Rule 4: An individual's right to object to the sharing of confidential information about them should be respected 

Individuals have a right to object to confidential information about them being used or shared beyond their treatment and care and to have that right respected.

Rule 2 addresses how to respect the choices of individuals in relation to the sharing of confidential information about them for direct care purposes.

The general principles governing how health and social care organisations should handle objections are explained below in part A. Specific rules governing the sharing of confidential  ;information from GP records for indirect care are set out in part B.  The sharing of anonymised information in circumstances where an objection to the sharing of confidential information is implemented is explained in part C. Circumstances when individuals’ objections may or must be overruled are set out in part D.

Organisations should ensure that members of staff show respect for the wishes of any individual who objects to particular items of confidential information being shared. The likely consequences of an objection should be explained to the individual to aid an informed decision.

To ensure objections are considered consistently, organisations should review the criteria for assessing objections on an ongoing basis.

Parts of patients’ records will be sent by GP practices to those who have special approval to use health information for purposes other than direct care. A specific example will be where GP practices send parts of patients’ records to the HSCIC where the information will be anonymised and used to benefit the community. Any patient may object to confidential information about them being sent from a GP practice or being shared onwards by the HSCIC. In either case, the patient’s objection should be implemented. This means that if a patient tells their GP that they
⦁    do not want information about them leaving a GP practice in identifiable form for purposes other than direct care, then confidential information about them will not be shared. AND/OR
⦁    do not want information about them leaving the HSCIC in identifiable form, then confidential information about them will not be sent to anyone by the HSCIC 

Sharing anonymised information where an individual objects to the sharing of confidential information about them means that the individual’s confidential wishes are respected. 

Anonymised information about service users and patients contributes towards the improvement of services that they and the community benefit from, without infringing their privacy or disrespecting their confidentiality wishes.

There are rare circumstances when part of an individual’s objection (relating to a particular piece of information) may, or must, be overruled by law. Individuals should be made aware of these when they object. It should be made clear whether the law requires that their objection ‘must’ be overruled, or ‘may’ be overruled.

When the law says there is an obligation to share the confidential information, for example in the case of notifiable diseases,³⁷the individual should receive an explanation of why their objection must lawfully be overruled.

When the law allows pieces of confidential information to be shared, for example where there is an overwhelming public interest justification the individual should receive an explanation of why the available permission has or has not been used in their case. The exception is where it is judged that informing an individual might prejudice the purpose of sharing (for example where serious crime is suspected) or might put someone at risk.³⁸