Staff as patients

Recently I asked practice managers about how they deal with the situation where staff are registered as patients. It was very interesting to see a wide variety of responses including a couple of technical solutions which I’ll share here.

I’ll say at the start that there is no law involved here and no specific right or wrong way to do this. I’m told that the GMC have specific guidance for doctors registration but I could not find it and so this article does not apply to them.

First of all lets consider the difficulties it can cause. Confidentiality can be an issue, although of course we’d all expect that everyone should maintain an appropriate level of confidentiality as they do for all records, and of course all access to any record is subject to audit – more about this later. The other issue could be favouritism for staff in levels of service. Many of these issues are well described in this article from Medical Protection.

The single most significant factor in responses was the geographical location of the practice, either rural or urban. Or to be precise the distance between the practice and another suitable practice. Practices located in a city or town where there are others within a reasonable distance tended to have a policy of either requiring or encouraging staff to not register where they were employed. Those in rural areas, where employed staff may live close to the practice with no realistic alternative, tended to relay on a policy that staff had to read and follow.

Finally in both EMIS and SystmOne there are technical solutions that can be implemented. As a start simply making all staff aware that any access to a record will create a log and can be audited is a good idea. The EMIS solution is described here, and the SystmOne solution is here.

Overall this can be a sensitive area and for some, depending on location, it can be a challenging one. My recommendation would be to consider the issue carefully and if possible either encourage or require staff to register at another practice. Where this is not possible have a clear policy in place which you discuss with staff and have a look at the technical solutions available. In this respect our Clinical Application Support Team are very willing to help you out and provide advice on implementing them, just log a call to our service desk.

Additional information. I’m grateful to Sarah Powell at Holderness Health for agreeing to share their policy on this issue.