Patient Confidentiality

The confidentiality of all aspects of the relationship between the patient and the optometrist is of the utmost importance. The optometrist should not divulge any information about the patient to a third party without the patient's written permission, which the optometrist should retain on the patient's file. The few exceptions to this include:

• where the third party is a person with legal responsibility to act acting on behalf of the patient, e.g. a child patient's parent or a person appointed by the court to manage the affairs of patients incapable of doing so for themselves. In these cases the third party's written request should remain on the patient’s record. Please note that in the case of an adult patient the third party should have either a Power of Attorney or documents from the court appointing the person to manage the patient's affairs. The optometrist should request the original documents or a certified copy of the documents and keep a copy on the patient's record.

• In the case of children, however if the practitioner decides that the child is "Gillick competent", then the patient may refuse the request of a third party purporting to act on behalf of the child. A "Gillick competent" child is a child under 16 who has sufficient understanding in relation to the proposed treatment to give, or withhold consent. The practitioner will have to decide if the child is Gillick competent. If the practitioner decides that the child is Gillick competent then the child's consent should be respected. However, good practice dictates that the child should be encouraged to involve parents or other legal guardians in any treatment. If a child refused treatment you should take legal advice. (Note. The law regards young people aged 16 or 17 to be adults for the purposes of consent to treatment and right to confidentiality. Therefore if a 16 year old wishes a medical practitioner to keep the treatment confidential then that wish should be respected.)

• where the optometrist is commanded by a Court Order to divulge information.

• Do you want to deal with GOC/ PCT requests for copy records. I think it needs to be dealt with specifically or we will spend a lot of time explaining to members that request for copy documents is legal!!

There are occasions where a third party will request that the patient has an eye examination and on these occasions the third party may request details of the results of the eye examination. This will usually happen where an employer is asking for an employee to have an eye examination for the purposes of their work, or where the patient is applying for a job which requires an eye examination to ascertain whether his/her eyesight meets the required standard of vision for that occupation.

In these cases the optometrist should have the written agreement of the patient before providing the employer with the results of the examination. This may be obtained directly from the patient or should be sought via the employer. Employers should be made aware that the patient's written agreement to the information being divulged to them is required to show the patient is willing for the confidentiality of the relationship with the optometrist to be countermanded.

The patient's written agreement should be obtained, even where a patient is applying for a job and provides the optometrist with a form for an eye examination in respect of the job. The presentation of the form would appear to indicate the patient's willingness for the information to be divulged to the prospective employer. Notwithstanding, the patient's written consent, e.g. the patient's signature on the form or a brief letter of authorisation from the patient, should be obtained.

DVLA