Ethics Guidance for Occupational Health Practice 9th Edition - Book - Page 63
3.113. Within occupational health practice, such situations may arise where a worker’s
health poses a significant risk to others and the worker refuses consent for
disclosure. Examples include fitness to drive concerns, bloodborne viruses in
healthcare workers, psychotic illness associated with a risk of violence, or
substance misuse within safety critical roles. Every effort should be made to
obtain the worker’s consent unless seeking consent would undermine the
purpose of the disclosure. Any consideration of breaching confidentiality should
follow discussion with senior colleagues and/or an appropriate professional or
indemnity body.
3.114. Any disclosure must be limited to the relevant authority — for example, the
Driver and Vehicle Licensing Agency, the police, social services, the Health and
Safety Executive, or the employer. The practitioner should document the
rationale for breaching confidentiality, any steps taken to encourage the worker
to disclose the information themselves, and the reasons why this was not
possible (for example, in an emergency).
3.115. GMC guidance emphasises that any public interest disclosure must comply
with the law, be restricted to the minimum information necessary, be shared
securely, and be communicated in a transparent manner so that the individual
is informed that a disclosure has been made and why. Equivalent expectations
are set out in NMC and HCPC standards, which highlight the need for
lawful, proportionate and accountable information sharing.
Disclosure where there is a risk to the health and safety of others
3.116. When a worker performs safety critical duties, an occupational health
assessment may identify a health issue that prevents them from continuing in
that role, temporarily or permanently. Clinical details should not be shared with
the employer without consent. However, if it is necessary to protect the safety
of coworkers or the public, a statement of fitness to work may be provided
without consent. The worker should be informed that this disclosure is being
made. This principle also applies where there is a statutory duty under health
and safety law to inform an employer of a risk.
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