Jill has a mental health disorder-panic disorder, which had arose from a traumatic event while she was a child.A panic attack is an immediate period of inverse fear when one is not necessarily in danger and triggers severe physical reactions. The disorder is lethalsince it may cause a heart attack or even death. Some of the symptoms associated with panic disorder include a sense of impending danger, rapid heartbeat, fear of loss, sweating, trembling, and feeling of detachment, among others(Berko andFeiser751).
In the recent past, the disorder had not had a severe impact on Jill’s general health and performance in the previous work environment.She discloses the information about his health condition to the Occupational healthofficer. However, she had stressed that it should be confidential, but later the manager shares it with the team leaders.In this case, the occupational health practitionerhad breached the confidentiality of personal healthcare information. Breach of confidentiality occurs when confidential information provided by a client or, preferably, a patientis shared with a third party without the consent of the informer. In nursing, to be specific, patient confidentiality is the law that restricts doctors and other medical practitioners from sharing patients’ information during treatment or consultation.
Medical policies and legislations
In the United Kingdom (U.K.), there are set medical policies and legislations to address such pertinent issues like breach of confidentiality. According to the NHS Confidentiality code of practice, the patient’s sensitive information is paramount, and practitioners should uphold the privacy; therefore, patients should entrust them with the knowledge to seek treatment (Dyban P1). Although there no specificity of law that governs the right to privacy and confidentiality,case laws have been utilized in line with other statutes.In some of the case law, for example, in the case of Hunter vs. Mann, it was ruled that the medical professionals have a duty in their professional capacity to avoid disclosure of health information without the consent of the patient (Dyban 2). In another case of Campbell v Mirror Group Newspaper, it was decided that health records outlined that medical information should be maintained private to protects the dignity of a person (Dyban 4).
There are other legislations like the Data Protection Act 1998 that protects confidential patient information, including ways of storage, acquiring, to avoid disclosure. The Computer Misuse Act 1990protects information in databases and states that accessing a database without formal authorization is a criminal offense (Dyban 5).Mental health legislation and policies are concerned with the provision of a legal framework to address critical mental health issues like access to high-quality care fromcarers as well as seek justice in case of mistreating.
Occasionally, confidential information may be disclosed without the consent of the patient in cases when the rule of law states so, in case of public interest when data is shared among healthcare practitioners taking care of the patient and in cases of clinical audits (Dyban 10). There are common challenges associated with the instances of confidentiality breaching since mostly are solved through court rulings. They include biasness, corrupt investigators and prosecutors, court delays due to the complexity of the trials, and overt threats, among others.This paper seeks to study thelegislation and policies associated with the breach of confidentiality ofhealthcare information by practitioners in the United Kingdom as well as discuss service user and carer relation in mental health.
Policies and Legislations governing medical practitioners
Mental Health policies and legislations helps promote mental health in society by establishing ways to prevent, treat, and rehabilitate people with the disorder.Countries use the proper procedures and plan to formulate and implement the country’s mental health policies as well as to capacitate the country to tackle mental health issues over the long term. Studies show that approximately 450 million people in the World experience psychological or neurological disorders. Although mental disorders can be diagnosed and treated cost-effectively, they cause devastating socioeconomic effects to individuals and the country (World Health Organization 1).
Some policies govern medical practitionerswhile handling the client’s problems and information during the consultation and treatment in accessing and sharing patient health records.
Current legislation allows individuals to have to access their health information. This applies to public and private health practitioners. The patient’s health records are governed by the General Data Protection Regulation (GDPR) since 2018, then later enacted by the Data Protection Act 2018. The Department of Health issued a guide on the procedure for accessing health information that covered patient’s access to information, including; The Access to Health Records Act 1990, which governs access of knowledge of the deceased by specific persons, and the Medical Reports Act 1988, which granted individuals authority to access health reports for employment purposes. Under DPA 1998, individuals were supposed to request access to health records in writing while in new data protection legislation, patients are not required to present any paper (Parkin and Loft 5). While accessing the files, £10 – £50 was charged as access fee DPA 1998. Contrastingly, no access fee was charged since 2015. In certain circumstances, access to health records is limited, especially where the health records could cause harm to the mental health of individuals. The entrance of information is also limited to third parties except where they contributed or compiled the health records.
Patient- medical practitioner confidentiality is referred to as the cornerstone of medical practice. According to the NHS Constitution for England, which ensures patients’ information is safe and secure. They have a right to have their information restricted to their medical care and treatment. For research purposes, the policies tend to have a balance between personal information confidentiality and the use of data to improve medical care. The British Medical Act (BMA) highlights that privacy is paramount in preserving trust between patients and health professionals. The Health and Social Care Act 2015 states that patients should expect their health information to be shared among their care team to facilitate quality care (Parkin and Loft 9). The act only allows this in the best interest of the patient.
NHS Digital produces a Code of Practice. NHS Digital published a guide to confidentiality in health and social care, which set out the confidentiality rules. The guide was formed based on the 2013 Caldicott Report by Dame Fiona Caldicott.Caldicott reviewed seven principles which included justifying the purpose of information, avoiding the use of personal data unless necessary, minimal use of confidential data, beware of responsibilities associated with personal data, complying with the law, and understanding the duty to share information as essential as the duty to protect patient’s confidentiality. The Caldicott Review made 26 recommendations covering areas like access to electronic care records, information sharing among the individual’s care team (Parkin and Loft 11). The Government published a response accepting the Caldicott principles.
Demonstration of Understanding of Legislation and policy related to` service user and carers
Mental health legislation and policy are essential due to the unique nature of mental disorders and the vulnerabilities associated with people’s mental disorders. The existence of these vulnerabilities is because the disease affects the patient’s way of thinking and behaving; as a result causing stigma and discrimination in the society inhibiting quality services from the carers.People living with mental health disorders sometimes experience harsh living conditions in most communities. They face economic marginalization because of a lack of legislation protecting from improper and abusive treatment. They are denied access to opportunities like education and employment and access to public services.Therefore, mental health legislation and policies are concerned with the provision of a legal framework to address critical mental health issues like access to high-quality care fromcarers.
However, some legislations and policies govern and protect the interests of the carers. In this context, carers are people who provide support, without necessarily being paid, to family members or friends who have a mental disorder or other disabilities. In most cases, caring is a way of self-satisfactory for carers, and if adequate support is not given, they can face substantial challenges that include; effect on own mental and physical health, impact on social life, and financial constraints (Betts and Thompson 10). Although the economy ignores the role of informal carers, a study by Ralse paper outlines that approximately 218,000 people in Northern Ireland currently undertake carer’s role, the majority being in the 35-64 age bracket. It also found that about 6,000 young people age between 0-17 years serves as unpaid carers (9). The carers play a vital role in the U.K. due to the aging society and the increasing prevalence of people with chronic diseases and mental disorders. The Confederation of Family Organizationsoutlined some core issues that are common across the E.U. The issues include the gender distribution of carers in unequal with females forming the majority, labor market policies and practices do not reflect the needs of aging in the society, and the recognition of informal care means recognition of skills and possibility of training in future employment(11).
The European Association Working for Carersadopted ten principles to strengthen the position of carers. The principles include recognition, social inclusion, equality, equality to opportunity, choice, information, support, time off, compatibility of care and employment, health promotion and protection, and financial security. In Northern Ireland Law, appropriate carers’ legislation and benefits are highlighted (11). The Carers and Direct Payments Act 2002 was the recent legislation and was implemented in two stages. The first stages, implemented in 2003,provided provisions allowing HSS Trusts to deliver social services to carers, assessment of carers’ needs, and the HSS Trust to provide people with information on their legal rights (13). The second stage provided for direct payments, which was availed to people living with disabilities.
The Employment Act (2002) provided that working parents (carers) with children with disabilities have a flexible working schedule. Carer’s Allowance, published in 2017, was the most beneficial to carers across the U.K., where they were entitled to a weekly allowance if certain conditions were satisfied (15). These legislations were similar in England, Wales, Scotland, and across the U.K.The legislationsare meant to ensure carerseffectively combine care responsibility with paid work, improve the mental and physical health of carer, and compensating and recognizing carers.
In an example to demonstrate the understanding of legislation, policy, and quality, we will use Jill’s condition, Panic disorder, assuming that she had a carer. The carer’s responsibility is to ensure Jill is physically and mentally active, eat balanced diet food, and take a close look at Jill to identify the sudden episodes of a panic attack and provide medication.The carer should be able to study Jill’s behavior to ensure they identify any changes. The carer understands the code of practice, policies, and legislation to handling a service user. Privacy and confidentiality are principal to the carer’s task. Jill should ensure the carer’s rights are upheld, including remuneration, the flexibility of work schedule, and equality. Quality of care should be considered
Possibilities and Limitations of Concepts
The right of the service user to confidentiality is a limiting factor to the carer’s work, which restricts service users from sharing their health information with carers.From a health professional perspective, breaching confidentiality is regarded as unethical and potentially result in disciplinary measures or legal obligations.However, human rights are meant to increase knowledge and improve the ability to translate human rights concepts to high-quality service delivery.
The high cost of care
In most cases taking care of patients with mental disorders involves a high level of consumerism, which requires medication, a highly balanced diet, and remuneration of carers, among other expenses.Where patients are taken to care facilities, other costs like the boarding fees and professional consultationswill be incurred.This turns out to be very expensive for the majority in society resulting in limited attention and care to patients.
Often, most of the carers are informal (informal carers), meaning they have no learned skills and knowledge. Professionalism in this area is quite a challenge because most carers are family and friends.
Some mental health disorders may cause the service users to be violent and aggressive, causing fights. This exposes carers to the immense danger of being hurt during physical confrontations. This limits the carer’s ability to perform tasks.
Jill’s case was a breach of confidentiality of healthcare information by an occupational health practitioner. This act is regarded as unethical and attracts disciplinary measures or legal obligations to the offenders. Patients’ privacy and confidentiality are protected by legislation like the Data Protection Act 1998, Computer Misuse Act 1990, British Medical Association, and the NHS Code of Practice, among others. All the law follows the mantra of having full access to personal health information and limited access to other people’s. Health professionals and carers must ensure they abide by legislations and policies while practicing.Carers are governed by legislation like the Employment Act 2002 and Carer and Direct Payment Act 2002, among others.We then discuss the possibilities and limitation concepts in a service user and carer relationship, which include the right to confidentiality, high cost of care, and risk involved.
Elizabeth Parkin and Philip Loft. Patient health records: access, sharing, and confidentiality. [House of Commons Library] (2019).
Eric H. Berko and Gabriela Feier. Ensuring prompt recognition and treatment of the panic disorder. 750-755 [Behavioural Health Consult] (2017).
Jennifer Betts and Janice Thompson. Carers: Legislation, policy, and practice. 9-40 [Nothern Ireland Assembly] (2016).
Maria Dyban. All healthcare staff has a duty of confidentiality. Guidelines in Practice, July 2017. Available at: uk/your-practice/all-healthcare-staff-have-a-duty-of-confidentiality/352639.article.”>https://www.guidelinesinpractice.co.uk/your-practice/all-healthcare-staff-have-a-duty-of-confidentiality/352639.article.
World Health Organization. Mental Health Policy, n.d, Available at https://www.who.int/mental_health.
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