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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.


COPYING CHARGES Q A


Can you advise whether our practice can charge for photocopying patient records that have been requested by court order but via a solicitor’s office?


A practice complying


with a court order to supply copies of patient records is not


allowed to charge a fee for photocopying. This applies irrespective of whether the order is received directly from the court or via a solicitor. However, the solicitor is obliged to supply the practice with a copy of the court order so you should make sure you are in receipt of this before sending the photocopied records.


ACCESSING DECEASED RECORDS Q


The daughter of a deceased patient has written to the practice requesting a copy of all notes relating to her mother’s care during the final 12 months of her life. We are unaware of any instructions from the patient with regard to access to her records after death and she had not appointed a personal representative. We have discussed the request with the patient’s two other daughters and they have no objections. Should we comply?


A 04


It would be advisable to consult the General Medical Council’s guidance on Confidentiality regarding disclosing


information after a patient has died. The guidance advises that in these


circumstances you should consider whether disclosing such information would likely cause distress to the patient’s partner or family and whether there are any concerns over a breach of third-party confidentiality. Among the circumstances in which the GMC states you should usually disclose relevant information about a deceased patient is when “someone close to an adult patient asks for information about the circumstances of that patient’s death and you have no reason to believe the patient would have objected to such a disclosure”. This may apply in this particular case, and


consideration should be given to which records might be relevant to disclose.


NURSE INVESTIGATION Q A


We have received a request from the Nursing and Midwifery Council (NMC) for access to the full records of two patients. They say they need the files as part of an investigation into the conduct of a nurse who worked at the practice up until six months ago. Am I allowed to hand over the records without asking the patients’ consent?


Ordinarily, before disclosing identifiable information you would be expected to first seek express patient consent. In this case, the NMC has a statutory power to request information for the purposes of their investigation, so patient consent is not strictly necessary if the NMC states that they are relying on these powers. That said, the GMC’s Confidentiality guidance states that, whenever practicable, you should inform patients about such disclosures unless that would undermine the purpose, even if their


consent is not required. It also states that disclosures should be kept to a minimum so it is worth confirming with the NMC whether the full patient records are required, or if specific information can be supplied.


INSURANCE CLAIM Q A


The sister of one of our patients has attended the practice asking one of our GPs to fill in a travel insurance form on behalf of her brother, Mr B. She wants to claim back the cost of a holiday that he was forced to miss due to ill health. Mr B no longer has capacity to make decisions for himself and is unable to communicate. What should we do?


The first thing to do is to clarify whether Mr B has appointed a power of attorney (POA) or deputy to make health and welfare decisions on his behalf. If the sister has the relevant POA then this would permit your GP to complete the travel insurance form on Mr B’s behalf. In addition to this, you should check whether there is anything in Mr B’s records to indicate that he would not want this information disclosed. If there is POA in place, be sure to comply with relevant capacity legislation and act in the patient’s best interests. If you do decide to complete the form, be sure to disclose only the minimum amount of information necessary.


CHECKING UP Q A


The mother of a five-year-old patient has called up asking if we can confirm that her estranged husband attended with their son for his dental check-up this morning. We know she has parental responsibility and isn’t on speaking terms with the dad. Are we allowed to confirm this information for her?


Dealing with the estranged parents of a child patient can be a difficult situation for practices as emotions often run high. In this instance, it may be best to phone the mum to discuss her request and any concerns she may have about her son’s ongoing care. As she has parental responsibility and if it is in the child’s best interests, she would be entitled to know


SPRING 2018  ISSUE 18


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