From the case files...

“From the case files” features unusual cases and cases with strong learning points. Here we deal with a common question on the MPS helpline – how to deal with a father’s requests to access his child’s records.

MPS frequently receives calls about access to a child’s records. The most frequent scenario is an estranged father making a request to have access to information or copies of his child’s records. These requests can place practices in a difficult position for the following reasons:

• There is commonly a background of a parental dispute
• Both parents may be patients at the practice
• The motivation behind the request may not be clear
• The potential to get drawn into the parental dispute.

The algorithm below provides a structured approach for dealing with a father requesting access to his child’s records. In relation to non Gillick competent children it is important to establish whether or not the father has parental responsibility. Box A sets out in what circumstances a father would have parental responsibility.

Upon receipt of a request from a father to access the records of a non Gillick competent child, you should explain that in order to deal with his request you would require sight of a relevant document that confirms that he retains parental responsibility

In practical terms, upon receipt of a request from a father to access the records of a non Gillick competent child, you should explain that in order to deal with his request you would require sight of a relevant document that confirms that he retains parental responsibility. This may include a copy of the relevant court document, a copy of a marriage and/or birth certificate, or a letter from the father’s solicitor, confirming that he retains parental responsibility.

Fathers request for accessFathers request for access

*Refer to the Parental Responsibility quick-guide 

**This would not include healthcare professionals who have been involved in the patient’s care 

***If the records are redacted then they should be supplied to the father under the cover of a letter explaining that the records have been redacted to remove third party and/or harmful information

Box A: Parental responsibility – A Quick Guide

The Children Act sets out who has parental responsibility. A father would have parental responsibility in the following circumstances:

• If he holds a custody or residence order for the child
• If he holds an emergency protection order for the child
• If he has adopted the child
• If he is the child’s father and was married to the child’s mother when the child was born
• If he is the child’s father and was not married to the child’s mother when the child was born but:

1. now has a residence order
2. now has a Parental Responsibility Order
3. has made a Parental Responsibility Agreement with the child’s mother
4. has since married the child’s mother
5. (since 1 December 2003) is registered as the father under paragraphs (a), (b) or (c) of sections 10(1) or 10A(1) of the Birth and Deaths Registration Act (1953) or the corresponding law in Scotland or Northern Ireland.

Frequently asked questions

Q. The father requests that he is updated every time his child attends; do I have to comply with this request?

A. If the father does have a right of access to his child’s records then he would be able to request access at reasonable intervals. However, the practice is not obliged to agree to update the father every time his child attends and this may present the following difficulties:

• There may be a significant administrative burden associated with this request
• The practice may be criticised for not informing the father if the child attends and the father is not informed as a result of an oversight
• There may be legitimate reasons why it would be inappropriate to inform the father of a child’s attendance
• If a child becomes Gillick competent then they may object to the father being informed of their attendance. If a father makes such a request, you might wish to encourage him to liaise with the child’s mother in relation to their child’s health (appreciating that their personal relationship may be strained).

Q. Can a charge be made for providing copy records?

A. If the father has legitimate right of access to his child’s records, then his request can be considered as a Data Subject Access request under the provisions of the Data Protection Act (1998). The Act makes the provision to charge a fee of up to £10 for the provision of hard copies of computer records, or up to £50 for the provision of a combination of hard copy computer and/or hand written records. The charges should be commensurate with the costs incurred in relation to the provision of copy records and should not exceed the specified ceiling charges.

Q. The practice has received a Court Order requesting disclosure of a child’s records – should they be provided?

A. The practice would be obliged to disclose the records in accordance with the instructions on the Court Order.

Q. Should the mother be informed that the father has requested access to their child’s records?

A. There is no absolute obligation to inform the mother that the father has requested access to their child’s records, although there may be circumstances in which you would consider doing so, for example, if you felt that it was in the child’s best interests to inform their mother that the request had been made. The key issue is to seek confirmation that the father has a legitimate right of access to the records, in which case disclosure could reasonably be justified with the caveats set out in Box A.

The guidance should assist in relation to addressing most requests from fathers to access their child’s records, but if you have a particular concern about the circumstances of a particular request, then please contact MPS for further advice.

Useful links

• MPS factsheet, Parental Responsibility
• MPS factsheet, Confidentiality – General Principles
• GMC, 0-18 Years: Guidance for All Doctors
• GMC, Confidentiality