Confidentiality and Access Policy for Children

 

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Introduction

This policy is specific to patients seeking help under the age of 18, who are defined as Children, with special emphasis on those under 16 years who may not necessarily be competent to consent to any treatment or assessment unless they are judged “Gillick competent.” 

 

Policy

The principles of confidentiality apply equally to all patients regardless of age. Young people (including those under 16) are entitled to expect equal confidentiality as all other patients.

image of children

This includes respecting their wishes to withhold information from parents or guardians. The GP involved will determine the competency of a young person seeking treatment and will determine the extent to which confidentiality guidelines apply in each case. 

Care must be taken to ensure that this right of confidentiality is not inadvertently breached by following the procedural guidelines in force (for example seeking additional consent for a contraceptive procedure.) There is a separate policy defining the right to on-line access to the records of patients aged under 11, and 11 to 16 years.

Any young person regardless of age can independently seek medical advice or treatment, including surgical procedures, if a health professional believes that they are capable of understanding the choices of treatment and their consequences, that the minor cannot be persuaded to inform the parents, that otherwise there will be risk to physical or mental health, and that advice or treatment will be in their best interests. This includes contraceptive advice, but the principles apply to other treatments, including abortion. Patients over 16 are assumed to have this competence and therefore in most cases are seen and treated as an adult.

The policy of the Practice is to support young people in exercising their choice of medical treatment, and to deal with them in a sympathetic and confidential manner. Where a young person aged 11 to 16 presents at the surgery without adult support they may be booked in to see a clinician in the normal way. Where there is some question of the urgency of an appointment the matter should be referred to a nurse or the duty doctor in the first instance to triage the request.

At Marden Medical Centre we will only ever see patients under 13 years without parents or a clearly delegated responsible adult (grandparent, nanny, etc.) in exceptional circumstances to facilitate disclosure, and we are most unlikely to offer treatment there and then. We will not see children under 11 without an adult present.

If someone accompanies a minor that the clinician feels is inappropriate to witness the assessment or treatment they may ask them to leave and try to contact a parent instead. They may opt to defer the appointment, and/or they should consider using a chaperone when seeing a child without a parent or responsible adult.

Prescriptions may be given to those under 16 years who are appropriately competent in each circumstance so that special consideration is needed for prescription only medicines. Controlled drugs may not be issued to unaccompanied patients under 18 years.

The practice also has a Child Safeguarding Policy and the clinicians have statutory, professional, regulatory and contractual obligations and responsibilities which include making the Child’s best interests paramount.