PART 6: Confidentiality, Disclosure & Statutory Reporting

PART 6: Confidentiality, Disclosure & Statutory Reporting

• Core Dilemma: Knowing when patient confidentiality is overridden by mandatory statutory law versus discretionary public interest in the ED.
• Mandatory Statutory Disclosures (You MUST Report): Notifiable infectious diseases to UKHSA (e.g., Meningococcal sepsis, TB, Measles—not HIV), Female Genital Mutilation (FGM) in girls under 18 directly to the Police (101), Terrorism Act offenses, Child Safeguarding (s.47), and providing a driver's name and address only (not clinical notes) to police under Road Traffic Act 1988 s.172.
• GMC 2-Stage Rule for Gunshot & Violent Knife Wounds:

1. Stage 1: Inform police immediately that a gunshot or violent knife wound has arrived, WITHOUT giving the patient's identity if the capacitous patient refuses.
2. Stage 2: Only disclose the patient's identity without consent if the risk of death or serious harm to others outweighs privacy.

• MRCEM/FRCEM Exam Trap: After a seizure, Group 1 (car) drivers require 6–12 months off driving and Group 2 (bus/HGV) require 5–10 years off. If a patient refuses to stop driving, educate them on their legal duty, offer a second opinion, warn them, and notify the DVLA Medical Adviser directly (or call 999 Police if they walk out to drive from the hospital car park immediately).