A GP member was contacted by a detective constable (DC) who was investigating what he described as a serious crime. The DC asked the GP to disclose details of a patient's medical history, explaining that it was appropriate for the GP to do so in accordance with the Data Protection Act (DPA) 1998, section 29(3). The GP rang the MDU for advice.
The MDU adviser explained that this section of the DPA was an enabling provision which meant that the GP could disclose the information without breaching the Act. However, doctors have a professional ethical duty of confidentiality to patients which also needed to be considered, and the adviser referred the member to the GMC guidance on disclosures in the public interest.
One justification for disclosing information in these circumstances may be for the detection or prevention of a serious crime, but the DC had not given any information about the crime in order for the GP to be able to justify a disclosure without consent. The GP was however aware that the patient was in police custody, and therefore did not pose any current risk to the public.
The GP was advised to ask the DC to obtain consent from the patient in the first instance. If the patient consented to the relevant disclosure, the GP could then provide the information asked for. If the patient didn't consent, the GP would need to be able to justify any decision to disclose the information, and this would depend on the information provided to him by the police.
If the crime was not felt to be serious enough to justify disclosure in the public interest, the police could consider seeking an order from the Court to order the GP to disclose the information.
The DC explained that the patient did not currently have capacity due to what appeared to be a mental health condition. The crime was not a serious crime against a person but the forensic medical examiner (FME) needed information about the patient's medical history and medication in order to treat them.
The GP discussed this with the MDU adviser and a decision was made that as the patient lacked capacity, appropriate information should be disclosed in the patient's best interests, although this disclosure was made to the FME rather than to the DC.
It's not unusual for the police to request information about patients in connection with a crime. The police will often quote the DPA as a justification for doctors to disclose information but it is important to maintain confidentiality unless there is a very good reason not to. This will require the police to provide at least some information on which the doctor can base their decision.
Where a patient is in police custody, it's unlikely that they will be a risk to the public and therefore consent should be sought wherever possible. If consent is not available, the doctor needs to be able to justify their decision to disclose information and should clearly document their reasons for doing so. As well as contacting the MDU, other helpful sources of advice might be the GP's colleagues and the Caldicott Guardian of the relevant area team of NHS England.