Staff working for a care provider in the Isle of Man lost an unencrypted memory stick (encryption means you have to put in a password before you can get at the information on the stick) with lots of client/patient information on it. Nobody knows where it went. They have had to sign an undertaking with the Isle of Man and UK regulator for information security.

Within the undertaking Praxis have agreed that all memory sticks, laptops and similar devices will be encrypted, all staff will be trained in the company’s policy for the storage, use and disposal of personal information, information which is no longer relevant will be disposed of in a secure manner, compliance with data protection policies will be regularly monitored and lastly the company will take steps to ensure personal data is secure.

In the iPad age, information is becoming more mobile, and people take it for granted that they can work on stuff on their mobile phones, Blackberries and iPads wherever they are. That means stuff is going to get lost. I wonder how many health and social care memory sticks have been lost from handbags or pockets over the past year or two. And how many were encrypted – difficult because you have to remember and input the password every time you use it. But it’s still personal information and often in a hospice or social care agency it will be highly personal stuff. Are we thinking carefully enough about this?

Another organisation got hammered for losing membership aplication forms on a train.

Details on the web here: http://www.ico.gov.uk/news/latest_news/2012/action-taken-after-care-provider-lost-unencrypted-memory-stick-18012012.aspx

Back from an interesting conference last Friday run by the University of East Anglia and the journal Ethics and Social Welfare on Confidentiality and Collaboration. Some very thoughtful contributions from experienced people mainly from safeguarding. Of course, the worry in that field of practice is that people’s professional rules about confidentiality prevents them sharing concerns about children and vulnerable adults at risk of abuse and neglect. But the law and all professional codes of ethics and practice require disclosure of concerns to colleagues to prevent offences and risk to others. This is really not difficult. Is someone at risk? Then disclose your concerns; at least at the outset we are only talking about conversations with professional colleagues who have the same objectives of public safety and concern for the people we are trying to help.

However, my view of this emphasises the importance of ‘informed consent’ as the answer to many confidentiality problems. One contributor was right in saying that I think informed consent should be threaded through our practice; I thought this was a nice concept. After all, it is contained in most social work codes of ethics, but I don’t think it is emphasised enough in practice. See my Humanistic Social Work: Core Principles in Practice, (Palgrave Macmillan, UK; Lyceum, USA). Chapter 2 promotes informed consent as an important way of offering accountability to service users and professional colleagues as well as to agencies.

For Humanistic Social Work in the UK and Europe: http://www.palgrave.com/products/title.aspx?pid=497063

For Humanistic Social Work in the US: http://lyceumbooks.com/HumanisticSocialWork.htm

(You get some free chapter downloads from the US site).

Of course, you can’t make rules against people behaving stupidly, but it seems surprising that most health and social care professionals would fail to be aware that this was a no-no, but apparently not, and the Information Commissioner has started getting strict about people breaching confidentiality. A legal report tells us about a fine for an employee of a private injury claims service who got his nurse girlfriend to give him names of patients who were recently injured – he followed them up to try to get personal injury claims. The nurse’s PCT found out about it when patients complained about being contacted. The report ends:

in a statement released by the ICO last week, the Information Commissioner Christopher Graham said that “the ICO will always pursue prosecutions where individuals breach both their duty of confidentiality and the Data Protection Act. Those whose responsibilities include the custodianship of sensitive personal data should take note.”

http://www.macroberts.com/content/content_1484.html#page=1

The Standards Board for England has published guidance on what is confidential for local councillors and the like, which is clear and succinct; other people may find it useful. It says:

Information is confidential:

* if it is about something serious and not trivial
* if the nature of the information is sensitive or personal, for example it is a business secret
* if it is information that you would expect people would want to be private
* if it was divulged in a way which implied it should be kept confidential
* if disclosing the information would be detrimental to the person who wishes to keep it confidential.

The good thing about this formulation is the emphasis on thinking what the person (a normal reasonable person) would want, and thinking about what they implied rather than specifically stated. Not news, but it sets it out well.

The full guidance on the web: http://www.standardsforengland.gov.uk/Guidance/TheCodeofConduct/Guidance/Quickguides/DisclosingConfidentialInformation/

The Standards Board sets standards for how local councillors and other elected/quango people should behave and investigates complaints: on the web: http://www.standardsforengland.gov.uk/

Their links site gives links to the Boards for the other countries: http://www.standardsforengland.gov.uk/aboutus/Usefullinks/

Another element of the clinical review was the palliative care culture that we shuld talk about our deaths compared with the culture of some minority groups and the preferences of some individuals, never mind their ethnicity, not to talk about death. Does this mean that they cannot be helped so well? Is talking about your own death always good for you? Is not talking about your death always a bad thing?

Who rescues the rescuers, I ask? Sitting at home today, having decided it’s impossible to get to work in snow which is apparently the worst in London for 19 years, I see an RAC van stuck in the road outside my window, accompanied by another RAC van that has come to rescue it, only also to get stuck. I’ve often been caused to wonder who deals with the social workers who beat their children or neglect their elders. Yesterday, a nursing colleague who is in hospital has been plied with requests by her consultant to have a private room, on the grounds that she should have the privileges of a senior NHS staff member. Equality of access to health care?