The Caldicott Guardian Guide: Protection and Sharing of information

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The Caldicott Guardian Guide Protection and
Sharing of information

• IG Policy Team
• NHS Connecting for Health

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Learning points

• Confidentiality Guidance
• Confidentiality Decision Models
• Appropriate Sharing of Personal Identifiable
  Information
• Seeking further Guidance

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Confidentiality Guidance

• Common Law Duty of Confidence
• Professional Ethical Standards
• Caldicott Report and Recommendations
• Data Protection Act 1998
• Human Rights Act 1998
• Freedom of Information Act 2000
• Health and Social Care Act 2001 (Section 60)
• Confidentiality NHS Code of Practice 2003

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Confidentiality Decisions Models

• Where it is proposed to disclose confidential
  information in order to provide healthcare.
• Where the purpose isnt healthcare but it is a
  medical purpose as defined in legislation.
• Where the purpose is unrelated to healthcare or
  another medical purpose.

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Annex B(B1) Disclosure in providing healthcare
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If

• there is a statutory requirement for, or court
  order demanding, disclosure

Yes
Disclose appropriately. Unless special
circumstances exist, the individual should be
informed of the disclosure a.s.a.p.
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If

• Disclosure is to support or audit the provision
  of healthcare to the patient concerned
• The Patient is competent to consent or parental
  consent sought in appropriate cases
• The patient has been made aware of who may see
  the information and for what purpose
• The Patient has been informed of his/her right to
  object
• The Patient has raised no concerns and does not
  object

Yes
Disclose information, on a need to know basis to
provide and audit care
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If

• the patient is not competent to understand and
  give consent to proposed information sharing

No
Must act in the best interest of the patient
concerned, informing as much as possible and
using/sharing information to provide care and
treatment.
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If

• It is not possible to agree a compromise where
  use /sharing of information is acceptable to the
  patient and the quality of care is compromised

No
It may not be possible under these circumstances
to provide safe healthcare by sharing. In this
case make sure that decisions are carefully
documented and do not Disclose.
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Annex B(B2) Disclosure for medical purpose as
defined in the legislation (Data Protection Act
1998)
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If

• The disclosure of patient identifiable
  information is essential and appropriate for
  disclosure
• The proposed disclosure is in connection with a
  medical purpose other than care and treatment
  e.g. medical research
• The patient has been made aware of who may see
  what information for what purposes and his/her
  right to object has been proposed
• The patient has given explicit consent to
  disclose
• OR there is public interest in disclosure then

Yes
Disclose and document appropriately.
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If

• the disclosure of patient identifiable
  information is NOT essential or appropriate

No
Only disclose information in an effectively
anonymised form
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If

• the patient has NOT given explicit consent to
  disclose

• Then is disclosure approved under Section 60 of
  the Health and Social Care Act 2001

No
Yes
If the patient has not objected to disclosure
then disclose appropriately and, if applicable,
in compliance with any additional requirements
introduced by section 60.
Dont disclose if the patient has objected and
unless the public interest justifies disclosure.
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Annex B(B3) Disclosure for purpose unrelated to
healthcare or another medical purpose
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If

• There is satisfactory gateway permitting
  disclosure
• The patient has been made aware of who may see
  what information for what purpose and his/her has
  been informed of their right to object
• The patient has given explicit consent to disclose

Yes
Disclose information and document appropriately
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If

• There is NOT satisfactory gateway permitting
  disclosure
• The patient has NOT been made aware of who may
  see what information for what purpose and his/her
  has NOT been informed of their right to object
• The patient has NOT given explicit consent to
  disclose

• Is there
• public interest in disclosure?
• A condition in schedule 3 of the DPA98 that can
  be satisfied e.g. condition 3 vital interest
  or condition or 7 administration of justice?
• The patient should be told of the disclosure
  unless special circumstances apply.

Yes
No
Disclose information and document appropriately
Disclose in effectively anonymised form
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Follow up ActivityIt is highly recommended
that Caldicott Guardians read the Confidentiality
NHS Code of Practice completely to support the
content of this presentation.
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Further Guidance and useful links