Confidentiality levels

Absolute confidentiality
Spoken or written confidentiality
Organisational or professional confidentiality

The only true confidentiality is when only you know what you are thinking. As soon as this is told to someone there is a need to specify the level of confidentiality you want to achieve. Be explicit about what you want but also realistic. Bear in mind it helps to talk to others. Talking things through helps you to solve issues and opens your mind to solutions you might never have considered

Absolute confidentiality

Only one person knows and it is you. If you really want confidentiality then don’t tell anyone. However many issues resolve when they are discussed and considered from an outside perspective

Spoken confidentiality

Only one other person knows and there is no record. It may be more than one person is actually told, but most confidential discussions involve one person.  With nothing written down accidental disclosure is less likely and can be denied as hearsay.

Written confidentiality

A written record is held and only specific people can access this. Control starts to move away from those people and confidentiality depends on the system and “data protection” arrangements  in place.

Written confidentiality extends to who has access to the written document in either the paper form (physically controlled) or the electronic form (password controlled)

It is possible to negotiate and review what is written. Written confidentiality should include a discussion about who can access the records, their role and the extent of expected use of the records.

Organisational confidentiality

All people who are involved in care of that individual can access records. This should be limited to those who are acting in your best interests for your own support or care

This is the current position with medical records. In primary medical care you can request that your records are confined to the surgery and do not go outside the GP surgery other than to the next registered GP

No one is allowed to divulge records to another person outside the organisation without specific permission

A breech of confidentiality to someone outside the organisation is expected to lead to dismissal.

Professional confidentiality

A professional group holds information relating to that person and has specific consent from the individual to share that information with others in the professional group

This would apply to referrals outside the local organisation such as a referral to hospital care.

Decide what level of confidentiality you want to have at the same time as being realistic about what level is appropriate. Consider being explicit about what you regard as spoken confidentiality and what you agree can be written to best help you with your own issues.