Confidentiality and Medical Records

Information is collected and stored in records and on computer to allow proper care and treatment to be given.

All team members at Severnbank Surgery are signed up to a strict code of confidentiality. This protects the information we hold and hear about you from being passed on unnecessarily.

We want you to feel comfortable in discussing issues that relate to your health with your Doctor. These could include matters relating to sex, sexuality, relationships, mental illness, work, drugs, drinking and even the fact that you are a patient registered at this practice.

Our strict duty of confidentiality to all our patients is enforced by the General Medical Council and the various data protection laws. The rules apply to all Doctors, regardless of where they work in the UK.

Young People

Confidentiality is just as important an issue for young people. If a child under 16 is fully competent to understand and make informed consent regarding their own health problems, information about that child’s medical health of history may not be released to a parent, legal guardian or teacher. Over 16’s are responsible for their own lives.

Staff

Practice staff have to access your records to type letters, file incoming hospital post and for a number of administration jobs. They are not allowed to access your notes for any other purpose. Our staff are highly trustworthy people and professional in their attitude. They take responsibility for confidentiality very seriously. They are not allowed to discuss any work related issues outside of the workplace.

The receptionists may ask questions when you make an appointment. They are not being deliberately intrusive but need this information to make sure you receive the most appropriate care.

If you know staff on a personal level and you are worried about the contents of your records, please discuss this with the Doctors or the Operations Manager.

Computer Data

The computer is the modern way to retain medical records and allows us to provide you with a better, safer service. Only the Doctors and staff employed by the Practice can access the data on the computer. Before they can do this each member of staff must sign a confidentiality agreement. Some very basic information is sent electronically to the Health Authority’s computer so that the Doctors can be paid for their work. No information is shared with any company outside the NHS unless it has been made anonymous. This is only ever for clinical audit purposes.

Other Health Professionals

It helps the Doctors, Nurses, Health visitors and Social Workers who look after you with us, to share information. We won’t be involving anyone in your care without your knowledge. Data disclosed will be kept to the minimum required to serve the purpose. Please remember that all NHS employed staff have confidentiality clauses within their employment contracts. If there is any information you don’t want the Doctor to tell these co-workers, just mention it to your Doctor.

Reports Requested by Other Agencies

There are times when you might need a report from your Doctor for someone who is not looking after you e.g. your employer, an insurance company or your solicitor. We would never provide such a report without your signed consent. If we receive a request we will ask for your consent directly. As with sick notes, we always provide the minimum necessary information for their and your purposes. We do not normally answer personal questions about you, which you could answer yourself. If you wish, you have the right to check any of these reports before we send them off. If you have any worries we would recommend that you ask to check them at the time.

Family and Friends

If you are unwell, your partner, family or carer will be worried about you. The Doctor can not divulge information to them without your consent. To avoid confusion, you can bring them with you to see the Doctor.

Occasionally you may be concerned about a relative and unable to persuade them to inform the Doctor about their symptoms, which you think might be important. In such circumstances, you can write to the Doctor or make an appointment. The Doctor will not be able to provide you with information, but may be able to act on the information provided. It is always better to tell the patient that you are sharing this information.

Releasing Information Without Consent

There are a few situations when Doctors are allowed to release information without your consent. These situations are defined by law. Such information can only be passed to the relevant Health Authorities if you are profoundly mentally ill, have serious infections which can be passed easily to the general public (Not STD), are placing others at risk of death or very serious harm or are at risk of death or very serious harm to yourself.

The Doctor would have to make a judgement based on the individuals circumstances before going against your wishes.

We want you to feel confident about the information which we retain about you in your records. You have the right to see your own records to check their accuracy. If you would like to see your records, we need your request in writing. We have 40 days to respond to your request. We will also need proof of your identity.

Test results are often requested at the reception desk. We understand that this is a very public area, please ask the receptionist if you would prefer to have your results written down on paper and handed to you.

If you ask someone to collect your results, please send signed consent. Your results will be given in a sealed envelope. Your results will be given to you personally over the telephone once we have established your identity, this may mean that we have to ask you several questions.

We always endeavour to keep your information secure and act appropriately. If we are unable to share information with you please understand that this will be because we do not have sufficient information to know that you are who you say you are. In these instances we may ask for proof of ID. If you are concerned with information that has been shared please ask for the Operations Manager.