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Confidentiality and trust are often seen as two of the fundamental requirements within the practice patient relationship. The sensitive subject has, once again, entered the spotlight following the GOC consulting on new draft guidance around disclosing confidential information about patients.
The guidance covers various scenarios where disclosing sensitive and confidential information about patients may be required. Scenarios include when requested by third party organisation such as the police or courts and where there is a need to report suspected abuse. In particular, the draft guidance has a particular focus on vision and safe driving and if there may be a need to disclose information if a patient is unfit to drive.
The DVLA in England, Scotland and Wales, and the DVA in Northern Ireland, are legally responsible for setting the medical standards of fitness to drive including vision standards, and deciding if a person is medically fit to drive. The licence holder has a legal responsibility to notify them of any medical condition that may affect safe driving, including advice from an optometrist that details that they fall below the vision standards required for safe driving.
The DVLA publishes guidance for healthcare professionals, Assessing fitness to drive – a guide for medical professionals, which includes the minimum medical and vision standards required to hold a driving licence.
There have been a number of high-profile media stories in recent years involving accidents or fatalities by drivers who continued to drive against the advice of their optometrist or GP. Some of the victims’ families asked the government to introduce new legislative requirements so that healthcare professionals automatically notify the DVLA or DVA when a patient is unfit to drive, regardless of whether a patient has given consent to share their records.
The GOC has also been doing work in this area to gain a better understanding of the issues affecting its registrants in relation to decisions to override confidentiality, particularly in reporting to the DVLA or DVA when there is a concern.
The AOP undertook independent research that highlighted that 18% of registrants were unaware of the DVLA guidance and that 72% of registrants would not feel comfortable informing the DVLA or DVA about a patient’s vision if the patient could not or would not do it themselves. This highlighted that further guidance was needed in this area to support the profession. The draft consultation is aimed at providing support to registrants to inform the DVLA or DVA where they see fit and provide the mechanisms to do so.
