Can I ask for some legal brains to input on an issue about confidentiality?

[Al1Langdownthecleghole]

Not a TAAT but the thread below about recording maternal alcohol use has moved onto a discussion about maternal health records being automatically transferred into child health records, and a few of us are having a woah there moment.

I'm coming at this from a healthcare POV, not a legal one and would be very interested to know what legal people think.

Would anyone have time to pop over and take a look? It's mainly the last third of the discussion.

Thanks in advance.

Mothers alcohol use shown on medical records www.mumsnet.com/Talk/womens_rights/4025308-Mothers-alcohol-use-shown-on-medical-records

Mothers alcohol use when pregnant obviously impacts on the baby and needs to be in their records surely, same as drug use.

Every time I've seen the paediatric team (random kid stuff) they've wanted family history, which is not a problem for me. Even as an adult family history is taken, including for pregnancy management (family hx of pre-eclampsia/premature birth) so if parents would be happy to consent to their history being linked (express written consent) would probably be useful.

I'd assume that the detailed notes taken of relevant family history stay with the child's ongoing notes... so how different is having accurate first hand notes rather than vague memories.

Disadvantage would be need to repeat link (plus consent) as parent's history changes.

The discussion stems from some posters claiming that full maternal health records are automatically integrated into the child health record when they are created.

I'm not yet certain that these claims are true, but if those posters are correct, then it raises the possibility that when a child reaches adulthood they could access their health records and by default their mothers confidential medical history.

I'm an HCP myself and very much in favour of convenience, this seems a step too far though.

The other worry is if the father accesses the childs notes.

I've always been asked for both parents' histories... would be happier if both parents were included rather than just the mother's history - because clearly with only 1 parent present any hx from the other side will be less accurate...

@fluffyjumper

The other worry is if the father accesses the childs notes.

Oh shit. I hadn't even considered that one.

When parents are asked about their histories it is when it is relevant to their child's care, and so usually something parents are happy for the child to be aware off

If maternal notes are transferred to child records, at adulthood, that child could discover their mother had previously had an abortion for example, that she had not disclosed.

The discussion stems from some posters claiming that full maternal health records are automatically integrated into the child health record when they are created

They aren't. There is a separate maternity system Euroking used in some areas used to record antenatal, delivery, and post natal info for the mother and baby whilst they are accessing maternity services. Initially just the mother has a record but once the baby is born and whilst still under maternity services the two records are as one.

When you register the baby with the GP a new separate record is created for the baby. Included on this record will be the birth information letter from wherever you gave birth, which will say e.g 'natural labour, no interventions, etc etc'. So information about the baby's birth that may be relevant in the future to the treatment of the baby rather than information about the mother.

If a child is under child protection for any reason in the early days then the maternity notes from Euroking which combine mother and baby might be accessed and used as evidence for any pre-birth concerns etc. For the vast majority of people though these maternity notes never see the light of day outside of maternity services.

Thank you hatgirl That's the bit I was after. And I'm very relieved that it isn't the extensive information that was being suggested.

@Al1Langdownthecleghole

The discussion stems from some posters claiming that full maternal health records are automatically integrated into the child health record when they are created.

I'm not yet certain that these claims are true, but if those posters are correct, then it raises the possibility that when a child reaches adulthood they could access their health records and by default their mothers confidential medical history.

I'm an HCP myself and very much in favour of convenience, this seems a step too far though.

@Al1Langdownthecleghole it’s not true that all records are automatically integrated. Relevant information (ie ante natal concerns) may be put in the child’s record as required on a case by case basis.

When notes are accessed by a patient or their parent certain information may be redacted. Hopefully this type of information would be but I have no personal experience of that