3. Ms O complains that the community mental health nurse (CMHN) at the Trust breached her and her father’s, Mr O’s, confidentiality on 16 December. She complains the CMHN shared her opinion which was confidential.
4. Ms O says both herself and Mr O have been upset by the information that was shared by the CMHN.
5. Ms O is seeking further information regarding the meeting on 19 December and an apology.
6. On 9 December the CMHN emailed Ms O to arrange a home visit. This was to monitor Mr O’s compliance of medication, review the carers log book and monitor and assess his condition. The Trust say the CMHN was unable to contact Ms O on that day.
7. On 13 December Ms O contacted the CMHN over the phone. Ms O said the visit was not necessary. The CMHN advised the request had come from Mr O’s social worker.
8. On 16 December, the CMHN attended Mr O’s home. During this meeting the CMHN spoke to Mr O’s niece about his condition.
16 December 2019
11. Ms O complains the community mental health nurse (CMHN) breached her father’s confidentiality by communicating new and distressing information to him in front of a family member on 16 December. She says the CMHN provided the view of Mr O’s consultant.
12. She also complains the CMHN shared Ms O’s personal opinion which was confidential.
13. The Trust say there was no breach of confidentiality and information was shared with Mr O in his best interest with his consent.
14. We have reviewed the CMHN’s record on 16 December. We have also considered Ms O’s account, her complaint letter and the Trust’s response.
15. The records show on 16 December the CMHN attended Mr O’s home for a visit. The CMHN was greeted by his granddaughter, Ms O’s niece.
16. The records show the CMHN provided their opinion that Mr O needed 24 hour care. The records do not say this was the opinion of Mr O’s consultant.
17. GMC ethical guidance on confidentiality says:
’The people close to a patient can play a significant role in supporting, or caring for, the patient and they may want or need information about the patient’s diagnosis, treatment, or care. Early discussions about the patient’s wishes can help to avoid disclosures they might object to. Such discussions can also help avoid misunderstandings with, or causing offence or distress to, anyone the patient would want information to be shared with.’
’You might need to share personal information with a patient’s relatives, friends, or carers to enable you to assess the overall benefit to the patient. But that does not mean they have a general right of access to the patient’s records or to be given irrelevant information about, for example, the patient’s past healthcare.’
18. As we were not there, we cannot say what specifically was said at the time. The records indicate Mr O was present at the time of the conversation. There is no note in the records or complaint Mr O had requested his granddaughter to leave the room or not be informed of his care.
19. In line with GMC confidentiality guidance, information can be shared with those close to the patient.
20. Ms O complains this information was upsetting for her father to hear.
21. GMC decision making and consent guidance says:
’You should not withhold information a patient needs to make a decision for any other reason, including if someone close to the patient asks you to. In very exceptional circumstances you may feel that sharing information with a patient would cause them serious harm and, if so, it may be appropriate to withhold it. In this context ‘serious harm’ means more than that the patient might become upset, decide to refuse treatment, or choose an alternative. This is a limited exception and you should seek legal advice if you are considering withholding information from a patient.’
22. The CMHN shared information with Mr O so he could make a decision about his care. We acknowledge this information was upsetting for Mr O. In line with GMC decision making and consent, guidance information was shared with Mr O as it was needed to make a decision, even if the decision was upsetting.
23. We understand Ms O holds a different view of the events. We do not dispute Ms O’s version of events. The actions of the CMHN are in line with both GMC confidentiality and decision making, and consent guidance. There are no indications of failings.
24. Ms O says the CMHN informed Mr O’s granddaughter that she had objected to her father going into a care home.
25. The CMHN’s notes say:
‘I was led to believe that Ms O feels dad could stay at home with the appropriate care package’
26. As we were not there, we cannot say what was specifically said. We do not dispute Ms O’s version of events. We can see from the records the CMHN did share an opinion held by Ms O.
27. Ms O says this caused her distress and she is seeking an apology from the Trust. The Trust in its letter dated January 2020 said, ‘I am very sorry for the distress that this situation has caused you’.
28. Our principles of good complaint handling set out that an organisation should acknowledge mistakes and apologise where appropriate.
29. In line with our principles of good complaint handling, the Trust have acknowledged the distress caused and apologised for this. This puts right what went wrong and we will take no further action on this complaint.
30. Ms O is also seeking information regarding a meeting on 19 December. We have not seen evidence Ms O has complained to the Trust regarding this meeting and it has not been requested from the Trust. Ms O should first contact the Trust regarding the meeting on 19 December to raise any concerns.
1. We have carefully considered Ms O’s complaint about Mersey Care NHS Foundation Trust (the Trust), and we have seen no indication that anything went wrong. We have seen indications the Trust shared information with Mr O, Ms O’s father, so he could decide about his care. The Trust have apologised for sharing an opinion held by Ms O.
2. We recognise Ms O has been through a difficult time caring for her father. We understand this was an upsetting time for Ms O and we are sorry to hear of her experience.