Information sharing and confidentiality
Whenever a child in this country dies as a result of abuse, local agencies are required to undertake a serious case review to look at the case and any lessons that might be learned from it. One consistent theme comes out in all these case reviews; a failure of communication between professionals involved with the child. If we are ever going to protect children from abuse, it is crucial that we learn to communicate with each other and share information.
As a dental practitioner seeing a child, you will have information about the child that no other professional will have. You have a responsibility to share that information appropriately. Where you have identified concerns, you should highlight those to the social worker to whom you are referring the child, backing those concerns up in writing. In other situations you may be asked to provide information for the purposes of an initial assessment or as a contribution to a case conference.
Practitioners are often anxious about the legal or ethical restrictions on sharing information, particularly with other agencies. You should be aware of the law and should comply with the principles of current ethical guidance for the dental team.2 These do not provide an absolute barrier to information sharing. However, the amount of information shared should be proportionate to your level of concern about the child. You should be prepared to exercise your judgment. A failure to pass on information that might prevent a tragedy could expose you to criticism in the same way as an unjustified disclosure.
In most situations, it will be appropriate to share any concerns you have identified with the family and to obtain their consent to sharing information with others. However, as discussed earlier, there may be situations where to discuss your concerns with the family could put the child at greater risk or may put you or your staff at risk. In practice, such situations are rare.
Restrictions on sharing information are embodied in the:
Within these frameworks there is provision for sharing information where:
common law duty of confidence
Human Rights Act 1998
Data Protection Act 1998
those likely to be affected consent; or
the public interest in safeguarding the child’s welfare overrides the need to keep the information confidential;
ordisclosure is required under a court order or other legal obligation.
Therefore, if you have concerns about a child's welfare, and you consider the sharing of information to be important in safeguarding that child, you should consider sharing that information even if you are unable to gain parental consent to do so. Sources of further guidance include the
defence organisations (Dental Defence Union, Dental Protection Limited, MDDUS or other) and Caldicott guardians (see also
Further information). Defence organisations welcome enquiries from practitioners in any and every situation and can provide immediate advice and legal assistance if necessary.