CALL LOG
Manager Practice
Call log
These cases are based on actual advice calls made to MDDUS advisers and are published here to highlight common challenges within practice management. Details have been changed to maintain confidentiality.
SECRET RECORDING Q A
I was chatting to a patient this morning and she mentioned in passing that she recorded her last consultation with the dentist as she wanted to keep track of what was discussed. Surely she should ask permission before doing this?
The increasing use of smartphones and tablets makes audio/video recording much easier and increasing numbers of patients (both medical and dental) are taking advantage of this in consultations. Despite what you may think, patients do not need to ask permission before taping a consultation, as section 36 of the Data Protection Act 1998 considers that the information in the recording belongs to them. Conversely, the dentist would not be allowed to record without the patient’s permission. MDDUS experience suggests most patients make these recordings for positive reasons (i.e. to help their understanding of health advice) rather than to challenge their clinician. Dentists acting professionally should have nothing to fear. As ever, by keeping clear, comprehensive and accurate records of consultations, dentists can justify their actions in court if necessary.
ACCESS AFTER DEATH Q A 04
The daughter of one of our elderly patients who died last month has been asking questions about the nature of the care provided before her mother’s death and has now requested access to her mother’s medical records. Am I allowed to provide this to her?
Requests for access to a deceased person’s records are covered by the Access to Health Records Act 1990. The GMC’s Confidentiality guidance is also a
useful reference (paragraphs 70 to 72). After death, access may be granted to the deceased’s personal representative (i.e. the administrator or executor of their will) or to anyone who may have a claim arising from the death. Before disclosing, first check whether the patient had specifically requested her records remain confidential after her death and be sure to comply with her wishes (unless there is an overriding public interest in disclosing). Then confirm with the daughter the nature of her request as she should only be supplied with relevant information. Make sure you do not disclose any information in the record that may cause mental/physical harm to anyone, and remember to redact any third party information.
TRANSFER OF RECORDS ABROAD Q
A family in our practice has moved abroad and is requesting that full medical records be sent to their new practice. Should the records be sent via an “International Signed [for]” service to ensure secure delivery and can we charge for the extra postage?
A
Subject access requests from patients abroad would not differ from those made within the UK under The Data Protection Act. The maximum amount that can be charged for copies is £10 for computer copies and up to £50 for paper copies or a mixture of the two. This figure would include postage. It would be reasonable to be able to show that you have made every effort to ensure safe delivery should a complaint arise later – thus an International Signed [for] service may be advisable. But you may also wish to advise the patients that the practice is no longer responsible for the records once they have been posted. Remember that all requests for medical records should be made in writing and signed – and you should take all reasonable steps to ensure you have checked the identity of the patients (or parental guardians) requesting the records. In this case, a signed request and copy of passports showing the signature would be reasonable.
REQUEST TO RE-REGISTER Q
A former patient has contacted our practice wanting to re-register her, her husband and her children. The family had previously been registered but moved to another practice after the husband was removed from our list for verbally threatening reception staff. The partners have met and decided that the practice would be willing to take on the patient and her children but do not want to allow the husband to re-register. We would also want assurance that the husband would not accompany her or the children to the practice, nor be present if a home visit was required. Is this reasonable?
A
It would be reasonable to re-register the former patient and her children but to stand by your original decision and refuse to take the husband back on the list. However, it may be difficult to enforce the condition that the husband not be allowed to accompany the children or be present during necessary home visits as there may be circumstances when this is not possible, particularly in medical emergencies when the practice would be in no position to
AUTUMN 2015 ISSUE 13
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