Recording, refusing and escalating information requests

Clear records show what was asked for, what authority was checked, what was shared or refused, and whether any safety concern or follow-up action remains.

Record proportionately

Routine calls may only need a short note. Any request that affects confidentiality, consent, proxy access, safeguarding or safety must be recorded clearly and factually. Avoid labelling people with judgemental phrases such as "nosy relative" or "difficult caller"; if behaviour is relevant to safety, describe what happened.

If you refuse a request, note the practical reason: authority not confirmed, no recorded consent, direction to a formal process, a safe-contact concern raised, or urgent clinical information passed to a clinician.

Consistency protects staff

Callers may try a different staff member if they want a different outcome. Clear records and consistent wording reduce the chance of pressure, mixed messages and accidental disclosure.

If a caller becomes persistent, upset or aggressive, follow the practice's process and seek manager support. Staff safety procedures should be used if behaviour becomes abusive or threatening.

Escalate uncertainty

• Authority is unclear or disputed.
• The request involves sensitive information.
• There is coercion, abuse, safeguarding or immediate-risk concern.
• The caller is aggressive, threatening or trying to bypass process.

A clear record protects the patient, supports staff and prevents the next person being pressured into a different answer without new authority.

Subject access and formal records requests