Disclosing confidential information

45. There may be other circumstances where there is a risk of serious harm to individuals or the wider public and, accordingly, you need to make the decision as to whether there is a public interest in disclosing information that outweighs your duty of confidentiality. Examples include (but are not limited to):

• • evidence of suspected abuse;
  • evidence of serious crimes, including terrorism 2; and
  • evidence of serious communicable or transmissible diseases

46. This list is not exhaustive and there may be other circumstances where you need to balance your duties of public protection and patient confidentiality. In all such circumstances, you should follow the same thought process set out below.
47. When considering whether to disclose information in such circumstances, you should weigh your duty to protect the public with the benefit of keeping your patient’s information confidential. You may wish to consider:

• • Is there potential for harm to others if information is not disclosed?
  • Would sharing anonymised information be sufficient to avoid harm?
  • To whom does the information relate, and is it sensitive to more than one patient?; and
  • What are the potential effects on the patient of accessing future treatment and/or engaging with healthcare services?

48. If you decide to disclose information in the public interest, you should consider advising your patient of your intentions. However, this may not always be appropriate (i.e. if advising the patient would defeat the purpose of the disclosure), and if you believe this to be the case, you should document the reasons why.
49. If you are unsure about your decision in any way, you should seek further advice from a colleague, representative or professional body, indemnity insurer or independent legal adviser, taking care to maintain confidentiality so far as possible.

Exception: Female genital mutilation

50. In England and Wales, there is a mandatory legal duty for all regulated healthcare professionals to report to the police where:

• • a child or young person (under the age of 18) has told you that they have been subject to female genital mutilation (FGM); or
  • you have observed a physical sign appearing to show your patient (under the age of 18) has been subject to FGM.

51. If you encounter such a situation as set out above, you must call 101 as soon as possible to report it to the police and consult the Department of Health advice on this subject.
52. Whilst the scope of practice of optometrists and dispensing opticians means that it is less likely that you will encounter such situations, patients may still confide in you as a healthcare professional and you need to be aware of the reporting requirements in these circumstances.

2 It is an offence under section 38b of the Terrorism Act 2000 to fail to report information about acts of terrorism.