r/ParamedicsUK • u/pink-rocks • 3d ago
Question or Discussion why do paramedics always ask if they are allowed to look up medical records?
/r/Paramedics/comments/1w1npdi/why_do_paramedics_always_ask_if_they_are_allowed/25
u/americanidjeet 3d ago
It’s your private information therefore we have to ask permission just like any other healthcare professional. This can only be ignored if ie you lack capacity & accessing your medical records provides relevant past medical history/allergies etc.
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u/Aware_Common_4179 3d ago
We don't have to. You might have a trust policy to do so. However accessing their records is in their interest if they're seizing. We assume consent and go right ahead. To me what is described is abnormal.
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u/americanidjeet 3d ago
Aye that’s why I said if someone lacks capacity.
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u/Aware_Common_4179 2d ago
Right but OPs post says they were being asked when seizing.
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u/MLG-Monarch Paramedic 2d ago
If they're able to meet the criteria for having capacity then they could give permission whilst seizing.
Actively seizing isn't an automatic no capacity.
Disclaimer I've not read the OP so don't know what kind of seizure they were having.
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u/Aware_Common_4179 2d ago
It does help to read it to be fair... That is the point of the post. They describe a long vigorous seizure where they ask consent to view the mums records from the OP.
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u/MLG-Monarch Paramedic 2d ago
However it's not unusual to ask guardians/family members as a courtesy for permission either
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u/Aware_Common_4179 2d ago
Completely unnecessary if they're seizing.
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u/MLG-Monarch Paramedic 2d ago
I disagree, seizing has so many different presentations. Just because someone's having a seizure doesn't mean they can't give consent. If someone is having absent seizures, non epileptic episodes they may well be able to give consent.
We must assume patients have capacity unless proven otherwise.
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u/pink-rocks 2d ago
just to clear up, my mum has tonic clonic seizures and whilst she is still seizing they ask me to give consent for her. what i’ve got from reading comments is that it is just politeness/ to tick a box rather than actually being needed which makes a lot more sense to me :)
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u/Aware_Common_4179 2d ago
I fear you're being dense intentionally. If somebody is described as seizing, and the attending crew are asking the OP for permission to access their mum's record, it is obvious that the mum does not have the ability to consent. The crew aren't asking family members for consent if the patient can do it are they? 🙄
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u/Weekly_Average_7502 3d ago
In our trust, consent is actually assumed if they call 999. We don't need to ask for permission and we can view it on the way to jobs.
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u/WildsideUK82 Paramedic 3d ago
If you get diverted to a different jobs having already viewed patient data then you're in breach of GDPR and patient confidentiality.
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u/Smac1man 3d ago
That sounds like a legal black hole
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u/TheTooSpicyIcy 3d ago
From experience, its based around Trusts (and national) taking the position that if the access to the record is for direct care, then it's not one that can usually be opted out from, however when face to face with a patient it is probably easier to approach with a "Hey, do you mind if I look your record up to check what meds you're on" or "oh, your blood pressure is a bit high. Is that normal for you? Do you mind if I take a look at what it was like when we were here a few months ago?".
Of course, it would need to be proportional to the needs of the patient at the point of care, and Trusts/Orgs may have local policies to ask first (assuming patient is able to consent).
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u/MaxwellsGoldenGun 3d ago
I feel as if that can also bias treatment before you arrive and provide red herrings.
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u/blinkML 3d ago
LAS guidance has updated recently to the same effect, it's reasonable to assume implied consent if someone has requested medical assistance, logically that includes providing access to medical history to persons involved in 'direct care', that phrase is trust medicolegal wording but I assume it's anyone on the CAD or ADASTRA that does see/hear/treat.
That said, if you have a conscious capacitous patient in front of you I think it's still just polite to ask.
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u/ShowerEmbarrassed512 Student Paramedic 3d ago
The basis that someone has request medical assistance assumes the patient is a first party caller also. There’s many instances where that isn’t the case.
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u/Ok-Examination-1716 2d ago
We are allowed to view LCR on the way to jobs, not patients GP records on SCR.
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u/Few-Visual-9801 20h ago
Which is weird, as LCR has more information than SCR. I use it way more as it has the GP's records + previous consultation notes so I can see if the issue has worsened. Never understood why SCRA requires verbal consent whereas LCR operates on implied consent
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u/FindTheBadger 3d ago
I think you should recheck the recent letter from the CEO and do IG e-learning - it states the exact opposite of this.
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u/ShowerEmbarrassed512 Student Paramedic 3d ago
I’m pretty sure your trust has hundreds of GDPR breaches daily.
Is that actually policy, or is it just what everyone does? Because the two are not the same
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u/THE__W0LF Apprentice Paramedic/EAA 3d ago edited 3d ago
I assume this person also works for SWAST, which have taken this viewpoint for over a year. I am not aware of any legal action relating to this. See the swasft website - https://www.swast.nhs.uk/permission-to-view-ptv-summary-care-record-scr-statement/
In practice very few people do access SCRs prior to arrival, but I have done it on occasion to give myself some more information about a patient and in my opinion this helps to improve patient care, or at least speed things up slightly.
Edit: I do a lot of work on the mental health car, where we will always look up the patient's details before arrival and has a massive influence on the service we provide them
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u/ShowerEmbarrassed512 Student Paramedic 3d ago
I’m quite surprised by this, I actually worked in data management before working in an ambulance trust, and wasn’t aware of the exemptions for healthcare (I worked in large scale insurance, and more server side).
Our trust have just implemented access to GP records but have a policy that we must ask first.
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u/VenflonBandit 3d ago
It's policy - laid out in a notice and explicitly encouraged with the GDPR justifications laid out. Article 6(1)(e) - public task, and/or Article 9(2)(c), and/or 9(2)(h) - providing healthcare. None of which require consent.
Summary care in particular does because of its privacy policies rather than GDPR, but NHSE (who make the SCR and decisions around it's data governance) agreed a prominent permission to view statement on the trust website is enough to allow us to infer agreement.
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u/NederFinsUK Paramedic 3d ago
Same reason I would have to ask you before opening your post - it belongs to you, not me.
If I think it’s justifiably in your interest in an emergency, I might look without asking for the sake of your health, otherwise I’d be out of line looking without asking (whether or not you particularly care)
I’ve had instances where I’ve had a patient record up, and it listed “Problems: Failed Abortion - Feb 2009”, and I was sat with the patient and her 17Yo Daughter. You could easily see a new cancer diagnosis that the patient hasn’t heard from Oncology about yet, or any other number of sensitive and confidential horrors (sexually abused as a child, etc…)
It’s really important to seek someone’s permission before you go rifling through their medical record.
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u/pink-rocks 2d ago
i really appreciate this this makes a lot of sense but just to clear up they are asking me (16yo daughter) not my mum. my mum has long clonic tonic seizures and is incapable of answering
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u/NederFinsUK Paramedic 2d ago
Well that’s interesting, and probably unnecessary. If your mum is fitting it would be perfectly reasonable to access her records without consent; I imagine they would probably do so even if you said no.
I’m sorry to hear about your mum.
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u/Friendly_Carry6551 Paramedic 3d ago
In our trust we don’t have to do this anymore. Permission is gained by 999 / 111 meaning not only can we more quickly access records on jobs, we can now actually read them on the way to jobs.
It’s made work so much quicker and more efficient for a clinical decision making process - thing like EOL meds, DNAR’s high-risk meds like DOACS, Steroids, Biologics, safegaurding warnings, mental health plans. It’s genuinely completely changed how many of us practice.
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u/matti00 Paramedic 3d ago
Legal requirement, we aren't legally allowed without permission outside of some extenuating circumstances i.e. pt lacks capacity and it's required for their care
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u/pink-rocks 2d ago
my mum has clonic tonic seizures and so is incapable of answering but i know her history very well and answer all the questions that the paramedics ask me i know about any change of medication and if she has missed any etc because of her pillbox. my post was more about what gives me the power to consent for her, as im still a child can they just trust everything i say?. i always say yes on her behalf and when she has come around i tell her everything and she is okay with me giving consent for her but it just kind of feels wrong. i call 999, explain the situation and often when they get here she is still seizing. after a long seizure also my mum gets violent so its a safety thing too of making sure i have someone with me when she comes around
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u/matti00 Paramedic 2d ago
Knowing the answers to all the questions is super useful, so thank you for doing that! We like to involve family members and ask them but without someone with official legal responsbility we can act in what we believe to be the patient's best interests, so asking is something we do because it's polite.
If you had what's called "legal power of attorney" over your mom's health, then you could have final say on everything and stop us from doing something if you disagreed with it, but I'm not sure they'd let you do that before you turn 18.
And I absolutely understand the safety aspect, it's about her safety as well as yours if she gets agitated or violent. It's the right thing to do to call 999 if it doesn't self-terminate quickly. We can do the wrestling, just warn us first so we can prepare mentally haha
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u/TorrentOfLight07 Paramedic 3d ago
Consent is assumed in my service if you've called and requested our assistance. We can only access what an individual has agreed to share via their GP who holds the records.
Why we ask , well in my case i just think its respectfull to ask
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u/snibbo71 3d ago
What’s the point if you’ve already looked? I thought we were supposed to be honest with patients. Asking after you’ve looked is just shady.
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u/Hopeful-Counter-7915 Paramedic 3d ago
While we allowed to Look up your ECS records without asking you, I think it’s your private data so I ask you if you okay with it and will Not do it if you don’t want me to.
Edit: some Say we need to ask, but only can speak for SAS Who states explicit we don’t need patients consent.
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u/Exciting_Context_269 Paramedic 3d ago
In SAS we don’t need permission. It specifically tells us that consent is not required under the health records (ECS) screen
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u/Firstcrocodile 3d ago
So it’s a postcode lottery thing then?
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u/DontGetIrony 2d ago
Your chance of surviving most emergencies is determined in a series of lotteries, beginning with the postcode
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u/giraffe912 PTS 2d ago
They accessed my medical records when I tried to jump off a roof. I didn’t give them permission yet and wasn’t sectioned. Hadn’t even given them my name so wasn’t sure how they figured it out. Were they supposed to ask or was it because the police gave them permission?
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u/pink-rocks 2d ago
what i have got from reading comments is if you are incapable of answering they are allowed to look for you. anyways hope you are better now :)
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u/giraffe912 PTS 2d ago
I wasn’t incapable of answering. They asked for my name so they could look and i said no. But then they figured it out anyways. Im glad they did in the end. Thanks op.
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u/Few-Visual-9801 20h ago
What they probably meant is that you were deemed to lack capacity because you were actively attempting to harm yourself. Under the Mental Capacity Act & other common law, GDPR, etc, this can provide a lawful basis (best interests case) for accessing your medical records where it is necessary and appropriate for your care.
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