You owe a ‘duty of care’ to your patients, your colleagues and other people you come into contact with. Sometimes you may have to report incidents or concerns to your employer, the HCPC, or other body. This is your ‘duty to report’.
Whether you are a physiotherapist, associate or a physiotherapy student, it’s important that you understand these obligations. You must also understand how they link to other aspects of professionalism such as confidentiality, data protection and safeguarding.
This paper covers duty to report obligations from the perspective of the person rather than the duty. The paper is divided into the following sections:
- Your duty to self-report
- Your duty to report others
- Your duty to report specific concerns to protect others
- Where others may have a duty to report you
When do I have a duty to report?
Unlike duty of care, duty to report is not an absolute duty. There may be circumstances where another duty overrides this, such as the duty of confidentiality.
When considering whether you have a professional duty to report a matter, you must weigh up and balance the need to report against the harm of possible over-reporting, or unnecessary reporting, and the damage that can be done to professional relationships or relationships with patients.
You must always have an honestly held belief in your concern, and you should have some evidence to support your concerns.
Do I have to declare cautions and/or criminal convictions?
Yes. The HCPC places an obligation on registrants to make self-declarations of good character. You must declare criminal convictions and/or cautions to the HCPC either before you apply to join the HCPC register, or as soon as you receive the penalty if you are currently on the register.
If you acquire a conviction during your pre-registration physiotherapy programme, you should raise this with your Higher Education Institution (HEI) and discuss any implications that this may have for continuing your studies. You must declare your conviction when you apply to join the HCPC register.
What should I do if I believe my patient is suicidal but they ask me not to report this?
You must remember that a duty of confidentiality does not stop you from sharing information with health professionals ordinarily involved in the care of your patient. In this situation, your duty to report overrides the patient’s right to confidentiality. You should take professional steps to raise your concern as far as you are reasonably able, for example:
- You should try to get the patient to seek help themselves
- You may contact the patient’s GP or psychiatrist, even without the patient’s consent, and raise your concerns
- You must document your concerns clearly in your records
- You must note your concern with a senior colleague
- You must consider if you need to raise an adult or child safeguarding concern
What if I suspect my patient may allegedly be involved in criminal activity?
You have no legal or professional duty to report a patient to the police or other authorities if you believe them to be allegedly committing criminal activity. Your professional duty of confidentiality overrides any moral duty to report.
What should I do if I believe a colleague’s standard of a care to a patient allegedly falls below an acceptable standard?
Concerns regarding an individual’s fitness to practise should first be addressed through supervision and/or mentoring processes, which may feed into the appraisal and performance review cycle. Concerns may also be managed by the employer’s capability procedures.
What should I do if I feel my patient is a danger to drive yet they continue to do so despite my advice?
A driver is legally responsible for informing the Driver Vehicle Licensing Agency (DVLA) of any heath or medical condition that may affect their ability to drive. If a patient fails to make a health notification they may be subject to a substantial fine. The DVLA publishes clear guidance that states that a doctor may breach patient confidentiality to inform the DVLA if a patient is still driving when it is unsafe to do so. There is no duty on any other health professional to report a driver to the DVLA if they fail to self-notify.
If you believe your patient is continuing to drive when it is not safe to do so, you should seek to ensure the patient understands your opinion, and makes a self-notification. If they will not do this, you may highlight your concerns to the Consultant or GP involved in the patient’s care for the doctor to decide if a medical DVLA notification is required.
What do I do if I have a safeguarding concern about one of my patients?
You must raise your concern with your relevant adult or child safeguarding lead in your organisation. If you do not have an organisation lead, you must contact the Local Authority safeguarding contact. They will review all the information provided and make a decision if the matter needs to be formally reported and escalated. Safeguarding is a statutory obligation and your duty to protect patients and/or service users from all forms of abuse, harm and/or neglect overrides any duty of confidentiality.