethics, Nottingham School of Pharmacy
• Joy.wingfield_at_nottingham.ac.uk 1st October 2004

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Application
Required practice for those who work in, or under
contract to, NHS organisations
The standard expected of the private sector too
Replaces 1996 Protection and Use of Patient
Information Preserves the Caldicott guardian
concepts
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Some Definitions

• Identifiable, anonymised, psudonymised
  information
• Explicit, implied consent, disclosure
• Health care purposes
• Medical purposes
• Social care
• Public interest
• ISPs info sharing protocols

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Types of Information

• Patient identifiable information includes
• Name, address, post code, date of birth
• Pictures, photos, videos, other images
• NHS No. any other identifiers
• Anonymised information
• Cannot identify the individual at all
• Pseudonymised information
• Holder of data can still identify individual

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Consent and Disclosure

• Explicit or express consent
• articulated patient agreement interchangeable
  terms
• Implies voluntary, informed, capacity
• Implied
• Agreement signalled by behaviour
• Disclosure
• Divulging or providing access to data

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Purpose

• Health care purposes
• Diagnosis, care and treatment
• NOT research, teaching, management
• Medical purposes
• Preventive medicine
• Medical research
• Audit and management
• Social care
• Support for vulnerable people

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Other definitions

• Public Interest
• Exceptional circumstances that justify overruling
  the right of an individual to confidentiality in
  order to serve a broader societal interest
• Information Sharing Protocols (ISPs)
• Documented rules on disclosure and use of patient
  data between two or more organisations or agencies

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The Confidentiality Model

• Protect
• Look after patients information
• Inform
• Ensure patients aware of how info is used
• Provide Choice
• Allow patients to decide on disclosure
• Improve
• Look for better ways of the above

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Annexes

• A detailed requirements
• B How to make a confidentiality decision
• Flow charts underpinning law
• B1 in order to provide healthcare
• B2 for a medical purpose
• B3 for a purpose which is neither health care or
  a medical purpose
• C examples of confidentiality decisions

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Healthcare example
I have a patient who is an elderly lady in her
eighties and lives in her own home. The lady
has all her marbles but is visited regularly by
her middle aged daughter who does her shopping
and other household chores for her. The daughter
wants me to explain about her mothers medication
and treatment options. Can I do this?