The maintenance of confidentiality in primary care: a survey of policies and procedures

We investigated policies and procedures for the maintenance of confidential ity in primary care by means of a postal survey of 109 general practices in a large non-metropolitan urban health authority in England. The response r ate was 61%. Practices believed a variety of staff should be informed if a patient was HIV-positive, ranging from 'patient's own GP' (100%) to 'cleric al staff' (8%). In 88% of practices receptionists occasionally or normally asked patients why they wished to see a doctor, although in 76% such conver sations were audible to other patients. Ninety-nine per cent claimed to hav e a policy on confidentiality, although it existed in writing in 62% and wa s publicized in only 27%. In 88% of practices non-clinical staff had access to written patient records. Ninety-three per cent provided staff training in confidentiality, but in 34% it was confined to induction. Almost all pra ctices had taken some steps to safeguard confidentiality, but few had expli cit, formal confidentiality policies. Information sharing and non-clinical staff access to medical records were extensive, and few practices communica ted their arrangements to patients. Practices need to review their policies and procedures for the maintenance of confidentiality.