A2 - DESCRIBE THE BOUNDARIES OF CONFIDENTIALITY IN RELATION TO THE SAFEGUARDING, PROTECTION AND WELL-BEING OF INDIVIDUALS
Introduce the topic - tell me what confidentiality is.
We looked at confidentiality in C3 of Communication, so you can use some bits from there BUT make sure you relate it to safeguarding and protection!
Maintaining confidentiality is important (obviously) however, when it comes to safeguarding and protection, it has to be breached sometimes!
Duty of care
As part of duty of care, all HSC practitioners should ensure that they maintain confidentiality.
Practitioners should follow policies and procedures so that they are accurately maintaining confidentiality, especially when it comes to vulnerable people.
Practitioners should ensure that they reassure vulnerable service users, and explain how they carry out their duty of care, and how the organisation maintains confidentiality.
Practitioners should also explain why it is important to follow a duty of care - as part of this, if the practitioner was to suspect/ witness any harm/ abuse, they have a duty to investigate this. Practitioners should ensure that service users are aware of this.
Consent is very important in HSC, however when it comes to S&P, we are talking about people that have been abused/ harmed. Such individuals may refuse the practitioner to share any information to others, however you may have to!
Firstly, you should be calm with the service user, and assure them that it is not their fault. You should also explain why it is important for THEM, that you share this info - it is within your duty of care, as you are protecting them.
You should also clarify with the service user, as to who you will share this information with, and HOW. You must ensure that info is disclosed in the strictest manner.
Consent
Need-to-know
When sharing any information about service users, you need to ensure that you safeguarding the individual, therefore, you should only share with those that NEED to know
Need-to-know means that the other colleague/ team need this information to carry out their roles and responsibilities.
For example, if Molly told me that she is being abused at home, then I would have to pass this information to my manager and Welfare. However, it would not be professional for me to give this information to Molly's classmates/ family.
Confidentiality policies and procedures, in relation to safeguarding and protection are all guided by the Caldicott Principles, which are:
Justify the use and purpose of all confidential information
Confidential information should only be used when absolutely necessary
Use minimum confidential information
Confidential information should only be accessed on a need-to-know basis
Those accessing confidential information should be aware of responsibilities
Confidential information should only be used in line with law
Practitioners should be supported to carry out their duty to share information, when necessary
Inform individuals about how their confidential information will be used
Policy and procedures
PS - the book mentions 7, but this was revised in 2020!
A* COMMUNICATION - DESCRIBE THE TENSION BETWEEN MAINTAINING CONFIDENTIALITY AND THE NEED TO DISCLOSE INFORMATION
Think about WHY there is sometimes tension between maintaining confidentiality, and the need to disclose information. There are three main areas, and you need to choose ONE:
- Duty of care
- Consent
- Need-to-know
When we say there is 'tension', we usually mean that there is an ETHICAL DILEMMA - this means that there are two choices/ options, and professionals are in a dilemma of which option to go to. In HSC, this typically means that the patient has a particular view/ preferred method (this might fall within a human right), which might conflict with what the professional is legally obliged to do as per their roles and responsibilities.
Confidentiality can cause an ethical dilemma, especially when it comes to duty of care, consent, and 'need to know'.
Duty of care
As part of duty of care, all HSC practitioners must maintain safety and wellbeing of all service users
This is a LEGAL requirement, which ensures that practitioners:
act in the best interest of the individual
ensure individuals are kept safe from harm and danger - take action to prevent harm
work in ways that they are able to, and have the correct knowledge/ skills
An ethical dilemma may occur, when the professional wants to support the individual in exercising their right, however it comes in conflict with duty of care.
For example: ''Anita is 16 years old, and has cancer. She has been offered specialist treatment to cure this, however Anita does not want to have this treatment''
Anita has a RIGHT TO CHOICE, however as per the professional's duty of care, they want to act in the best interest of Anita, therefore there is an ethical dilemma.
Consent means that there is agreement in regards to an action/ decision, therefore it needs to be INFORMED. If I do not know the benefits and outcome of a particular action/ decision, how can I consent to it?
Therefore, HSC practitioners should give service users ALL information so they can make a fully informed decision - as part of this, professionals should also let individuals know about the consequences of NOT giving consent.
When talking about consent, think about WHY is it important? for example, it respects rights, places individuals at the centre of their care, and promotes individuals' dignity.
Also think about LACK OF CAPACITY - there are some groups of people that cannot give consent, e.g. those with mental health experiences, young children, or those with learning difficulties.
What would you do in this situation? talk to individual again, consult with colleague/ manager, check with the individual's advocate.
Consent
Need-to-know
As discussed, information should only be shared on a NEED to know basis!
There can be an ethical dilemma, because individuals may not want you to share information with others, however as a professional, you may have to - be mindful of who MUST know, and ensure that you let the individual know that you are sharing this information. Tell them WHO you are sharing them with, and WHY you are sharing it with them