To want to know who can access my hospital records?

[namechange4000]

Just that really. Name change but long time poster.

I have several complex medical conditions and have quite a detailed history in my medical notes. I'm under a few different specialities but have recently been referred to a new one. I've had 2 appointments and all going well.

I have a friend who works at the hospital and has done for years. For the first time, I've crossed in to the department she works in. She is admin/reception and sorts out appointments, books you in as present etc.

It's the etc but I'm worried about. What else can she see? I know she is the worlds biggest gossip and I don't want my notes being ruffled through for tidbits and gossip.

In particular I have some MH issues as a teenager, which are nothing to do with the dept she works in. The issues were 35 years ago, I don't know if they are even recorded anywhere.

I also had many failed attempts at IVF, my whole gynae history is in that file, as well as my pre-adoption health check. It's so important to me that the adoption of my DD doesn't get out. There are serious safeguarding issues.

What can someone see?! Please put my mind at ease, I've been worrying about this for days now.

I don't think she would have access to all that info. Data sharing in the NHS is generally on a need to know basis, not everyone has access to everything. If she accessed any of your notes without an express need to it would be a breach of confidentiality and possible grounds for dismissal, especially if she passed any info on. The hospital I work at actually do random checks as they can see a history of patient details accessed, so they actually check that no one is misusing the data

I'm pretty sure you should be ok. Caldecott report means information is on a need to know basis and if she accesses your records to be nosy, there'll be a footprint.

I am in Ireland so not sure what way your system works but I had a similar situation with my sil, I had nothing to hide but she's a nosey bitch I wouldn't trust as far as I could throw her, I know for she could check my files for test results but I don't know about notes and history. I would ask your doctor, especially because of your dd

Well I guess ‘what you can see’ will differ from Trust to Trust and what kind of setting you are in. At mine Everyone has access to everything but due to the rules around confidentiality and data protection you are forbidden to access any record of a patient that is not being cared for by you, you are not allowed to access your own record and if you are admin staff and you access a record to work on it (e.g booking an appointment) you are only allowed to access the relevant information. Everything is easily traceable and it’s a disciplinary offence, which willmore than likely end in dismissal, if you diviate from those rules.

She may recognise your name but if she values her job, she’s be a very silly lady to access something outside her remit and/or talk to anyone about knowing you.

She wont have access to your mental health records u worked in mental health for many years our records were kept entirely seperate , different people will different levels of access and if she tries to acccess records that she hasno reason to be doing it will become apparent and its a dscplinary offence.

I know there must be a good reason - but why can’t you access your own record as a healthcare worker?

She will potentially have access to your written notes e.g if she is collating patient files for a particular clinic.

She may have access to a list of past appointments, if her role is to book appointments. How far this goes back may depend on the age of the software.

She shouldn't have access to your computerised test results/scans as these require login and passwords, which are given to those who need access to this info. However, some of this information will be in the clinical records, clinic letters etc and so potentially accessible.

It is a disciplinary offence to access records if you are not involved in the patient's care and even then only the relevant ones should be accessed.

I know several friends/relatives/acquaintances who have been treated in some capacity where I work and I wouldn't dream of accessing any of their records and would let them know if I had to as part of their care.

Confidentiality is key and no member of the hospital staff is exempt from it.

I'd be surprised if she could access them when she has no need to for her role.
Considering my DD's consultant doesn't appear to be able to access her records whenever we have an appointment

I agree with the above posters, it's a very serious disaplinary offence to access notes without reason to.
I've previously been involved in the treatment of two patients who had there notes 'locked' so a password was required and access monitored much more heavily than usual. One was a celebrity involved in a high profile incident and the press were attempting to get details & one was the serious treatment of a senior member of staff in a sister department. I don't know how often this is done or what the threshold is for it to be authorised but it is possible. Perhaps have a chat with your consultant.
As an after thought, does your consultant work at any other sites? Would it work for you to ask to be seen there if possible?

Thanks everyone, I think I'm reassured. Although I know it's a serious offence, it won't stop her being actual able to read the notes. And only if I get wind of gossip would I know confidentiality could have been breached. I'm worried that my only protection seems to be retrospective punishment rather than preventative.

A close relative of mine works in medical records for an NHS hospital in England.

From what she's said in conversations about her job, detailed information doesn't sit in computer systems that can be accessed by anyone. Any access is very traceable and there has to be legitimate reasons for data requests.

She can't even look up her own records. So I really wouldn't worry.

Polarbearflavour because you have to follow the same protocol as everyone else and formally apply to see your medical records.

To do otherwise would be taking advantage of your professional position and against ethical codes etc.

You are all labouring under the misapprehension that hospital notes are all digital, this is very very far from being the case. While most hospital have computer systems to record demographics and admissions data, few of them are mature enough in their use to have full electronic clinical noting as used by pretty much all GP practices.

Most hospitals are still using paper based patient records that have to be moved about between departments and checked in and checked in by admin teams. There is nothing to stop nosy staff from having a quick flick through and certainly no way of tracking whether this has happened.

I work in a surgery so slightly different but we can open the record and we could see anything on tbe record but we are only allowed to look at what's required so say the doctor said can you chase up results from the hospital we would ring the hospital and then record the information for the doctor. We also scan on or attatch hospital letters , order medication and sometimes we will go into the record but only if patient asks is to say they want us to look which doctor they saw last time or they got a medicine last time and have forgotten the name can we look ECT. Everything we do is recorded so if someone thought that we had looked at their record they could trace everything we did and its gross misconduct I don't know anyone I work with who would look confidentiality is taken very seriously. In your case I can't think they would see things that have no relevance to the condition your being seen about but havnt actually ever worked in a hospital but please just ask in sure they will be happy to reassure you.

I've seen alot of medical notes when pre-assessing patients, I've never seen a pre adoption health check in any, so it might not be in there.

If your hospital has digital notes, then it's very difficult to read anything you shouldn't. Parts of the system might be unable (e.g. sensitive results like HIV status) and at the very least, everything you look at is recorded against your login ID. No one would share that because it would open you up if anything was looked at that shouldn't.

With paper notes however, certainly in our hospital, they're recorded against the ID who requested them and has them, but any staff member could flick through them. It would be quite brazen, but there would be no record of eyes looking at the contents, only a record of who's ID they are recorded again in terms of location. I think that's a good reason why everyone is moving to digital notes, you can't read anything without it being recorded.

I worked in the accounts department of a hospital. We had access to a database, you could search a name it would bring up generally info which department the person attended, appointments, AE visits. We could request a patient file if there was a query on their account It was in Ireland so all patients pay for overnight stays, if the patient said the procedure was cancelled, You could not just request a patient file.

It really depends on the IT department. I have worked in call centres if you looked at a customer account without a call IT could flag it, For me the hospital were not savy. If you are really concerned I would call them and ask them to lock your file. The women I worked with never attended the hospital we worked out for this reason.

Where I work we have a mixture of digital and paper notes. Some patients have 8 or more HUGE files of paper notes (thinking here of cystic fibrosis patients).

Anyway, all our admin staff are run off their feet. They wouldn't get a moment to open patient files and if they did it's just to check page one of the next of kin details etc.

Secretaries will have the most access as they type the letter & file them. Again, they will type hundreds of letters a month & are genuinely so pushed for time I can't see them having a good read.

You say your issue is her being a gossip. Why don't you ask for your file to be digitally archived? Then there is an audit trail if anyone accesses it.

I do know of an RN struck off for accessing a colleagues medical record. This was a colleague of mine many many years ago.

I work in a hospital. If the patient is admitted to our ward or have an appointment their paper notes are retrieved and kept in the ward. Anyone working there could potentially read them. So I would say it's definitely possible that she could read them, sorry

I work for a GP surgery and we have access to everything. I know hospital is a different entity but they work off the same internal system. I would ask about this at the hospital.

There is an audit trail and it would show if she’s been nosing.

I'm now a bit more anxious than before. I know this dept she works in are using a paper file for me to record details of treatment, only relating to this specialty. That's fine.

On top of mental health and pre-adoption, I'm now worried about HIV tests. I've had 3 of them.

First was because of a doctor with a needle stick injury. I was in theatre being prepped for a minor op and she accidentally caught herself with a needle that had been used to give local anaesthetic. I was fully awake when it happened and consented to testing so that she could be suitably reassured and be cleared for patient-facing duties sooner. (That's what I was told, anyway)

2nd test was part of pre IVF referral, not to prevent us doing it but for the doctors there to know exactly what issues they were dealing with. Was tested for other things as well at the same time, full std's check and immunisation active (that I'd had chicken pox I think)

3rd was again for IVF when we changed clinics. Our notes were being transferred but they wanted up to date test results. Our consultant worked at the private clinic we were moving to, and was also our NHS consultant. He offered to put the tests through on the NHS side before discharge to save the additional fees (£100 each).

I can see all my test results on my record (EMIS?) that I use to make GP appointments etc. But obviously there are no reasons attached to each test and result, just the name of the test and the result. The same as a test I had for ovarian cancer. I know what they were looking for, but it's just the test name and it's result.

Shit!!! This could absolutely be misinterpreted if she sees 3 HIV tests. with negative results, but it's still weird to have 3. That would be tasty gossip for the school run. Shit shit.

There's nothing dodgy about an HIV test. I've had 2 as part of the standard things they test for in pregnancy.

But would the fact there is no maternity notes, midwife referral etc stick out?

So even if the pre-adoption medical isn't listed, it would look strange as I clearly have never given birth but have 2 kids.

What a nightmare!

If your friend is a receptionist why would she ever have a need to access your medical notes? If she just makes appointments and books people in then she isn't medical staff connected with the treatments and should not need to be anywhere near your notes, paper or digital.

She would also know that being caught accessing information she isn't required to have is instant dismissal and she would not get employed by a medical employer ever again. The risk is too great and she should be professional. If she had access there will be other people she will have access to and you haven't heard her gossip about them hopefully.

I love a good gossip but patients are off limits and I would never consider mentioning any one of them.

The hospital won't hold all your records, just the record of what has happened at that hospital. Medical records in this country aren't all neatly stored together (unfortunately!)

I have to obtain medical records for people as part of my job and you have to apply separately to the GP, any hospital attended, physiotherapists etc and they each just send the records they hold relating to the patient's visit at that place. Your GP will often get copied into letters from the hospital but the hospital don't hold your GP records or records for treatment that took place somewhere else.