What is ‘Confidentiality’ in Health & Social Care?

Confidentiality is of the utmost importance for all health and social care workers. It is critical to understand your duty of confidentiality at work, and the legislation behind this. Additionally, there might be instances where you have to override this duty. Thus, it’s imperative to understand the types of situations these are and how you should act if they arise. The following guide will provide you with all the information you need about confidentiality in health and social care:

What is ‘confidentiality’?

Confidentiality refers to the need for someone’s privacy to be respected. In essence, if an individual provides personal information or details that they don’t want to share with anyone else, you must respect their wishes. As a health or social care worker, you will often come into contact with people that provide intimate information as well as being privy to personal information about them. This information should not be shared unless it is necessary. There are obvious instances where you must share these details, such as when referring an individual to another professional. But, for the most part, you have to keep everything confidential and ensure you don’t share private information with others. It’s also important to note that confidentiality does not solely refer to instances where you verbally share information. If you have someone’s records on a file or computer storage, you have a duty to keep them safe. Nobody else should access or look at them unless there is a valid reason.

When is your duty to confidentiality overridden in a health/social care setting?

The problem with confidentiality is that it can be quite confusing. Some situations are very easy to figure out. For example, if you are a GP and have an appointment with a patient, you don’t repeat information about their medical conditions to others – unless you have to refer them. Most instances are similar to this, and it’s easy to maintain confidentiality. Nevertheless, problems occur when you start running into ethical issues. There may be scenarios where you question whether keeping information confidentiality is the right thing to do. So, are you able to override your duty of confidentiality in these situations? The short answer is yes, and you will find two main instances where it is the case:

1. You suspect a patient is at risk of harm from someone else
2. You suspect your patient is a risk to someone else

What can you do in situations like these? For starters, you must be able to justify your decision to break confidentiality. Let’s say you work as a carer and you inadvertently observe one of the individuals that you care for watching (legal) pornographic material. They stress how embarrassing it is for them, so ask you not to tell anybody. Here, you don’t have substantial evidence that anything untoward is happening. Let’s look at another example, this time where confidentiality can be broken. Again, you’re doing the rounds as a carer, and you come across one client that seems to be hobbling. They’re a lot quieter than usual and keep avoiding eye contact. You ask if anything is wrong, and they confide that another one of their carers pushed them over this morning. They don’t want you to tell anyone as they’re worried about what might happen. They confess that they’re scared the carer might return and hurt them again if the story breaks out. This is a clear instance where you can override your duty of confidentiality. There’s substantial evidence to suggest your client is at risk of physical harm. Despite the fact they’ve asked you not to tell anyone, you have to breach confidentiality for the safety of the client. This should be raised with your manager immediately as a safeguarding issue.

What should you do when you have confidentiality concerns?

Understandably, if you’re in either of the previous situations, you may wonder what to do. When it is acceptable to breach confidentiality, you should begin by explaining it to your client. Be gentle and explain that you know why they’re afraid, but they have experienced abuse. Tell them they are at risk of harm, so you have to take action to protect them. Let them know that you will do everything you can to keep them safe, ensuring they have nothing to worry about. Following this, you must contact your manager/supervisor. Essentially, go to whoever is above you and responsible for your work. Explain the situation, and they will take action. You will likely have to help take further actions to keep your client safe and ensure the right solution is found. Also, it is worth speaking to your manager if you have any confidentiality concerns. You don’t have to breach confidentiality, but you can ask them hypothetical questions that are similar to this situation. As such, you haven’t provided any private or confidential information, but you have painted a picture that could help you understand whether to break your duty or not.

The 5 legislation covering confidentiality in UK health and social care sectors

In the UK, we currently have five primary legislation relating to confidentiality for health and social care workers. Naturally, you must read up on and be aware of these laws as you cannot break them while working.

The Human Rights Act 1998

The Human Rights Act gives people control over their private life. Anyone in the UK has the right to withhold personal information held in confidence. In health and social care settings, this could include a patient telling a doctor about their sexual activity. It’s personal information that they have the right to remain private. This right can be overridden in some circumstances, such as the ones mentioned earlier in this guide.

The Common Law of Confidentiality

The common law of confidentiality isn’t specifically targeted at healthcare settings. Instead, it is a common law that helps people come forward with various problems or concerns. In effect, they provide information under the pretence that it will be confidential and nobody will know they provided it. Therefore, if a patient/client comes forward with information and wants it to remain confidential, it is technically protected under this law. Again, you can override this law if breaking it will keep people safe and prevent harmful situations.

The Care Act (2014)

The last six years have seen three new acts relating to confidentiality in the UK. The first of those is The Care Act, which is in place to protect people in health or social care. It is all about the safeguarding process and improves people’s independence and wellbeing. The aim is to encourage caregivers to take action when spotting signs of abuse, making it okay to break confidentiality. Under this act, local authorities must take action and provide services to help those in need. Essentially, it’s helping you take swift action if you spot any signs of abuse in clients. This was groundbreaking legislation that rewrote the way these situations are handled, getting rid of the previous law that had been in place for 60 years.

The Health and Social Care (Safety and Quality) Act 2014

One year later, this act was introduced to improve the safety and quality of care. Various measures were introduced, but the most relevant one is that health and adult social care providers can now share information about a person’s care with other health and care professionals. We’ve touched upon this concept when speaking about referring patients. This act makes the sharing of information possible, meaning other health and social care providers can provide better treatment. The best example is someone switching from one care home to a new one. By being allowed to share the patient’s information, the new care home can make provisions to treat them as best as they can.

The Data Protection Act & GDPR (2018)

Lastly, the most recent legislation is the Data Protection Act and GDPR. Both of these revolve around storing and sharing private and personal information. Not only does this relate to your client/patient data, but it also links to any employee data. The gist is that you are responsible for how this data is used and controlled. As per the GDPR guidelines, you need to ensure all information is:

• used fairly, lawfully and transparently
• used for specific, explicit purposes
• used in a way that is adequate, relevant and limited to only what is necessary
• accurate and, where necessary, kept up to date
• kept for no longer than required
• handled in a way that ensures appropriate security

Patients and clients have certain rights under this act, as well. They have the right to be informed about how their data is used, and they can object to how data is processed and erase it if necessary. Overall, the Data Protection Act and GDPR are ways of further enforcing confidentiality. You have to keep personal information private and secure at all times! On that note, you have reached the end of this guide. Hopefully, it provides all the key details regarding confidentiality for health and social care workers. Remember, you have a duty to keep the information confidential in most circumstances. However, this duty can be overridden if certain risks are present, and it will ensure patients/clients/other individuals are kept safe.