Sharing for direct care

The biggest misunderstanding in care data security is the belief that the safest option is never to share. It is not. The seventh Caldicott principle exists precisely because that belief has caused harm: the duty to share information for direct care can be as important as the duty to protect confidentiality.

Direct care sharing is usually expected and lawful

Direct care means the activities directly involved in looking after an individual: assessment, treatment, personal care, medication, care planning, handover between shifts, referral to another professional treating the same person. Sharing relevant information within the team providing that care is normal, expected, and lawful. People we support reasonably assume that the professionals looking after them talk to each other, and they are usually right to.

So when a support worker tells the district nurse about a change in someone's skin, or a GP sends a summary to the hospital admitting their patient, no special permission process is needed. Implied consent and the legal bases for providing care cover it.

Need-to-know within the team

Lawful sharing for care still has edges, and the edge is need-to-know.

• Share with the people involved in this person's care, not the whole organisation.
• Share what is relevant to the care being given, not the entire life history.
• A cook needs to know about allergies and texture-modified diets. They do not need the psychiatric history.
• Being a colleague, or even a clinician, does not by itself create a right to look at a record. Looking up someone you are not caring for, including a neighbour, an ex-partner or a famous patient, is unlawful, and staff have been prosecuted for it.

When in doubt

If you are unsure whether to share for care, ask yourself: is this needed for this person's care, would they expect it, and am I sharing the minimum that does the job? If the answer to all three is yes, sharing is very likely the right thing to do. If you are still unsure, ask your manager or Caldicott Guardian rather than defaulting to silence. Failing to pass on an allergy or a safeguarding concern can hurt someone just as surely as a leak can.