Hospital staff are often faced with requests from the Police; varying from requests for information relating to a patient to the provision of blood or urine samples following a road traffic accident. Even in non-urgent situations, requests are often made to frontline staff who are then faced with difficult decisions to make, often in highly pressurised situations. This can often lead to frontline staff feeling vulnerable and potentially there is exposure to civil or even criminal sanctions. Laura Forsyth provides a summary of essential knowledge for any frontline member of staff or in-house legal adviser.

In a non-urgent situation the Police should take their request to the appropriate person responsible (usually the Caldicott Guardian). Whilst the Police may argue that they are not aware of who this, hospitals should ensure that all staff are aware so that they can direct the Police accordingly.

General obligations

Hospital staff are highly aware of their duty of confidentiality to patients but when confronted with a Police Officer requesting information may easily be persuaded into providing this information thinking that the Police have a right to know it. There is no general obligation to assist the Police in their criminal investigations (see exceptions below) and whilst it is an offence to obstruct the Police in the execution of their duty without lawful excuse, it is generally considered that the protection of patient confidentiality is such a lawful excuse.

Whilst this means that healthcare staff do not have to assist the Police, there may be situations in which it is considered that the public interest in disclosing the information outweighs the interest in maintaining patient confidentiality. This will usually be the case if the crime and alleged harm caused by the crime is serious, particularly if it is a crime against the person. In such situations it is generally considered to be best practice to disclose the relevant information required. However, time permitting, frontline staff should not be put in a position where they are making these decisions themselves and all requests for information should be passed to the appropriate person (usually the Caldicott Guardian).

When confronted with a request staff should take the following steps:

		If the Police say that they need the information as a matter of urgency, obtain their reasons for this and record in the patient’s medical records.
		If there is time, ask the Police to provide a formal written request and pass this to the appropriate person responsible for dealing with such requests.
		Seek the patient’s consent unless to do so would enhance the risk of harm or inhibit its effective investigation.
		Consider if the Police can obtain the information from elsewhere.
		Consider if the Police’s task of preventing or detecting the crime would be seriously prejudiced or delayed without the information.
		Decide if the public interest outweighs the need to maintain patient confidentiality. (Guidance from the Department of Health and professional bodies provides some assistance in regard to the public interest consideration.)
		If it is decided that the information should be disclosed and the patient has not provided consent, inform the patient that the disclosure will be made and why (unless to do so would enhance the risk of harm or inhibit its effective investigation).
		Obtain agreement from the Police that they will only use the information disclosed for the purposes of the current investigation and that they will destroy the information after it has been used.
		Disclose only the minimum information necessary for the Police’s purposes.
		Record the decision made and why.
		If in doubt seek legal advice.

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Legal requirements to assist the Police

As set out above, there is no general obligation to assist the Police. However, there are some specific circumstances in which there are statutory requirements to assist the Police. The provisions under the Road Traffic Act 1998 are usually of particular interest to hospital staff and are therefore discussed below.

Hospital staff may find themselves in very difficult emergency situations when the Police request either to breathalyse a patient or to take samples of blood/urine following a road traffic accident. Under the Road Traffic Act, the Police can require people to be breathalysed or to provide a specimen of blood or urine for analysis.

If a patient is capable of providing his consent, he must give it before any samples are taken otherwise this may constitute an assault upon the patient. If a patient does not consent, he is likely to be committing an offence but the Police will inform him of this and this is his decision to make. If the medical practitioner requested to take a blood sample by the Police is of the opinion that, for medical reasons, it cannot or should not be taken then he can object. In these circumstances the Police can then require a sample of urine – again, the patient may refuse this and this is his decision.

If the patient is unable to give his consent because of his medical condition following the accident, the Police can request a medical practitioner to take samples if needed. However, a doctor with any involvement in the clinical care of the patient must not be requested to do this and the samples should usually be taken by the Police Surgeon. The sample should not be tested until the patient is able to give permission for its processing in a laboratory.

Although the Police do have powers to require samples to be provided as outlined above, the patient’s clinical care should always take priority. As well as the ability of the medical practitioner to object to a blood sample (as mentioned above), section 9 of the Road Traffic Act requires that the medical practitioner in charge of the patient’s care is informed of any request to breathalyse the patient or to take a blood or urine sample. If, in the doctor’s clinical opinion, the requirement would be prejudicial to the proper care and treatment of the patient he can deny access to the patient.

Similar provisions are in the Transport and Works Act 1992 in relation to train and tram drivers involved in accidents.

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Conclusion

All hospital staff should be aware of the basic procedure in responding to information requests from the Police and of the identity of their Caldicott Guardian. Where a situation arises which staff have not come across before, they should try to not feel pressurised by the Police and should feel confident to ask the Police to clarify their request and, where necessary, to set out the relevant statutory requirements underlying their request in writing.

For further information and help, please contact:

	London Laura Forsyth Assistant Solicitor laura.forsyth@bevanbrittan.com		Bristol Jane Bennett Assistant Solicitor jane.bennett@bevanbrittan.com
	Birmingham James Cassidy Assistant Solicitor james.cassidy@bevanbrittan.com