The need for the strict confidentiality of personal information about patients is essential. This document describes our policy for maintaining the confidentiality of all personal information and all members of the practice team are required to comply with these safeguards as part of their contract of employment or contract for services with the practice.
The importance of confidentiality
- The relationship between dentist and patient is based on the understanding that any information revealed by the patient to the dentist will not be divulged without the patient’s consent. Patients have the right to privacy and it is vital that they give the dentist full information on their state of health to ensure that treatment is carried out safely. The intensely personal nature of health information means that most patients would be reluctant to provide the dentist with information if they believed that it would be passed on. If confidentiality is breached, the dentist, dental hygienist, dental therapist or dental nurse concerned faces investigation by the General Dental Council and possible erasure from the Dentists or DCP Register. They may also face legal action by the patient for damages and, for dentists, prosecution for breach of the Data Protection Act.
General Dental Council
- All staff must follow the General Dental Council’s rules for maintaining patient confidentiality contained in its publication ‘Standards for the dental team’ (visit: gdc-uk.org).
- If confidentiality is breached, each registered dental professional involved is responsible to the GDC for their individual conduct.
What is personal information?
- In a dental context, personal information held by a dentist about a patient includes:
- The patient’s name, current and previous addresses, bank account/credit card details, telephone number/email address and other means of personal identification such as physical description
- Information that the individual is or has been a patient of the practice or attended, cancelled or failed to attend an appointment on a certain day
- Information concerning the patient’s physical, mental or oral health or condition
- Information about the treatment that is planned, is being or has been provided
- Information about family members and personal circumstances supplied by the patient to others
- The amount that was paid for treatment, the amount owing or the fact that the patient is a debtor to the practice.
Principles of confidentiality
- Personal information about a patient:
- Is confidential in respect of that patient and to those providing the patient with health care
- Should only be disclosed to those who would be unable to provide effective care and treatment without that information (the need-to-know concept), and
- Should not be disclosed to third parties without the consent of the patient except in certain specific circumstances described in this policy.
Disclosures to third parties
- There are certain restricted circumstances in which a dentist may decide to disclose information to a third party or may be required to disclose by law. Responsibility for disclosure rests with the patient’s dentist and under no circumstances can any other member of staff make a decision to disclose.
- Personal information can be disclosed where:
- The patient has expressly given consent to the disclosure
- Disclosure is necessary for the purpose of enabling someone else to provide health care to the patient and the patient has consented to this sharing of information
- Disclosure is required by statute or is ordered by a court of law
- Disclosure is necessary for a dentist to pursue a bona-fide legal claim against a patient and disclosure to a solicitor, court or debt collecting agency may be necessary.
- There are certain circumstances where the wider public interest outweighs the rights of the patient to confidentiality. This might include cases where disclosure would prevent a serious future risk to the public or assist in the prevention or prosecution of serious crime.
- Information may need to be disclosed to third party organisations to ensure the provision of care and the proper functioning of the NHS. In practical terms this type of disclosure means:
- Transmission of claims/information to payment authorities such as the Practitioner Services for Scotland
- In more limited circumstances, disclosure of information to the Health Board for Scotland
- Referral of the patient to another dentist or health care provider such as a hospital.
Data protection code of practice
- The Practice ‘data protection code of practice for patients’ provides the required procedures to ensure that we comply with the Data Protection Act 1998. It also describes to patients the personal data that we collect , how we use it and our procedures for storing it safely and securely. It is a condition of engagement that everyone at the practice complies with the code of practice.
Access to records
- Patients have the right of access to their health records held on paper or on computer. A request from a patient to see records or for a copy must be referred to the patient’s dentist. The patient should be given the opportunity of coming into the practice to discuss the records and will then be given a photocopy or print-out. Care should be taken to ensure that the individual seeking access is the patient in question and where necessary the practice will seek information from the patient to confirm identity. The copy of the record must be supplied within forty days of payment of the fee and receipt of identifying information if this is requested.
- Access may be obtained by making a request in writing and the payment of a fee for access of up to £10 (for records held on computer) or £50 (for those held manually, including non-digital radiographs). A copy of the record and, if required, an explanation will be provided within 40 days of receipt of the request and fee (where payable).
- The fact that patients have the right of access to their records makes it essential for information to be recorded properly. Records must be:
- Contemporaneous and dated
- Accurate and comprehensive
- Neat, legible and written in ink
- Strictly necessary for the purpose
- Not derogatory
- Such that disclosure to the patient would be unproblematic.
- Signed by the dentist
- The principles of confidentiality give rise to a number of practice rules that everyone in the practice must observe:
- Records must be kept secure and in a location where it is not possible for other patients or individuals to read them
- Patients should not be able to see information contained in appointment books, day sheets or computer screens
- Discussions about patients should not take place in public areas of the practice
- When talking to a patient on the telephone or in person in a public area care should be taken that sensitive information is not overheard by other patients
- Messages about a patient’s care should not be left with third parties or left on answering machines. A message to call the practice is all that can be left
- Recall cards and other personal information must be sent in an envelope
- Identifiable information about patients must not be discussed with anyone outside of the practice including relatives or friends
- Demonstrations of the practice’s administrative/computer systems should not involve actual patient information
- A school should not be given information about whether a child attended for an appointment on a particular day. It should be suggested that the child is asked to obtain the dentist’s signature on his or her appointment card to signify attendance
- Do not provide information about a patient’s appointment record to a patient’s employer, unless the patient’s consent is obtained, such queries must be referred to the dentist
- disclosure of appointment books, record cards or other information should not be made to police officers or HM Revenue and Customs officials unless upon the instructions of the dentist.
- If, after investigation, a member of staff is found to have breached patient confidentiality or this policy, he or she shall be liable to summary dismissal in accordance with the practice’s disciplinary policy.
- Employees are reminded that all personal data processed at the practice must by law remain confidential after your employment has terminated. It is an offence under section 55(1) of the Data Protection Act 1998, knowingly or recklessly, without the consent of the data controller the dentist, to obtain or disclose personal data. If the practice suspects that you have committed such an offence, it will contact the Office of the Information Commissioner and you may be prosecuted by the Commissioner or by the Director of Public Prosecutions.
- Queries about confidentiality should be addressed to practice manager.
Keeping your records
This practice complies with the Data Protection Act 1998 and this policy describes our procedures for ensuring that personal information about patients is processed fairly and lawfully.
The personal data that we hold
To provide you with a high standard of dental care and attention, we need to hold personal information about you. This personal data includes:
- Your past and current medical and dental condition; personal details such as your age, National Insurance number/NHS number, address, telephone number and your general medical practitioner
- Radiographs, clinical photographs and study models
- Information about the treatment that we have provided or propose to provide and its cost
- Notes of conversations/incidents about your care, for which a record needs to be kept
- Records of consent to treatment
- Correspondence with other health care professionals relating to you, for example in the hospital or community services.
Reasons for holding this information
We need to keep comprehensive and accurate personal data about our patients to provide them with safe and appropriate dental care.
How we process the data
We will process personal data that we hold about you in the following way:
Using personal information
Personal information submitted to us through our website will be used for the purposes specified in this policy or on the relevant pages of the website.
We may use your personal information to:
(a) administer our website and business , personalise our website for you ,enable your use of the services available on our website ,send you goods purchased through our website , supply to you services purchased through our website, send statements, invoices and payment reminders to you, and collect payments from you , send you non-marketing commercial communicationssend you email notifications that you have specifically requested , send you our email newsletter, if you have requested it you can inform us at any time if you no longer require the newsletter , send you marketing communications relating to our business [or the businesses of carefully-selected third parties which we think may be of interest to you, by post or, where you have specifically agreed to this, by email or similar technology (you can inform us at any time if you no longer require marketing communications , provide third parties with statistical information about our users (but those third parties will not be able to identify any individual user from that information , deal with enquiries and complaints made by or about you relating to our website , eep our website secure and prevent fraud
Your privacy settings can be used to limit the publication of your information on our website, and can be adjusted using privacy controls on the website.
We will not, without your express consent, supply your personal information to any third party for the purpose of their or any other third party’s direct marketing.
We will retain your dental records while you are a practice patient and after you cease to be a patient, for at least eleven years or, for children, until age of 25, whichever is the longer.
Security of information
Personal data about you is held in the practice’s computer system and/or in a manual filing system. The information is not accessible to the public; only authorised members of staff have access to it. Staff are trained in their legal responsibilities under the Data Protection Act and practical procedures for maintaining confidentiality.
We take precautions to keep the practice premises, filing systems and computers physically secure. Our computer system has secure audit trails and we back-up information routinely.
Disclosure of information
To provide proper and safe dental care, we may need to disclose personal information about you to:
- Your general medical practitioner
- The hospital or community dental services
- Other health professionals caring for you
- NHS payment authorities
- HM Revenue and Customs
- The Department for Work and Pensions and its agencies, where you are claiming exemption or remission from NHS charges
- Private dental schemes of which you are a member.
Disclosure will take place on a ‘need-to-know’ basis. Only those individuals or organisations who need to know in order to provide care to you – or in order to ensure the proper administration of Government (whose personnel are covered by strict confidentiality rules) – will be given the information. Only the information that the recipient needs to know will be disclosed.
In very limited circumstances or when required by law or a court order, personal data may be disclosed to a third party not connected with your health care. In all other situations, disclosure that is not covered by this Code of Practice will only occur when we have your specific consent.
Where possible, you will be informed of these requests for disclosure.
You have the right of access to the data that we hold about you and to receive a copy. Access may be obtained by making a request in writing and the payment of a fee of up to £10 (for records held on computer) or £50 (for those held manually, including non-digital radiographs). We will provide a copy of the record within 40 days of receipt of the request and fee (where payable) and an explanation of your record should you require it.
If you do not agree
If you do not wish personal data that we hold about you to be disclosed or used in the way that is described in this Code of Practice, please discuss the matter with your dentist. You have the right to object, but this may affect our ability to provide you with dental care.