Confidentiality - health professionals
There is no act of Parliament that defines when a confidential relationship arises. However, common law recognises the concept of confidentiality and legal action can be taken if confidential information is disclosed or misused.
The professional codes of practice of doctors, nurses and other health professionals place a duty on them not to disclose information about individual patients without their consent, except in exceptional circumstances.
The duty of confidentiality owed to a person under 16 is the same as that owed to any other person. Even if the health professional does not consider that a young person has sufficient understanding to consent to treatment, the consultation can remain confidential.
Exceptional situations may occur where a professional believes the health, safety or welfare of the patient or others is at grave risk. It would be usual to counsel the person to try to get them to agree to pass information on. If the patient will not agree to this, the decision whether to disclose information in these circumstances would depend on the degree of current or potential harm. It does not depend on the age of the patient.
The principle of confidentiality is not changed by new guidance in England on working with sexually active young people published in the revised version of Working Together to Safeguard Children from Harm (DfES 2006).
The guidance states that in making decisions about whether to share information about a young person with children’s social care the child’s best interests must be the overriding consideration. Decisions should always be based on an assessment of that individual’s situation and professionals have discretion to make decisions on a case by case basis taking account of a range of factors. This applies to all young people, including those under the age of 13. The guidance does state that cases involving under 13s should always be discussed with a nominated child protection lead in the practitioner’s organisation. However, it clearly indicates that professionals have the discretion not to refer a young person to other agencies where this would not be in their best interest. The reasons for this decision need to be fully documented.
Local Safeguarding Children Boards are expected to develop local protocols based on this guidance. Local protocols which require mandatory reporting on the basis of age are not in accordance with Working Together to Safeguard Children from Harm.
