Working with carers while keeping the patient central

Carers and supporters are often essential to a patient's care, but the patient must remain at the centre of the conversation. Consent, authority and the patient's wishes continue to guide what information can be shared.

Speak with the patient where possible

Ask the patient how they want the supporter to be involved. Some patients will want a carer to help explain, remember or plan; others will prefer to speak alone. Do not assume the carer should answer every question.

When confidential information is requested, check whether consent or recorded authority exists. A caring relationship does not automatically permit disclosure of results, appointments or records.

Good practice

• Include the patient in the conversation.
• Check authority before sharing information.
• Listen to carer information even if you cannot disclose back.
• Escalate if the patient cannot speak freely or appears controlled.

Supporters can help communication, but they should not automatically replace the patient's voice.

If a supporter asks for changes or information, separate the communication-support role from the confidentiality question: assist the conversation, but confirm consent or authority before disclosing personal details.

A supporter may have useful information about how the patient communicates, what causes distress, current medication and access needs. Staff can listen to this while still checking authority before sharing confidential information or making access adjustments.

Supporters can reduce barriers, but staff should still seek the patient's own wishes. Even when a carer is helpful, the person should be involved in decisions about their care wherever possible.

Capacity and consent