Common sense Confidentiality

A guide for carers, family and friends

Introduction

This leaflet provides advice and guidance to carers, family and friends on how information can be shared by Hertfordshire Partnership University NHS Foundation Trust (HPFT).

  • What is a carer?

    When we talk about carers, we mean people who provide support to someone who is using one of our services who may not be able to manage without that support. You may not think of yourself as a carer so it is important we make you aware of the support that is available to you. You might be a partner, husband, wife, sibling, parent, friend or neighbour.

  • The importance of sharing information with carers

    We recognise that, if you are supporting a friend or family member, the sharing of information between staff and yourself can be vital to the care and treatment of your friend or relative.

    Information about care plans and medication, and advice on managing a crisis, may help you to deal with difficult situations until other assistance is available.

  • Issues in sharing information

    The provision of high quality care should be a partnership between service users, carers, families and professional care staff. Sometimes there can be difficulties in relation to confidentiality and sharing information. When a service user wishes to withhold information then these wishes must be respected by professional staff. It is essential that you are informed of this. Staff should aim to ensure that you receive as much information as possible to help you in your caring role.

    ‘Lack of consent from a service user does not preclude discussion and appropriate and helpful sharing of general non personal information. Every effort should be made by staff to support carers in their caring role, and they should be supported and encouraged to discuss and resolve any concerns or difficulties for them as a carer.’ – HPFT Carer Practice Policy.

    As an area of good practice staff will:

    • Discuss issues of confidentiality with service user and carer at an early stage and ensure that views on information sharing are recorded
    • Discuss with the service user any particular information they wish to withhold
    • Explain to you what information can be shared and if information cannot be shared the reasons for this
    • Explain they are bound by law and professional codes and have a duty of confidentiality to service users
    • Explain that they have the same duty of confidentiality to you as a carer in relation to any information that you wish to discuss.
    • Continually review consent with service users to promote a good relationship between yourself, the person you support and the service.
  • How can information be shared?

    Issues around confidentiality should not be used as a reason for not listening to you or for not discussing fully with service users the need for you to receive information so that you can continue to support them. You should be given enough information in a way that you can readily understand to help you provide care.

    Even when the service user continues to withhold consent, you should be given enough information to enable you to provide care for them from an early stage. You should be given the opportunity to discuss any difficulties you are experiencing in your caring role with the care coordinator.

  • The provision of general information

    The provision of general information about mental illness, emotional and practical support does not breach confidentiality. Neither does discussion about facts (e.g. diagnosis or medication prescribed) of which the carer is already aware.

    General information can include:

    • Information about the condition and behaviour it may cause (consent may limit some of this)
    • Advice on managing behaviour, particularly in a crisis situation
    • Contact details of the care coordinator or named worker
    • Background information on medication and possible side effects
    • Information about Care Programme Approach and what it involves
    • Contact details for local and national support organisations.
  • HPFT Carer Pathway

    The Trust has worked with carers and staff over recent years to develop a pathway for carers through HPFT services to help improve people’s experience. Through this we encourage services to:

    • Identify Carers
    • Welcome Carers
    • Support Carers
    • Involve Carers
    • Support Carers through service changes

    More information is available at www.hpft.nhs.uk/carers – This is a work in progress but is important that we make continuous improvements.

    The pathway also links to the six points of the triangle of care, a model for good carer support:

    • Carers and the essential role they play are identified at first contact or as soon as possible thereafter
    • Staff are ‘carer aware’ and trained in carer engagement strategies
    • Policy and practice protocols re; confidentiality and sharing information are in place
    • Defined roles responsible for carer support are in place and shaped in a way that provides most benefit for carers
    • A carer introduction to the service and staff is available, with a relevant range of information across the care pathway
    • A range of carer support services are available including support for employees of the Trust who are also carers.
  • Good Practice Checklist

    The following checklist has been taken from the ‘Carers and confidentiality in Mental Health’ leaflet produced by the Partners in Care campaign and published by the Royal College of psychiatrists www.rcpsych.ac.uk It has been designed to assist closer working between staff and carers with the boundaries of current legislation and to help carers understand their rights.

    Where possible, carers are given general factual information, both verbal and written about;

    • The mental health diagnosis
    • What behaviour is likely to occur and how to manage it Medication – benefits and possible side-effects
    • Local inpatient and community services
    • The Care Programme Approach (CPA)
    • Local and national support groups.

    Carers are helped to understand;

    • The present situation
    • Any confidentiality restrictions requested by the service user The service user’s treatment plan and its aims
    • Any written care plan, crisis plan or recovery programme
    • The role of each professional involved in the service user’s care How to access help – including out-of-hours services.

    Carers are given;

    • The opportunity to see a professional on their own
    • The right to their own confidentiality when talking to a professional
    • Encouragement to feel a valued member of the care team
    • Confidence to voice their views and any concerns they may have
    • Emotional and practical support
    • An assessment of their own needs.
  • Further information
    • It is the responsibility of all care staff to work in partnership with carers
    • Within Hertfordshire, a wide range of carer support and information is provided by Carers in Herts www.carersinherts.org.uk
    • HPFT’s Carer Handbook should be made available to carers as soon as possible after we become aware of them
      • A guide for Young Carers is also available
      • Both above documents available online at: www.hpft.nhs.uk/carers

    • If you have any questions about the content of this booklet please speak to the team supporting you or contact the Carer Development Worker at 01727 804418