GPs required to quiz patients about crimes

GPs will have to monitor substance misuse patients for criminal activity, as part of an England-wide audit.

From mid-June the treatment outcomes profile (TOP) will have to be completed by all health professionals providing treatment for substance misuse, says the National Treatment Agency for Substance Misuse (NTA). This will include GPs on shared care contracts or those delivering a national or local enhanced service for substance misusers.

Using TOP, GPs will have to ask patients about crimes they have committed in the past four weeks, including shoplifting, selling drugs and assault.

The aim of the one-page form is to collect data on social outcomes and health in patients receiving substance misuse treatment.

Use of substances, including crack, amphetamines, cannabis and alcohol, will have to be recorded as grams daily. Risky injecting behaviour is also incorporated, as are visual scales to gauge psychological and physical wellbeing and quality of life.

From October, the information will be collected by the NHS National Drug Treatment Monitoring System, with a set of Read codes already being drawn up by Connecting for Health.

However there are concerns about what reporting criminal activity under TOP may mean for patient confidentiality.

GPC negotiator Dr Richard Vautrey said: 'It is something that may come up in a consultation, but it's not an appropriate thing for GPs to be reporting on.'

Such questions could mean patients 'have less confidence in consultations', he added.

Dr Susi Harris, GP representative on the NTA clinical team, said: 'We will all be bound by the usual rules of confidentiality and there is no intention of breaching confidentiality. We can use an anonymous identity to protect patient security.'

Dr Michael Devlin, from the Medical Defence Union, said that as long as GPs anonymised data, the tool should be consistent with GMC confidentiality guidelines.

'If you are going to take part in this sort of audit, we advise doctors to tell patients the information is being used in this way,' he said.

'The patient should also be given the opportunity to opt out should they wish.'

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