Interim GMC knife-attack guidance 'unclear'

Scottish defence union says that guidelines on knife wounds could lead to a breach of confidentiality.

GPs faced with a patient wounded in a knife attack could risk breaching confidentiality because GMC guidance is 'unclear', legal experts say.

Interim guidance from the GMC and DoH says that doctors treating a patient wounded 'in a violent attack with a knife, blade or other sharp instrument' should inform the police immediately.

They should then disclose no further information such as the identity or address of the patient without consent.

Disclosure should only occur if in the public interest or requi-red by law, the guidance states.

But the Medical and Dental Defence Union of Scotland (MDDUS) is worried that exceptional circumstances in which a GP can breach patient confidentiality are not fully explored in the interim guidance.

'The proposed approach has a degree of ambiguity and may dent public confidence if it deters a potential patient from seeking medical care,' the MDDUS says.

Doctors in doubt over consent should consult the practice Caldicott lead or the PCT's Caldicott guardian.

But a spokesman for the MDDUS said that knife wounds tend to occur outside normal working hours when Caldicott leads are unavailable.

The MDDUS has called on the GMC to explain its reasoning.

'Guidance can help to explain the issues where doctors have sometimes conflicting choices to make. However, this interim guidance lacks such finesse.

'We need to see more of the GMC's reasoning, bearing in mind the day-to-day practicalities faced by doctors, patients and the police,' said MDDUS medico-legal adviser Dr George Fernie.

Doctors in doubt about an injury's cause should ask a colleague. The GMC will publish final guidance on reporting knife wounds after consultation this month. A spokesman said the GMC welcomed feedback from the MDDUS and invited it to contribute to the consultation.

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