Audio-recording your consultations with NHS doctors

[nolegion]

I missed this broadcast and would much like to listen to it via iPlayer. Which day was it on, please, Sali/HB...

[honeybee13]

I didn't hear it either, NL, but it looks as if it was yesterday.

 

http://www.bbc.co.uk/programmes/b07m4d57

 

HB

[Guest]

cheers honey for the link

a virtual rep to you (i have to spread it around first )

[honeybee13]

cheers honey for the link

a virtual rep to you (i have to spread it around first )

 

Thank you Ford.

 

HB

[Sali]

That's really antiquated, isn't is, Sali? You'd think the DWP were being deliberately obstructive.

 

HB

 

 

 

Yes, I do think the DWP are being obstructive. My guess is that they know they cannot ban audio recording outright, so have made it so difficult for people that it becomes impossible for the majority. Still, I want to know, is it legal? I know what my advice would be to anyone attending such an interview - record covertly. I know it's difficult to predict our legal system, but I hope that if it ever came to it, a court would accept the recording as evidence. More likely, is that the DWP would cave in prior to any hearing to prevent a precedent. Cowardly, but predictable.

[Guest]

sali

any evidence cld be admissable, if deemed relevant and not specifically excluded (by way of legal provision, not a self 'guidance'), at a courts direction.

so whilst their guidance says xyz, if a matter ends up in court etc then it is up to the applicable rules of evidence, not their 'guidance'.

[Sali]

The problem is that most people will accept the DWP's rules and not have a recording to take to court - exactly as the DWP intended.

[Guest]

you're right. and the onus shldnt be on an individual to produce copies for the dwp/public authority.

and the signing of an agreement! such an agreement wld have to be legally scrutinised. i wonder if there is a copy draft of such available for scrutiny.

[BELINDA1066]

I believe that you must declare and get the consent of the people you are recording if you want to use it as evidence in any future legal proceedings. I don't think it a bad idea in the scheme of things. A patient could re-run the recording to confirm or clarify information that often flies past them during a consultation. I cannot think of why a consultant would refuse unless he has doubts about his/her own ability - I guess it could both damn and help them in a case of litigation.

 

As far as i am aware covert recordings cannot be used as evidence in a Court, but can on occasions be used in tribunals

[Sali]

Hi Belinda1066

 

 

I think it has now been established that covert recordings pertaining to a case can be accepted in court, and quite rightly. It is perfectly legal to covertly record a consultation in this country and there may be many reasons why a person would choose to do so.

 

 

On a different subject, I see the NHS is issuing some staff and Guys and St Thomas' with bodycams. It is not clear to me whether they will be operational all of the time or only when things get a little hairy with abusive patients.

[My Turn]

I know what my advice would be to anyone attending such an interview - record covertly. I know it's difficult to predict our legal system, but I hope that if it ever came to it, a court would accept the recording as evidence.

 

In order to avoid protracted arguments about the admissibility of an audio recording, it may be simpler to write up the consultation by hand while using the audio recording as a reminder of what took place.

 

If you subsequently need to rely on the recording as evidence then it could be produced but if it gets contested and declared inadmissible, you still have your detailed written notes as a sort of evidence.

 

I have to confess I'm no expert on the rules of evidence but that is what I would do.

[Kartnin]

If I record a nurse who visits me at home then do I have the same rights to record as I would have to record a doctor's consultation?

 

Does the appropriate nursing body back up a patient's right to record in the same way as the GMC and medical insurers do?

[Sali]

Cannot think why not if it's only for your personal use, although I'm no legal expert. Many people have security cameras around their homes now (I'm guessing you only want audio) and we have seen that relatives, concerned for vulnerable relatives, are increasingly installing them too. Are you intending to ask permission? Personally, I would keep it covert, just in case it caused a problem that would affect your care. I've often struggled to understand the logic of the NMC decision making. It seems to prefer persecuting justified whistleblowers, than trying to solve real issues.

[My Turn]

I recently bought a small dictation machine and am thinking of getting another like it (I use two recorders in consultations with one in full view and the other hidden away as a back up.)

 

My model of recorder come in shiny black or silver and I was wondering which colour people think is the most non-threatening to the doctor when put on the table and left in view.

 

SHINY BLACK seems self-effacing but on the other hand it could look a bit purposeful when you started looking at it.

 

SILVER seems a bit more eye catching although when you start looking silver seems more friendly and less-purposeful.

 

Thoughts please.

[Guest]

which colour people think is the most non-threatening to the doctor when put on the table and left in view.

zebra

[My Turn]

zebra

 

 

That might look a bit like a tiger. Heh heh!

 

 

.

[Sali]

I'd go for the silver on the desk. Black is less conspicuous and more easily concealed.

[My Turn]

I'd go for the silver on the desk. Black is less conspicuous and more easily concealed.

 

I was thinking that too. I've gone for the silver one.

[My Turn]

You may be interested in an article by Rich Cahill in which he offers advise to doctors as to how to avoid letting patients record them. It's worth reading the original article to see the way he develops his rather strange argument. Here are a couple of quotations.

 

"Despite these potential benefits, it’s typically not the best course to allow patients to record the appointment."

 

"It is recommended that patients be advised unequivocally that digital recordings by handheld devices, such as smartphones, are prohibited on the premises in order to protect the privacy of other patients and staff in compliance with federal and state privacy laws."

 

https://thedoctorweighsin.com/what-to-do-when-patients-want-to-record-their-doctor-visits/

 

Cahill goes on to suggest that policies could be developed which would prohibit recording! He writes as an American and I can't say how many of his suggestions would be permitted here. The author is completely ignoring the extremely useful ability to recall exactly what was mentioned in the consultation which a recording provides. Not one of Cahill's arguments to prevent a recording can match the importance and usefulness of this for the patient.

[nolegion]

Hi, My Turn. Family reasons have kept me from contributing much online recently, but you have spotted an occasion where I did.

 

That article really got my goat, and so I aimed a comment under it at the unprofessionalism and futility of such approaches. As things turned out, another commentator soon produced a more potent argument (at least in America) which I really liked. Yup, where healthcare is a contractual purchase, not a statutory entitlement as here, patients will sooner or later vote with their feet on this matter, and that’s where it will hurt the relevant doctors most: in the wallet.

[nolegion]

Yesterday, the Times carried two medical articles on two different pages, without any linking comment.

 

1. The first was headlined ‘ Doctors who trained abroad ”far more likely to be incompetent” ‘

 

Sources and some statistics were, of course, cited, and those included the GMC’s own records. Irish-trained, twice as likely, apparently. Bangladesh-trained, 13 times more likely, it is suggested.

 

2. The second article was entitled ‘Medical schools turn down 770 straight-A applicants’. It went on to explain that there is ‘a shortage of doctors in the NHS’, and:

 

“The government says it must restrict places because it takes £230,000 to fully train each doctor. Last year the NHS was forced to hire thousands of foreign doctors to fill jobs.’

 

But, surely, I hear you say, there is a grotesque ‘disconnect’ between these reports and the fact that history shows it costs billions of pounds in compensation and legal fees to deal with medical bungling and unprofessionalism, and the protracted bullying, cover-ups and deceit which, always, follow (not to mention the human cost)? Can’t the government ‘think ahead’?

 

Wrong, my friend: it already has. It removed legal aid from people claiming clinical negligence against the NHS in 2013, the miserable down-the-line effecs of which will be showing up good and soon. Problem solved: cash saved and history can be rewritten.

 

………………..

 

I acknowledge this has nothing (directly) to do with the topic I started, some years ago now. It just hit my ’rant-button’ yesterday, and I didn’t think that merited a separate thread in this forum.

[Guest]

don't tell me you voted brexit on the (false) 'promise' of all that extra money for the nhs

[nolegion]

LOL! No, I am not of that persuasion...

[Guest]

i was only jesting around....nothing personal.

if only brexit wld end up giving more to the nhs, but the reality is that it won't. and, as has been seen already, lots of nhs closures/cutbacks already despite impending brexit. and not just re the nhs.

recently saw an article re a gp/nhs doc saying that 'private' wld be the only way forward. can't recall where atm. think it was in 'pulse'?

[nolegion]

I regret to say that does seem to be true nowadays, Ford. Indeed, some say that through progressive ‘outsourcing’ and ‘subcontracting’ the privatisation process is already under way.

………………………………………………………………………………………………………..

 

Spring is in the air. Three pieces of commentary, bang on topic and committed to - in my view - sensible ways of thinking about it, have caught my attention so far this April:-

 

1. The first is in the form of a podcast by the Wall Street Journal which is only 6 mins long (& the ‘auto-type’ version, in a rare Klingon dialect, is unreadable.) The publication of this podcast a few days ago presents an interview which apparently largely re-hashes an article Dr. Gurpreet Dahliwal wrote about a year ago.

 

However that comes about, it is a calm and welcome discussion, in my opinion.

 

See:

 

WSJ Journal Report

Should Patients Record Their Doctors' Visits?

4/12/2017 11:17AM

 

http://www.wsj.com/podcasts/should-patients-record-their-doctors-visits/5E40D4E9-A22A-49BA-89AD-B26EB7FE87C9.html

 

2. Thinking of recording dental consultations?

BY LEO BRIGGS ON 13 APRIL 2017

http://www.dentistry.co.uk/2017/04/13/thinking-recording-dental-consultations/

 

which opens with:-

 

“ If a patient asks to record a consultation – do not assume the worst and think the patient does not trust you or is trying to ‘catch you out’, that’s not necessarily the case. In fact, a patient recording the consultation might actually be to your advantage. There’s often so much discussed in a consultation that the patient might not take it all in, so a recording can help to ensure they don’t miss any important information.

 

Moreover, recording a consultation also means the patient can go home and watch or listen to the recording in their own time, consider the risks and benefits of the different treatment options and make an informed decision.”

 

It might be worth remembering that when online discussion of our topic was still fairly new and scant some years back, it was one of the dental defence unions which published an early, succinct, positive and (well, very nearly) legally accurate response for all to see. Glad to see the profession is still on the right track. I think I may have mentioned before that when I brought the subject up with my own dentist long ago, he was entirely relaxed and accommodating about idea.

 

3. In many ways the most significant commentary, I think, came from no less than The Royal College of Physicians, and I suggest this really is another milestone. An article they published this month concludes:-

 

“If a doctor practises in a professional and responsible way, any recording should act in their favour. Surveys of patients have found that they record consultations for a variety of reasons; the British Medical Association suggests ‘usually it is to help them remember and cooperate with important advice or share it accurately with family members’.4 Patients who recorded covertly suggested that they did so because of previous negative reactions from clinicians.

 

So what should you do if a patient asks to record a consultation with you? GMC advice is that doctors must ‘make sure, wherever practical, that arrangements are made to give the patient any necessary support… using an advocate or interpreter; asking those close to the patient about the patient's communication needs; or giving the patient a written or audio record of the discussion’.

 

As a doctor, we owe a duty of care to patients, whether they wish to record consultations or not. It is best for the patient-doctor relationship if any recording is upfront. However, if a patient covertly records a consultation, rather than feeling that trust has been irreparably broken, it is more helpful to explain why you feel uncomfortable and to explore the patient's reasons for making the recording. Such recordings are legal and look set to become ever more common.” (Emphasis mine)

 

Refer:

 

Setting the record straight: patient recordings of consultations

 

1. Niall O'Hara, Foundation doctor,

2. Lily Walkergp, trainee and

3. Kanwaljit Singh, Elderly care consultant

 

http://www.clinmed.rcpjournal.org/content/17/2/188.full

 

It says nothing new – but good on the authors for saying it clearly, where and in the manner they have. (PS. Dear authors – just in case any of you should stray this way: I note that each of you acknowledges an ‘affiliation’ to or with Birmingham City Hospital. I’ve had a look at the website of the NHS Trust which operates it. No policy for patients to read about recording consultations. Give ‘em a jog?)