Carers, autonomy and confidentiality

Supporters can assist with access, communication and memory. They should not replace the patient's voice or receive confidential information unless the patient has given permission or a lawful authority exists.

Keep the patient central

Where possible, ask the patient how they want the supporter to be involved. Some autistic or neurodivergent patients need a supporter to communicate; others prefer private contact.

Confidentiality, consent and proxy access still apply. A supporter who knows the patient well may give useful context, but that does not automatically permit disclosure back to them.

Watch for pressure

• The supporter answers before the patient can speak.
• The patient looks uncomfortable or contradicted.
• The supporter asks for more information than their authority allows.
• There are safeguarding or coercion concerns.

Support should amplify the patient's voice, not silence it.

The important reception question is whether the current process allows the patient to access care and communicate effectively. If it does not, note the access barrier and route it for review.

Agree and record any supporter involvement. A supporter may help the patient process information, but staff should still check what the patient wants and whether information can be shared.

Supporters can assist with communication, planning and emotional regulation. The practice must still respect confidentiality and avoid letting someone else control the patient's care without authority.

Capacity and consent