5. Can the GP discuss concerns with carers?
Sometimes carers or those supporting the person with dementia want to speak to the GP about the person. For example, someone might want to talk to the doctor about their husband or wife's memory problems.
The General Medical Council (GMC) produces clear guidance on confidentiality. This guidance states that a doctor should not refuse to listen to someone who is close to the patient on the grounds of confidentiality.
They should listen to concerns that carers, relatives, friends and others close to the person have, because this information may help their patient - the person with dementia. However, the doctor should make it clear that they may tell the patient. The doctor is also responsible for considering how the person might feel about others sharing concerns and information with the GP.
It can help if people have had a chat with their GP previously about information they would like shared, with whom and in what circumstances. This way everyone has a clear idea of what the person wants.
Can the GP share medical information with carers?
Whether or not the GP can share medical information about the person with dementia to those supporting them will depend on whether the person with dementia has capacity - the ability to make decisions for themselves. For more information on capacity see our page: Mental Capacity Act 2005.
If a person has capacity to make decisions about their health and related matters it is up to them to decide whether to share this information and who to share it with.
Their doctor should only share information about them with other people in certain situations. In particular, they can share information when they think the benefit to the public or another person is more important than the public interest or patient's rights in keeping the information confidential. For example, if not sharing the information may result in a crime being committed, or another person being harmed.
If someone doesn't have the capacity to consent to their information being shared, the GP should make sure the person with dementia is their main concern and support them to be involved as much as they want and are able to be. They should take into account any views the person has previously expressed.
The GMC guidance on confidentiality (mentioned above) states that if the person does not have the capacity to consent to their information being shared, the doctor should assume that they would want those closest to them to know about their condition, unless they have indicated this is not the case.
If the person with dementia doesn't have capacity, there may be either a Lasting power of attorney (LPA) for health and welfare or a personal welfare deputy in place. In these cases the GP should disclose information to this representative, and they can make any decisions that the person would have made for themselves (eg consenting to treatment).
If someone objects to their information being shared, but they do not have the capacity to give consent, the doctor can still share relevant information with carers, relatives or friends if they think it is in the person's best interests. The GP may also need to share some information with relatives, friends or carers to determine what is in the person's best interests. However, this doesn't mean the person has a right to general access of the person with dementia's medical records or any other medical information that is not relevant - eg about past healthcare.
The GP may be reluctant to share information about someone who lacks capacity. If you (as a carer, family member or friend) think it is not in the person's best interests for the GP to withhold the information from you, explain this to the GP. It may help to give clear reasons and mention the GMC guidance. If you can't resolve the situation you can ask the surgery for a copy of their complaints procedure (see below).