1.1 Your confidentiality is important. I am aware that many people seek help from private practitioners because they do not want sensitive information held in their official medical records. As a clinical psychologist working in private practice I will necessarily be collecting, processing and holding a certain amount of personal information about you and/or any dapendent children you bring to see me. I will use this solely for the lawful purpose of processing data related to the provision of healthcare and treatment under provision 2(h) of article 9 of the GDPR (General Data Protection Regulation), a legal framework that is being introduced to safeguard your rights and privacy in relation to information held about you.
2.1 The type of information likely to be held includes:
- Information from the intake questionnaire
- Record of appointments
- Assessment and treatment session notes
- Psychometric test results
- Formal documents such as referral letters, GP letters and other official documents
- Financial information (invoices/payments/receipts)
- Any email exchanges between us or with other relevant parties.
3.1 As a general principle, sensitive information about you or your child will not be shared with anyone else, including other health professionals, without your explicit permission. The exceptions to this are:
- If I have reason to believe that you, your child, or someone else may be at risk if information is not shared. In such circumstances it may not always be possible to respect your right to confidentiality, although efforts will be made only to share information relevant to safeguarding.
- In the rare and unlikely circumstance where the disclosure of information about you or your child is legally enforced under a court order.
- Your case details may be discussed in anonymised form within the context of supervision. This is standard practice to ensure that you receive the highest standard of care. Clinical supervisors are also bound by medical confidentiality.
d) Be aware that if you are a client being funded by an agency such as a local authority, limited communication with other professionals involved in your care may be a precondition of my being able to work with you.
3.2 I will routinely copy you into any formal written communications such as letters and reports, except in the rare circumstances when it would injurious to your wellbeing or mental state for me to do so (in line with the current Data Protection Act guidelines).
3.3 Your consent to share any such information with relevant institutions or third parties will be sought upfront, so it is clear who you are happy for me to speak to about your case.
3.4 If your treatment is being funded by a third party such as a local authority or an insurer, there may be a reasonable expectation that some information will be shared, but I will make efforts to restrict this to what is strictly necessary.
3.5 In the case of minors, the limits of confidentiality are usually negotiated on a case by case basis. Sometimes it is appropriate to agree with the parents or carers of older children and teenagers that details of their sessions will not be shared with them. However, usually what is recommended and agreed with more mature young people is that nothing will be shared without their prior agreement.
3.6 In the case of younger children, however, it is normally important that their parents do know what is being shared, and that feedback is given so that appropriate support and parenting strategies can be put in place.
3.7 While the lawful processing of health data is not consent-based, in accordance with best practice teenagers of 13 or above will be required to give their own consent to my processing of their data. Below that age, a responsible adult will be asked to give consent on their behalf.
4.1 On discharge, my usual practice is to compile an assessment and treatment summary and then delete any existing session notes. I will archive the other information listed above for a period of 5 years. After this, all information except your attendance schedule and any data I am obliged to retain for my financial records will usually be permanently destroyed. If there is some reason why you feel your records need to be preserved beyond this point, or treated differently, you need to alert me.
Subject Access to Records
5.1 Two of the key guiding principles of GDPR are that data held about you belongs to you, and that you have a right to see whether that information is being processed appropriately. I will usually be able to provide you with a copy of your records in PDF form within 30 days of a formal request. There is no charge for this.
5.2 However, please be aware that even under GDPR health records remain a special case; the current Data Protection legislation exemptions still apply. In other words, access to your records may still be restricted or information redacted a) if your notes contain sensitive information pertaining to third parties and/or b) there is information in them judged likely to cause harm to either yourself or another person’s physical or mental health.
5.3 Also, please appreciate that because of the potentially sensitive nature of the information held within treatment records, I generally do not keep detailed session notes as part of the permanent record.
6.1 Information on the database is stored in encrypted form on a cloud-based server and is password protected. I currently use commercial practice software called Cliniko which I am assured will be GDPR compliant by the end of May 2018. You can read more about their security practices and policies at https://www.cliniko.com/security. Any additional information not on the Cliniko database is stored on an encrypted, password-protected drive or encrypted at source using Boxcryptor software before being backed up to a cloud-based server. This does not currently include emails. However, if especially sensitive information needs to be shared with you, I am piloting a new system that enables you to be sent a link via email which will then enable to you to download and unencrypt the relevant protected document securely.
8.1 I am happy to receive payment by cash, cheque, credit or debit card or BACS. I would however strongly request that payment is made before or on the day of the appointment itself, so I can keep track of my accounts.
8.2 I have no problem with taking payment at the beginning or end of a session, but some people find this disruptive so do give some consideration to what will suit you best.
8.3 Invoices for any outstanding amounts will be issued at the end of each month.
8.4 My BACS details, should you wish to use this method, are available on request and will appear on any invoices sent to you.
8.5 If you or a family member is ultimately to be funded by an insurance company, you need to check before your initial appointment that they are prepared to cover your costs. I am currently registered with some providers but not all, so you will also need to check that your insurer is happy for me to do to the work. It is administratively painful to become involved in billing the insurer directly, so I will usually expect you to cover the cost upfront. It is then your responsibility (not mine) to recoup any fees from your insurer at your convenience. I can provide receipts on request.
9.1 I do my best to be flexible but cancelled sessions cannot normally be filled, and this has implications for my income! If you fail to turn up at a scheduled appointment without adequate notice, please expect to be charged the full price, since I cannot replace that part of my income.
9.2 If you cancel less than 48 hours before an appointment, expect to be charged for the session. Also, be aware that if you are late for a session, I am unlikely to be able to extend it beyond the allocated hour.
9.3 If you opt in at referral, you should shortly receive automatic reminders by SMS or email prior to your sessions, which will hopefully minimise confusion over times or forgotten sessions.
Contact outside sessions
10.1 As an independent practitioner working part-time in an outpatient capacity, there are constraints around my availability and the range of services I can provide. I must stress that I am not an emergency service, and I will not necessarily be monitoring my messages or emails out of hours or on the days I am working clinically (Tuesdays and Fridays).
10.2 While I will do my best to accommodate clients who may need additional sessions, my clinic days do get booked up, and I cannot guarantee to be able to offer appointments at short notice.
10.3 If you are unfortunate enough to experience an acute mental health crisis or are feeling suicidal, you will need to seek emergency help from appropriate services such as your GP, emergency services (999) or your local Accident and Emergency department.
10.4 The following numbers may also be useful:
- Sussex Mental Health Line (not 24 hours) 0300 5000 101
- The Samaritans (any phone) 116 123
- Mind 0123 666950 or 0300020060
11.1 Generally, the best way to contact me is via email on Stephen@briersoneill.com so I can keep track of our communications. However, as far as possible, any clinical matters should be addressed face-to-face during the sessions themselves. I am not in a position to enter into extended ongoing dialogue outside of sessions.
11.2 In the normal course of events I would therefore expect communication outside of sessions to be restricted to administrative matters – cancellations, rescheduling of sessions, matters relating to payment, requests for letters/reports and so forth, although updating information can be useful.
Involvement in legal proceedings
12.1 If you are currently involved, or expect to be involved, in legal proceedings of any kind, including childcare disputes or insurance claims either for or against you, you must notify me as soon as this becomes the case. I try to work transparently with my clients and I expect them to do the same with me. Involvement in court proceedings or insurance clams may affect the timing of your treatment, or even your suitability.
12.2 Please be aware that unless agreed beforehand, I will not usually provide reports relating to therapy for use in legal cases. Experience has taught me that clients are usually in a much better position to benefit from therapy if they begin treatment after any legal disputes are settled. Otherwise agendas can become confused and confidentiality becomes much more complex for all involved. Individual circumstances can of course be discussed in more detail.
13.1 In order to comply with GDPR I am a registered ‘Data controller’ so if after raising the issue of concern with me you still feel unhappy about the way your data has been handled or stored, you are of course entitled to take up the matter with the Information Commissioners Office (https://ico.org.uk).
13.2 Regarding clinical issues, as a chartered clinical psychologist I am registered with the Health and Care Professions Council (http://www.hcpc-uk.co.uk), which also acts as the disciplinary body for my profession. You are welcome to approach them with any unresolved complaints.
13.3 However, in either case if you become dissatisfied with any aspect of the service provided please can I encourage you to raise this with me first, so I can see if anything can be done to rectify matters. It is important to me to provide a high standard of care and professionalism. If you feel there is room for improvement, please do let me know, whatever the nature of your concern.