Confidentiality policy for the practice team
At this practice, the need for the strict confidentiality of personal information about patients is taken very seriously. This document sets out our policy for maintaining confidentiality and all members of the practice team must 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 many patients would be reluctant to provide the dentist with information if they were not sure that it would not be passed on. If confidentiality is breached, the dentist/dental hygienist/dental therapist/dental nurse faces investigation by the General Dental Council and possible erasure from the Dentists or DCP Register, and may also face legal action by the patient for damages and, for dentists, prosecution for breach of the 1998 Data Protection Act.
General Dental Council
All staff must follow the General Dental Council’s rules for maintaining patient confidentiality contained in Standards for dental professionals and Principles of patient confidentiality.
If confidentiality is breached, each registered dental professional involved is responsible to the Council 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
This practice has adopted the following three 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
• such information 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. A brief summary of the circumstances is given below.
When disclosure is in the public interest
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.
When disclosure can be made
There are circumstances when personal information can be disclosed:
• where the patient has expressly given consent to the disclosure
• where 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
• where disclosure is required by statute or is ordered by a court of law
• where disclosure is necessary for a dentist to pursue a bona-fide legal claim against a patient, when disclosure to a solicitor, court or debt collecting agency may be necessary.
Disclosure of information necessary in order to provide care and for the functioning of the NHS
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 DPD/SDPD/CSA
• in more limited circumstances, disclosure of information to the PCT/HB
• referral of the patient to another dentist or health care provider such as a hospital.
Data protection code of practice
The Practice’s Data protection code of practice provides the required procedures to ensure that we comply with the 1998 Data Protection Act. 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 or for computer-held records with non-computer radiographs). A copy of the record will be provided within 40 days of the request and fee (where payable) together with an explanation, if required.
The fact that patients have the right of access to their records makes it essential that information is properly recorded. Records must be:
• contemporaneous and dated
• accurate and comprehensive
• signed by the dentist
• neat, legible and written in ink
• strictly necessary for the purpose
• not derogatory
• such that disclosure to the patient would be unproblematic.
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
• identifiable information about patients should not be discussed with anyone outside of the practice including relatives or friends
• 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
• demonstrations of the practice’s administrative/computer systems should not involve actual patient information
• 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
• do not provide information about a patient’s appointment record to a patient’s employer
• 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
• disclosure of appointment books, record cards or other information should not be made to police officers or Inland Revenue officials unless upon the instructions of the dentist
• 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.
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 Amy Groom, 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 or with the consent of the Director of Public Prosecutions.
Queries about confidentiality should be addressed to Amy Groom or Este Retief.
Practice data protection code of practice for patients
This practice complies with the 1998 Data Protection Act 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. We also need to process personal data about you in order to provide care under NHS arrangements and to ensure the proper management and administration of the NHS.
How we process the data
We will process personal data that we hold about you in the following way:
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. 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:
• dour general medical practitioner
• the hospital or community dental services
• other health professionals caring for you
• NHS payment authorities
• the Inland Revenue
• the Benefits Agency, 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/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 or for computer-held records with non-computer 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.
We are committed to meeting all relevant obligations relating to this website that apply under the Data Protection Act of 1998. We will strive to observe the law in all collection and processing of subject data and will meet any subject access request in compliance with the law. We will only use data in ways relevant to carrying out its legitimate purposes and functions in a way that is not prejudicial to the interests of individuals. We will take due care in the collection and storage of any sensitive data. We will do our utmost to keep all data accurate, timely and secure.
We may collect technical data about the type of Internet browser and computer operating system that you use. This information does not identify you as an individual and is used only for tracking of site use. We might also place a “cookie” on your hard drive that will help us to identify you when you return to the site and allow us to tailor content to your personal preferences. If you do not wish to use “cookies” you may disable this option in your Internet browser settings. “Cookies” can be removed from your computer.
Practice information security policy
This Dental Practice is committed to ensuring the security of personal data held by the practice. This objective is achieved by every member of the practice team complying with this policy.
Confidentiality (see also the practice confidentiality policy)
• All staff employment contracts contain a confidentiality clause.
• Access to personal data is on a “need to know” basis only. Access to information is monitored and breaches of security will be dealt with swiftly by Este Retief.
• We have procedures in place to ensure that personal data is regularly reviewed, updated and deleted in a confidential manner when no longer required. For example, we keep patient records for at least 11 years or until the patient is aged 25 – whichever is the longer.
Physical security measures
• Personal data is only taken away from the practice premises in exceptional circumstances and when authorised by Este Retief. If personal data is taken from the premises it must never be left unattended in a car or in a public place.
• Records are kept in a lockable fireproof cabinet, which is not easily accessible by patients and visitors to the practice.
• Efforts have been made to secure the practice against theft by, for example, the use of intruder alarms, lockable windows and doors.
• The practice has in place a business continuity plan in case of a disaster. This includes procedures set out for protecting and restoring personal data.
Information held on computer
• Appropriate software controls are used to protect computerised records, for example the use of passwords and encryption. Passwords are only known to those who require access to the information, are changed on a regular basis and are not written down or kept near or on the computer for others to see.
• Daily and weekly back-ups of computerised data are taken and stored in a fireproof container, off-site. Back-ups are also tested at prescribed intervals to ensure that the information being stored is usable should it be needed.
• Staff using practice computers will undertake computer training to avoid unintentional deletion or corruption of information.
• Dental computer systems all have a full audit trail facility preventing the erasure or overwriting of data. The system records details of any amendments made to data, who made them and when.
• Precautions are taken to avoid loss of data through the introduction of computer viruses.
This statement has been issued to existing staff with access to personal data at the practice and will be given to new staff during induction. Should any staff have concerns about the security of personal data within the practice they should contact Este Retief.