Recording patient calls

AS the number of patient telephone contacts continues to rise, primary and secondary care providers are increasingly opting to record these interactions for future reference.

This raises all kinds of questions over confidentiality and data protection, and members frequently contact our advice line for guidance. Common queries focus on the right to record calls and whether patients must be informed that recordings are being made. The Information Commissioner’s view is that "individuals should generally expect that an organisation will keep a record of the call. This could be by recording the call itself or by making notes."

But that is only part of the issue. The interception, recording and monitoring of telephone calls is governed by a number of laws and regulations, the most important of which is the Data Protection Act 1998 (DPA).

Where an organisation is able to identify the callers, compliance can be achieved by:

• Informing the other party how the recording will be used.
• Obtaining permission for the call to be recorded.
• Keeping recordings secure.

There are numerous reasons why call recording might be used, such as:

• Providing evidence of a transaction.
• Ensuring compliance with regulatory obligations.
• Ensuring quality standards or targets are being met.
• Prevention or detection of crime.
• Training purposes.
• Quality monitoring.

A common reason practices use call recording is where telephone consultations are carried out. This entails a clinician assessing patient symptoms and concerns before decisions are made about appropriate care pathways. Detailed written documentation of such calls is added to the patient’s notes. Where digital audio files of the consultation are made, they also form part of the patient record and can provide useful additional information. They can be particularly helpful in responding to complaints or allegations of negligence where disputes arise over the nature of the advice given.

The ICO (Information Commissioner's Office)provides advice on best practice for organisations who wish to record telephone calls which includes: posting warnings in literature, terms and conditions, letterheads and on websites. It may also be wise to include an automated message alerting callers before they are put through to the relevant department. The General Medical Council’s Good Medical Practice guidance warns clinicians they should "take all reasonable steps to inform callers that their call may be recorded" and "must not make secret recordings of calls from patients".

Patients who have been recorded (or are concerned they may have been) have a legal right to request a copy of these recordings under the DPA. This is known as a "subject access request" and applies to all businesses who record personal information. Failure to supply call recordings when required is a breach of the DPA and can be reported to the regulator. Such a breach can result in a fine from the ICO.

As a matter of best practice, an organisation that intends to monitor and record telephone calls should:

• Use pre-recorded messages to notify patients and all other callers that calls may be monitored and recorded, and the specific purposes for the recording. If pre-recorded messages are not possible, they should ensure telephone operators notify callers of this information at the outset of a call. For example, GPs responding to patient call-back requests would be advised to inform the patient that the call is being recorded as part of the documenting process for their medical record.
• Add suitable wording to terms and conditions or website contact details. For example: "We may monitor, record, store and use any telephone, email or other communication with you in order to check any instructions given to us, for training purposes, for crime prevention and to improve the quality of our services."

ACTION: Take all reasonable steps to ensure patients are aware of call recording and be aware of the requirements of the Data Protection Act as well as other relevant professional regulatory guidance.