Confidentiality and Disclosure Questions

Nurses hold a great deal of private information, and patients trust that it stays private. The Code makes confidentiality a professional duty, and the CBT tests whether you understand both the rule and its limits.

The default is simple: patient information is confidential. The harder skill, and the one the exam probes, is knowing the narrow situations where you can share it, and how much.

The three lawful grounds

You can disclose confidential information when one of these applies:

• The patient consents to the sharing.
• The law requires or permits it, such as a court order or a notifiable disease.
• Disclosure is justified in the public interest, to prevent serious harm.

If none of the three applies, the information stays confidential, however reasonable the request feels and whoever is making it. A police officer asking, a colleague curious about a former patient, a relative wanting an update: none of those is a lawful basis on its own.

Need to know

Sharing inside the care team is legitimate, but it is bounded by the need-to-know principle. The team treating the patient gets the information relevant to that care, not the whole record and not idle detail. Discussing a patient with staff who are not involved, or anywhere you can be overheard, is a breach even when you mean well. A surprising number of B1 questions are really about where and to whom you are talking.

The public interest test

The hardest questions describe a patient whose choices put someone else at risk: the driver with uncontrolled epilepsy who will not inform the DVLA, the person who threatens serious violence. Here confidentiality can yield. You try persuasion first, then disclose only to the body that can act, and only what is necessary to prevent the harm. Proportion matters: telling the right authority is defensible, telling an employer or posting publicly is not.

One point catches people out: the duty does not end when a patient dies. Access by relatives runs through specific legal routes, not an automatic right. Next: record keeping. Five confidentiality scenarios first.