Providing patient information to the Police
Date sent: Tuesday 19 September 2017
Email to all GPs, Practice Managers and CCGs
Following my recent email update in which I included a section on our statutory responsibilities and professional obligations (click here for the email), below is a letter I have sent to the Senior Police Officer who wrote to all Hampshire Practices. I have attached the Deputy Chief Constable's letter for your information.
19th September 2017
Deputy Chief Constable
Hampshire SO50 9SJ
Re: BMA Advice – Charging for Police Access to Medical Records
I am responding to your letter of the 8th September 2017 that has been written to all Practices in Hampshire.
Wessex Local Medical Committee is the Statutory Body that represents all GPs and Practices who work in Hampshire, the Isle of Wight, Dorset, Bath and NE Somerset, Swindon and Wiltshire. Following your letter, a number of GPs and Practice Managers have contacted the LMC to ask for advice.
As an organisation we have frequently worked with the Police and have enjoyed a constructive and productive relationship and we would wish this to continue.
There are some issues in your letter that I would like to address and it is these that have caused some concern:
- You believe that with increased joint working that public sector organisations should not charge each other.
- You refer to the fact that Hampshire Constabulary is the second lowest funded and if you were funded at an average amount you would receive £45m more.
- You suggest that mutual assistance costs do not rest solely with GP surgeries you believe that the Police provide services to the wider NHS and local patients.
- The Police have reduced the number of Senior Officer’s and you do not believe that Superintendents should be burdened with this sort of bureaucracy.
- You identify that the Police need access to medical information not only for serious crime.
As the representative body of General Practice I would like to respond to your comments:
1. Public Sector charging each other
General Practice is facing major issues in terms of workforce and recruitment and retention. There are approximately 20% of GP posts that remain unfilled and about 30% of the GPs in Hampshire have
indicated that they will leave the profession in the next 3-5 years. Although General Practice is part of the NHS, all Partners in a Practice are self employed and have to run a business.
The reality is that the workforce issues have been compounded with a falling percentage of the NHS budget and hospitals have received an increasing percentage of the total NHS budget. Despite being part of the Public Sector practices are charged for services from many different Public Bodies so I am not sure that this argument is valid.
2. Hampshire Police funding
We recognise that as Public Bodies our funding in Hampshire is below average and this is as true for the NHS as it is for the Police. General Practice is not exempt from this and GPs have seen their income fall over the last few years.
3. The Police support for the NHS
We recognise the great work that the Police does working with different parts of the NHS especially hospitals, but it is hard to see how General Practice should undertake unfunded work because of assistance provided to other bodies within the NHS.
4. The use of senior officer time and not wasting this on bureaucracy
We accept that Senior Police Officers do not want to be troubled with bureaucratic tasks. But please also recognise that GPs have undergone at least 10 years of training, are highly skilled and in short supply and also do not want to be undertaking bureaucratic tasks.
5. Police access to medical records
I am slightly confused by your comments. As GPs we have to comply with the Data Protection Act and also the Access to Medical Records Act. If we do not comply with these laws we are liable to be prosecuted and the financial consequences for a practice are significant and potentially could bankrupt a Practice. Therefore, if a GP is persuaded that the public interest is served then they are permitted to break patient confidentiality if a serious crime is involved. It does not mean that all requests from the Police can be addressed in this way. Hence the reason that the DP2 was implemented.
In addition, as GPs we are still finding that the Police are sending victims of crime who have sustained an injury to see their GP not for any treatment but to record the extent of the injury so that at a later date the Police or the Court can request this information from the GP. This is wholly inappropriate and does not form part of our role as a GP.
I am aware that the BMA Professional Fees Committee is still in discussion with the Representative Body of the Police force.
The BMA has stated recently “We have met with the National Police Chair’s Council about our guidance, and they are satisfied that the GP should ask for the superintendent signature”.
In the meantime, as I have said, we are keen to work in a constructive way with you and in this spirit  I have sent the statement below to all GPs, Practice Managers and CCGs in Hampshire and the Isle of Wight.
Statutory responsibility vs professional obligations - a personal view
I am proud to be a GP and have enjoyed being part of a respected profession for over 30 years. General Practice has never been "just a job" and has always been a vocation and a profession. Being part of the community and working as a family doctor makes us unique, call me old fashioned but I still consider that it is an honour and a privilege to be a GP.
Over the last few years we have all found that our working lives have got busier and the demands on us have increased significantly. This is not only in terms of clinical time but the administrative burden has become, at times, unmanageable. I therefore support the BMA’s work to try and help resolve the unnecessary additional workload for GPs.
You will have seen the recent BMA advice on requests for information about patients from the Police.
The Police can always request information from a Practice with the patient’s consent. However, there is also a public interest test and you are permitted to release information without consent in certain circumstance. This could be to prevent a serious crime (a public interest test) or it may be authorised via the use of a DP2 form, which needs to be signed by a Senior Police Officer.
You should only give the minimum, or relevant, information, to satisfy the request: there is a difference between disclosing general information about a patient, and releasing copies of a patient’s medical record. The golden rule is for both the Practice and the Police to be able to justify the release of information being in the public interest.
In the past the advice was that Practices could not charge for the release of this information as Practices saw this as part of their professional duty and it would need to be an Inspector or above who had to sign a DP2
The recent BMA advice has taken a new interpretation on the law that relates to the release of patient information and has suggested that practices can charge a fee for this information and that the DP2 needs to be signed by a Superintendent or above.
This has already caused significant problems for the Police forces locally and hence in Hampshire all Practices have received a letter from the Police about this.
As the law has not changed and does not define that a DP2 needs a Superintendent’s signature it is difficult to understand why the advice has changed. I have discussed the matter with the BMA and they are in discussion with the senior Police representatives for England and hope to reach a satisfactory outcome shortly.
So where does this leave us?
I go back to the start of this topic. I may not have a statutory responsibility to provide information to the Police, in the public interest, without charging them a fee and I could insist that to make their life more difficult I would ask a Superintendent to sign the DP2 but my feelings of professional duty tell me
that I should continue to work as before and provide this information without charge and accept the DP2 with an Inspector's signature. In return, I would expect to continue the positive and professional relationship that I have with the Police locally.
Each situation needs to be examined carefully and the balance struck between the two. Each of us must be prepared to justify our actions either to the Information Commissioner's Office, if release of information was later deemed a data protection breach but also to our patients and the public if any harm resulted from us withholding information from the Police in the vital work that they do. It is sometimes a difficult judgement but one that, as professionals, we must be prepared to make.
My advice is to continue with the previous BMA position and release information with a signed DP2 without charge, which can be signed by an Inspector whilst the negotiations continue between the Police and BMA.
I would be happy to discuss this further with you if that was helpful.
cc: Gareth Wilson, Chief Constable, Suffolk Constabulary
Michael Lane, Police and Crime Commissioner, Hampshire
Chief Operating Officers, Hampshire CCGs
Dr Nigel Watson
Churchill House, 122-124 Hursley Rd
Chandler's Ford, Eastleigh
Hants. SO53 1JB (Registered Office)
Attached file: BMA charging letter to GPs 070917.pdf