Metropolitan Police investigations and release of patient confidential data
The Metropolitan Police is currently investigating a serious major
crime that may have implications nationally. It is possible that individual
pharmacists
in a number of areas across the country may be approached by the Metropolitan
Police in respect of patient confidential information they hold regarding the
supply of particular prescription items. Before any patient confidential information
is supplied, the investigating officers should serve on the individual pharmacist
the relevant authority in the form of a request under Section 29(2) of the Data
Protection Act 1998, which should be signed by an officer of inspector rank or
above.
Investigating officers from the Metropolitan Police have been in contact with
senior members of staff from the Society and can confirm that the information
that may be requested is justified and its release is in accordance with Society
guidelines.
To be in accordance with Society guidelines any disclosure of patient confidential
information must comply with both the legislation and the pharmacists’ Code
of Ethics, which states the circumstances in which a pharmacist may disclose
information without a patient’s consent. Paragraph (b)(v) below would apply
in the circumstances described above.
C. Confidentiality
The public expects pharmacists and their staff to respect and protect confidentiality.
This duty extends to any information relating to an individual which pharmacists
or their staff acquire in the course of their professional activities.
Confidential information includes personal details and medication, both
prescribed and non prescribed.
Pharmacists must ensure that:
(a) the confidentiality of information acquired in the course
of their professional activities is respected and protected, and
is disclosed only with the consent of the individual other than
in the circumstances defined below in (b).
(b) information is disclosed without the patient’s consent
only in the following circumstances:
(i) where the patient’s parent, guardian or carer has consented to the
disclosure and the patient’s apparent age or health makes them incapable
of consent;
(ii) pharmacists should be aware that information about services provided to
adolescents should not normally be disclosed to their parents;
(iii) where disclosure of the information is to a person or body empowered
by statute to require such a disclosure;
(iv) where disclosure is directed by a coroner, judge or other presiding officer
of a court, Crown Prosecution Office in England and Wales and procurator-fiscal
in Scotland;
(v) to a police officer or NHS Fraud Investigation Officer who provides in
writing confirmation that disclosure is necessary to assist in the prevention,
detection or prosecution of serious crime;
(vi) where necessary to prevent serious injury or damage to the health of
the patient, a third party or to public health; … |
The decision to disclose patient confidential details remains with the
pharmacist who consents to the release of the data and patient confidential
information may only be disclosed without the patients’ consent
in one of the above circumstances. A copy of any written request for
disclosure provided by the police under Section 29(2) of the Data Protection
Act 1998 should be retained in the pharmacy in the event of any query.
If you are approached by the Metropolitan Police during the course of this
investigation and have any concerns about disclosure of patient confidential
information, please contact the Society’s legal and ethical advisory
service on 020 7572 2308 for further guidance.
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Medication error logs
The maintenance of medication error logs is seen as good practice in
pharmacy and, in line with clinical governance arrangements, should be
included in pharmacy
standard operating procedures.
Medication error logs are intended to be used as a risk management tool and information
from the logs should be regularly reviewed, analysed and discussed within the
pharmacy in order to identify risk areas associated with the dispensing and checking
process. Appropriate action to review systems and procedures with a view to minimisation
of future risk should be taken, where necessary.
Pharmacy owners and individuals may be apprehensive that information contained
in medication error logs could be used as a basis for disciplinary action by
the Society. However, the existence and regular audit and review of such logs
is considered to be indicative of good practice and robust risk management. Their
use is therefore encouraged.
During routine pharmacy inspections, Society inspectors may ask to see evidence
that a system is in place to deal with dispensing errors, including the maintenance
and use of medication error logs. However, inspectors will not ask to look at
any of the actual records or any of the specific information held within those
logs. Further information on the inspection of error logs during routine visits
is contained in a monitoring and inspection checklist for inspectors (PDF 90K).
If the Society receives a complaint about a dispensing error, the inspector may,
as part of the investigation, ask to see the specific error log which relates
to the complaint under investigation. Evidence of the maintenance of an error
log by the pharmacy (where the pharmacy has been made aware of the error) can
be seen as evidence of good practice. It may be particularly helpful if the error
log describes any review of systems carried out at the pharmacy in light of the
incident.
On rare occasions where serious concerns have been raised about a particular
pharmacy or about the fitness to practise of an individual, it may be necessary
for error logs to be examined. This action would only be considered in extreme
circumstances, where there was genuine cause for concern about public safety.
For further information on the handling of dispensing errors please refer to
the document “Dealing with dispensing errors” (PDF 120K).
Those without access to the internet can obtain copies of the above-mentioned
documents by contacting Seema Khan, Royal Pharmaceutical Society, 1 Lambeth High
Street, London SE1 7JN (tel 020 7572 2236; e-mail seema.khan@rpsgb.org |
The
Pharmaceutical Journal