Intended for healthcare professionals


To opt in or opt out of electronic patient records?: Electronic patient record is incompatible with confidentiality

BMJ 2006; 333 doi: (Published 13 July 2006) Cite this as: BMJ 2006;333:146

GMC Guidance on Confidentiality

Michael Foley quotes from our guidance on confidentiality in
expressing his view that patients should be asked to ‘opt in’ to the new
NHS Care Record. This helpfully draws attention to the importance we place
on confidentiality as a key to relationships of trust between doctors and

However, we do not share his conclusion that to comply with our
guidance ‘explicit consent is required to enter [patients’] data into a
national computer system’. The means of storing information – whether on
paper or electronically – does not itself raise questions of
confidentiality. It is the robustness of the security systems which
protect records from improper access, and the rigour with which system
users follow confidentiality policies and procedures, which determine
whether patient’s right to confidentiality is protected.

Michael Foley points out some of the ways in which confidentiality
and security policies are currently breached. So, alongside the
development of new systems, consideration needs to be given to minimising
disclosures made by accident, or by careless application of security
policies. All healthcare professionals have an important part to play in
ensuring patients’ confidentiality, however the information is recorded.

Competing interests:
I am Head of Standards and Ethics at the GMC

Competing interests: No competing interests

25 July 2006
Jane M O'Brien
Head of Standards & Ethics, GMC
350 Euston Road, London NW1 3JN