Confidentiality rights in UK

Based on FARS' experience, many problematic Farsi users do not access treatment in the UK because they believe that:

• The information they give to drug services may be given to other parties, such as the Home Office, their families, their workplace, social services, etc.
• By admitting to a drug/alcohol problem and seeking treatment, their legal rights or benefits may be taken away from them.

Unfortunately, these faulty beliefs have kept many Farsi problematic users from accessing treatment.

In the UK, anyone seeking treatment for addiction is:

• Considered a patient under the NHS and Department of Health and is entitled to the same rights to confidentiality as any other patient.
• Entitled to privacy and confidentiality as stated by the Data Protection Act, the Human Rights Act and the Department of Health's policies. The NHS is not allowed to pass patient records or information to any other party unless requested by the patient or if specified by law. The department of Health is a separate entity from other government departments, such as the Home Office and your confidential information is only kept by them. Refer to “Confidentiality and the Law” section below.
• Not regarded as a criminal purely because of a drug or alcohol problem – unless a crime has been committed as the result of their substance misuse.
• Provided with free and confidential treatment with the aim of supporting their return to the community and a healthy way of life. Accessing treatment for addiction also entitles you to other free social support, such as housing, education, employment and benefits.

Below is a summary of NTA's policy and guidelines regarding confidentiality and information sharing for the benefit of Farsi problematic users seeking treatment under NHS. This information has been summarized by and for FARS Services.

• What is confidentiality?
• What is information sharing?
• Procedure for confidentiality between the client and drug services
• When will your information be shared?
• What is a consent form?
• Confidentiality and the law
• When will a client's confidentiality be breached?
• Extra care for specific client groups

What is confidentiality?

Confidentiality is the central trust between a client and a drug service agency, which allows an open and honest relationship to develop between them.

What is information sharing?

In order for clients to benefit from the full scope of treatment, information has to be shared between professionals so that they can all work together to provide the best service available.

Information needs to be shared between agencies for:

• Clients who need the benefits of using multiple professionals such as your GP or specialist agencies.
• Clients whose care is transferred from one agency to another.

Procedure for confidentiality between the client and drug services

• All drug treatment services must have a clear confidentiality policy, which is understood by both staff and clients.
• The policy should be presented and clearly explained to the client, both verbally and in written form, before assessment for treatment begins. This form is called a consent form.
• The policy should be explained to the client on their first visit to the service agency and also be regularly reviewed.
• Clients should be clearly advised of their rights with regard to confidentiality, including their right to access the information that is held on them.

When will your information be shared?

Confidential information should only be revealed when the client agrees to it. This is usually done when the client signs a consent form specifically stating who can have access to their confidential information.

The NHS can share information for monitoring and research purposes, as long as the client is not identified or only if the client has given clear consent.

If drug service agencies are asked to provide confidential information about clients to partnership organizations, employers, friends or family, they should: First get the client to give consent.

What is a consent form?

A consent form is a set of principles which governs the use of information given by clients in confidence to drug service providers. As the information given by clients is of a sensitive nature (e.g. health, personal), there should be explicit informed consent between clients and drug service providers.

As defined by the Data Protection Act 1998, explicit informed consen t means that the client should understand:

• The nature and extent of what information will be revealed.
• Who is likely to receive the information.
• How the information given by them may be used.

Consent does not need to be written, though a signed consent form is good practice in services. Informed consent does not last indefinitely.

Clients can withdraw consent at any time and should periodically be given the opportunity to do so.

Confidentiality and the law

• The Data Protection Act 1998 has restrictions on storing personal data in all formats, written and electronic.
• The Human Rights Act emphasizes respect for private life and advocates privacy for the individual.

Due to these Acts and the duty of confidentiality, there is a potential conflict between protecting the privacy and confidentiality of individuals, and protecting the public and a duty of care to the service user.

There is no legal obligation to break a client's confidentiality in order to protect third parties or when a crime has been committed, unless and until instructed to do so by a court.

However, a drug service may decide to disclose confidential information about a client in the event of serious offences or risk to public.

When will a client's confidentiality be breached?

1. To protect children at risk of significant harm.
2. To protect the public from acts of terrorism.
3. As a duty to the courts.
4. Under the Drug Trafficking Offences Act 1986.
5. To prevent or detect a crime.
6. To ensure the service provides a duty of care in a life-threatening situation for the client (e.g. serious illness or injury, suicide and self-harming behaviour)
7. To protect the service provider in a life–threatening situation (e.g. calls to police regarding a violent service user).

Extra Care for Specific Client Groups

There are certain groups of people, who, based on a variety of reasons, may need extra reassurance about their confidentiality as clients. In the UK every client is entitled to equal confidentiality rights, regardless of race, nationality, political status, belief, sex, etc.

Treatment of addiction is a health issue under the NHS.

The NHS provides extra reassurance about confidentiality and information sharing to the following client groups:

• Women: Social stigma that can be attached to those women who misuse drugs.
• Parents : Fear that their children will be taken away by social services because of their addiction.
• Black and minority ethnic individuals: May feel that a drug service will make the assumption that they want a drug worker from their own community. (BME – includes ethnic minorities such as Iranians, Afghans, Kurds)
• Lesbian, transgender individuals: Feel their sexuality will be told to individuals without their permission.
• Individuals with a blood-borne virus like HIV or hepatic C: Fear of sharing information about their condition will affect attitudes toward them, insurance and employment.

The source of the above information is the National Treatment Agency – NTA and NHS. This information has been summarized by and for FARS services. . For the direct link to this source, click on:
http://www.nta.nhs.uk/publications/documents/nta_confidentiality_and_info_sharing_2003_dsp1.pdf
http://www.nta.nhs.uk/publications/documents/nta_data_protection_and_record_sharing_2003_dsp2.pdf