Confidentiality Statement
1. Introduction and context
1.1 CALM provides a freephone helpline service targeted at but not exclusive to young men who need support and information for a variety of reasons. A person centred approach is adopted and callers are not routinely asked for personal information. The service is promoted as confidential and anonymous.
2. Key partners and personnel
2.1 CALM is an independent registered charity, no 1110621 registed on 28th July 2005, funded by donations and grants.
2.2 the Essentia Group – operate the helpline and online service.
2.3 Local Commissioners of CALM - Co-fund CALM's local activity and contribute to the helpline's development.
3.0 Legislative framework for CALM's confidentiality policy
3.1 The policy and its implementation must meet the relevant legal requirements on which the Caldicott guidelines are based, and in particular:
3.1.1 The Data protection Act and the Freedom of Information Act
3.1.2 The Childrens Act
3.1.3 The Prevention of Terrorism Act
Training for the EG CALM team includes the relevant elements of this legislation.
3.2 There is a legal requirement to report suspected acts of terrorism.
3.3 In order to breach confidentiality under suspicion of a crime, the guidance suggests there has to be death or risk of death involved in the crime - defined as a 'serious arrestable offence as defined in the police and criminal evidence bill'. This is an ethical decision for CALM and it is anticipated that very extreme and serious circumstances would be necessary to breach confidentiality in this case.
3.4 There is no requirement in law to support the decision to breach confidentiality with knowledge of possible suicide or self-harm. It is an ethical decision for CALM, and the caller should always be given the option that CALM can disclose information to a 3rd party if they choose and consent to this.
3.5 Ethically, breaches of confidentiality relating to suicide attempts and physical violence to self should only be considered if there is a serious or imminent risk of death or the caller specifically asks for his/her details to be passed to a 3rd party.
4. Statement and definition of confidentiality for CALM
4.1 CALM is committed to providing a confidential service to its callers and the confidentiality policy is based on the principles that all callers deserve the right to confidentiality to protect their interests and safeguard the CALM service.
4.2 CALM understands confidentiality to mean that no identifiable information regarding a caller shall be given directly or indirectly to any third party external to the helpline operator staff (EG CALM team) - advisors, duty managers, team leaders, the CALM account manager and Chair of EG; confidentiality resides within the EG CALM team rather than with individuals.
4.3 Identifiable information about a caller is not routinely collected. CALM does not have access to caller display or any other automated call information collection facility and therefore no personal details or details about the location of the caller are known to CALM other than information cited in the course of the call.
4.4 Information about the types of calls CALM receives and how callers have been supported are more widely distributed outside the EG CALM team among all key partners (see 2 above), though as no identifiable information is collected this information is anonymous.
4.5 CALM will endeavour to protect the confidentiality of the caller at all times. The caller is entitled to a confidential service from CALM, but also the option for CALM to disclose information to a 3rd party at the caller's request. The caller will be offered this choice when appropriate (see 4.6)
4.6 It should be noted that CALM's advisors will use their skill and judgement in offering the caller the choice to disclose information about the caller to any 3rd party outside the EG CALM team and consent will always be sought from the caller in this case.
4.7 No individual alone will take the decision to disclose information about a caller to a 3rd party. In all circumstances where a decision about whether to disclose information is considered, the CALM advisor taking the call will not take this decision alone. The duty manager will be summoned to take this decision on the advice of and in consultation with the CALM advisor taking the call.
4.8 In all cases where a decision about whether to disclose information to a 3rd party is considered - even if the decision is not taken - the decision taken and call history will be recorded in order to monitor the policy and support future reviews.
5. Breaches of confidentiality for CALM
5.1 There may be occasions when considering the moral grounds, legal context and principles of good practice, the nature of information revealed in the course of a call demands that absolute confidentiality for the caller or any other parties cited by the caller cannot and should not be maintained.
5.2 It is accepted that these will be exceptional and extremely unusual situations and that the caller may have been supported by the CALM advisor prior to considering a decision to breach confidentiality. These circumstances relate to the following:
5.2.1 Attempted suicide where operator believes there is a serious or imminent risk of death
5.2.2 Physical violence against oneself (self-harm) where operator believes there is a serious or imminent risk of death
5.2.3 Physical violence against others where operator believes there is a serious risk of death
5.2.4 Illegal acts against minors (child abuse)
5.3 Consent - consent should always be sought from caller before disclosing information to a 3rd party. However, there are
instances where consent is not ultimately required:
5.3.1 Prevention of Terrorism - disclosing information to a 3rd party about acts of terrorism will not require the consent of the caller. This does not constitute a breach of CALM's confidentiality policy.
5.3.2 Risk of harm or death to self or others - In situations relating to a risk of harm or death to others, as defined in 5.2, the caller's consent is not required. The operator will need to make a judgement as to whether or not the situation is serious enough to warrant breach of confidentiality with or without consent.
5.4 If a breach in confidentiality is to be considered it must be remembered that:
5.4.1 These occasions will be extremely rare
5.4.2 A decision to breach confidentiality will not be taken by one individual alone
5.4.3 Breaching confidentiality is a last resort, and should be as limited as possible
5.4.4 Records about the circumstances under which confidentiality is breached should be completed fully
5.4.5 All the EG CALM team must work within the law
5.5 If a breach in confidentiality is to be considered, it is the responsibility of the CALM advisor taking the call to seek assistance from the Duty Manager at EG. The decision to breach confidentiality will be taken by the Duty Manager at EG on the advice of and in consultation with the CALM advisor taking the call. All circumstances relating to this decision will be recorded by the Duty Manager.
5.6 The responsibility for authorising a breach of confidentiality lies with the duty manager and nominated Caldicott Guardian at EG to disclose the information to the relevant 3rd party, according to the EG CALM procedure notes. Relevant 3rd parties are:
5.6.1 Police
5.6.2 Social Services
5.6.3 Ambulance Services
5.7 In any case where confidentiality is to be breached, the caller must be informed and consent sought in the first instance, unless this would involve the users or someone else's life being put at risk. The caller will be advised of what action is to be taken by the CALM Advisor taking the call in line with the guideline scripts which meet the requirements of the Data Protection Act.
5.8 In the case of information about another party cited by the caller, the above 5.1 - 5.6 also apply. Confidentiality of 3rd parties mentioned by the caller shall be breached without consent under the circumstances defined in 5.2. In such cases it should be made clear to the authorities that details are unsubstantiated 3rd party reports, and the source of the information and reasons should be stated.
5.8.1 In cases where the caller provides information on a third party but will not provide information on caller (i.e. caller wishes to remain anonymous), then confidentiality of 3rd parties may still be breached, as above.
5.9 Training for the EG CALM team includes practical case-studies and instances when a breach may be necessary.
6. Monitoring and review
6.1 Supporting documentation should be completed in every instance where the decision to disclose information to a 3rd party is considered.
6.2 This policy will be reviewed at 6 months from initial implementation and every 12 months thereafter. All reviews should include a written report from The Essentia Group on the number of breaches that have occurred over each reporting period (as well as cumulative breaches as the reports progress over time).