BMA Consent form[1]. - Law Society of Scotland

Consent form for access to patient records by solicitors(Releasing health records under the Data Protection Act 1998)About this formIn order to proceed with your claim, solicitors usually need to see all your records as they need to assess which parts arerelevant to your case. (Past medical history is often relevant to a claim for compensation.) Also, if your claim goes ahead, theperson you are making the claim against will ask for copies of important documents, including health records. So your solicitorneeds to be familiar with all your records. However if only part of the record is needed, this protects your privacy and reducesNHS photocopying costs. These records may be held either by your GP or the hospital(s) and you will need to apply for theseseparately.Part a – your, the health professionals’ and your solicitor’s or agent’s detailsYour full nameInclude Forename, Middle Name, Surname, Previous Surname when attended hospitalSexHospital number or CHI (community health index) number (if known)Your address/ address when you attended hospital (if different):Date of Birth:Date of IncidentSolicitor’s or agent’s name and address:GP’s name and address (and phone number if known):Name (and address if known) of hospital(s) and departments you went to in relation to this incident :If you have seen any other person or organisation about your injuries (for example, a physiotherapist) or have had anyinvestigations (for example, Xrays) please provide details:Part b – your declaration and signaturePlease see the ‘Notes for the client’ over the page before you sign this form.To health professionalsI understand that filling in and signing this form gives you permission to give copies of all/part relating to this incident of my GPrecords, or all/part relating to this incident of my hospital records (delete words which do not apply) to my solicitor or agent whosedetails are given above.Please give my solicitor or agent copies of my health records, in line with the Data Protection Act 1998, within 40 days.Your signature: Date: / /Part c – your solicitor’s or agent’s declaration and signaturePlease see the ‘Notes for the solicitor or agent’ over the page before you sign this form.To health professionalsI have told my client why particular parts of his or her health records are needed. I confirm that I need the full/part (Specifywhich………………………….) records in this case from (Specify dates………………). I enclose the authorised fee for gettingaccess to records.

Solicitor’s or Agent’s Signature:Date:/ /

Notes for the clientYour health records contain informationfrom almost all consultations you havehad with health professionals. Theinformation they contain usuallyincludes:• why you saw a healthprofessional;• details of clinical findings anddiagnoses;• any options for care andtreatment the health professionaldiscussed with you;• the decisions made aboutyour care and treatment, includingevidence that you agreed; and• details of action healthprofessionals have taken and theoutcomes.By signing this form, you are agreeing tothe health professional or healthestablishment named on this formreleasing copies of your health recordsto your solicitor or agent. During theprocess your records may be seen bypeople who are not health professionalsbut they will keep the informationconfidential.If you are making, or consideringmaking, a legal claim against someone,your solicitor will need to see copies ofall your GP records, and any hospitalrecords made in connection with thisincident, so he or she can see if there isanything in your records that may affectyour claim. Once you start your claim,the court can order you to give copies ofyour health records to the solicitor of theperson you are making a claim againstso he or she can see if any of theinformation in your records can be usedto defend his or her client.If you decide to go ahead with yourclaim, your records may be passed to anumber of people including:• the expert who your solicitoror agent instructs to produce a medicalreport as evidence for the case;• the person you are making aclaim against and their solicitors;• the insurance company for theperson you are making a claim against;• any insurance company orother organisation paying your legalcosts; and• any other person or companyofficially involved with the claim.When you send this form to the appropriate medical records controller please also enclose theauthorised fees for getting access to records.If you find out at any stage that the medical records contain information that the client does notknow about (for example, being diagnosed with a serious illness), you should discuss this with thehealth professional who provided the records.Unless your client agrees otherwise, you must use his or her health records only for the purposefor which the client signed this form (that is, making his or her claim). Under the Data ProtectionAct you have responsibilities relating to sensitive information. The entire record should not beautomatically revealed without the client’s permission. You should not keep health records for anylonger than you need them. You should return copies to the client at the end of the claim if theywant them. Otherwise you are responsible for destroying copies securely.Notes for the medical records controllerThis form shows your patient’s permission for you to give copies of his or her full GP record,and/or any hospital records relating to this incident, to his or her solicitor or agent. You must givethe solicitor or agent copies of these health records unless any of the exemptions set out in TheData Protection (Subject Access Modification) (Health) Order 2000 apply. The main exemptionsare that you must not release information that:• is likely to cause serious physical or mental harm to the patient or another person; or• relates to someone who would normally need to give their permission (where thatperson is not a health professional who has cared for the patient).Your patient’s permission for you to release information is valid only if that patient understands theconsequences of his or her records being released, and how the information will be used. Thesolicitor or agent named on this form must explain these issues to the patient. If you have anydoubt about whether this has happened, contact the solicitor, agent, or your patient.If your patient is not capable of giving his or her permission, this form should be signed bysomeone with: ‘Welfare power of attorney’ to act for your patient; or a Guardianship Order.Originals should only be sent if required by a Court Order. In all other circumstances photocopiesshould be sent.You may charge the usual fees authorised under the Data Protection Act for providing therecords. The BMA publishes detailed advice for doctors on giving access to health records,including the fees that you may charge. You can view that advice by visitingwww.bma.org.uk/ap.nsf/Content/accesshealthrecords.This form is published by the Scottish Executive Health Department, Law Society ofScotland and British Medical Association.Copies of this form can be downloaded fromwww.nhsscotland.co.uk/confidentiality/sitemap.htmNovember 2004You do not have to give permission foryour health records to be released but ifyou don’t, the court may not let you goahead with your claim and, in somecircumstances, your solicitor may refuse

to represent you. Once your solicitor hasreceived your records it is wise for you tocheck your records yourself both toremind yourself of their content and tocheck accuracy. You can do this byarranging to view them at the solicitor’soffice. If there is very sensitiveinformation in the records, that is notconnected to the claim, you should tellyour solicitor. They will then considerwhether this information needs to berevealed.The solicitor will destroy any copies ofthe record apart from the file copy . Ifyou wish to retain a copy you will need tomake arrangements with your solicitor.[l1]If you change solicitor you shouldarrange for the copies to be passed toyour next solicitor.Notes for the solicitor or agentBefore you ask your client to fill in andsign this form you should explain thatthis will involve his or her full healthrecords being released and how theinformation in them may be used. Youshould also tell your client to read thenotes above.If your client is not capable of giving hisor her permission in this form, this formshould be signed by someone who has:Welfare power of attorney to act for yourclient; or has a Guardianship Order.