Intended for healthcare professionals


Patient confidentiality in a time of

BMJ 2013; 347 doi: (Published 27 November 2013) Cite this as: BMJ 2013;347:f7042
  1. Julian Sheather, deputy head of ethics,
  2. Sophie Brannan, senior ethics adviser
  1. 1BMA, London WC1H 9JP, UK
  1. JSheather{at}

The benefits of unlocking patient data are enormous; hopefully the risks can be managed

The NHS is in the midst of an information revolution. Powers introduced by the Health and Social Care Act will enable the Health and Social Care Information Centre to extract large amounts of personal confidential data from GP medical records. These powers override the common law duty of confidentiality and the ordinary requirement to seek consent for disclosure, although patients have a right to object to their data being disclosed.

Any large scale use of sensitive personal data inevitably raises ethical concerns, and, unsurprisingly, the new powers have sparked controversy. Public confidence in large publicly held databases, and in the politicians who commission and control them, is scant. Trust between doctors and patients and consequently in the wider health service is predicated on the belief that, in all but exceptional circumstances, confidentiality will be respected. But the potential benefits arising from the proper use of medical data are too important to be ignored without exceptional reason. We therefore must be clear about what the changes involve and what the benefits might be.

The first use of the new powers is the initiative, commissioned by NHS England. …

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