When confidentiality and safeguarding meet

Confidentiality does not prevent sharing information when someone may be at risk. In those situations, appropriate sharing can protect the patient or others.

Frontline staff are not expected to resolve complex information-sharing decisions alone. Record clear, factual concerns and escalate them to the practice safeguarding lead, a clinician, or management for review.

Escalate uncertainty

• Safe-contact concerns: someone may be monitoring the patient’s phone, mail or records.
• Domestic abuse or coercion: a third party may be forcing or pressuring the patient to disclose information.
• Child or adult safeguarding: there may be a need for urgent assessment or referral.
• Serious harm: immediate protection may outweigh usual confidentiality limits.

Share with purpose

When sharing for safeguarding, use established routes and limit information to what is relevant. Do not discuss concerns casually with people who do not need the information.

If immediate action is needed, follow the practice emergency or safeguarding urgent process rather than waiting for routine review.

Confidentiality and safeguarding work together: protect privacy, but do not hide serious risk.

Need-to-know