Taking and using pictures and recordings of patients

The guidance covers photos, videos and recordings of patients of all types. The guidance reflects the basic principles of the GMC guidance on making and using visual and audio recordings of patients.
Location: UK
Audience: All doctors
Updated: Wednesday 22 January 2020
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Audio and visual recordings form part of the patient’s medical record and the same standards of confidentiality apply.

Download our full guidance for full details.

Recordings made as part of a patient's care

The GMC identifies six categories of recordings where consent is not needed separately:

  • images of internal organs or structures
  • images of pathology slides
  • laparoscopic and endoscopic images
  • recordings or organ functions
  • ultrasound images
  • x-rays.

Anonymous recordings

Anonymous recordings may be disclosed for use in research, teaching, training, or other healthcare-related purposes, without consent. You should explain that to patients and record it on their record.

Images, when used with a case history, could make a patient identifiable and require permission.

Making a recording anonymous

Other images or recordings may be anonymised by removing identifying details.

Anonymisation must be effective; eg simply putting a bar across a patient’s eyes would not be sufficient.

Apparently insignificant details may still be capable of identifying the patient. Extreme care should be taken before using them without consent in journals or other learning materials.

Seeking consent

The making of other recordings and images which contribute to patient care, and which fall outside the list above, generally require express patient consent.

You should seek consent and keep it on the patient's record.

BMJ - patient consent form

 

Recordings for patient care for adults who lack capacity

Where adults lack the capacity to consent to an identifiable recording for treatment, agreement should be sought from someone with the lawful authority to consent on their behalf.

Where no individual has legal authority, it may be in the patient’s best interests to discuss with family or friends close to the patient.

Where there are no family members or friends available or willing to be involved or where treatment must be provided immediately, recordings may still be made where they form an integral part of an investigation or treatment.

Where a recording has already been made as part of the patient’s care, but may also be of value for a secondary purpose, the recording should be anonymised wherever possible. 

In the BMA’s view, it is difficult to see how identifiable recordings used for secondary purposes could be in the individual’s best interests. Legal advice should be sought on a case-by-case basis for the use of identifiable recordings for reasons other than treatment and research.

 

Recordings for use in public media

Public media includes television, radio, internet and print.

In general, the rules relevant to making recordings for secondary purposes also apply to recordings for use in widely accessible public media.

No identifying material may be used in textbooks or journals, or used for teaching without express patient consent (in writing). 

Withdrawing recordings later

Patients should understand that, once material is published, it is unlikely to be possible to withdraw it.

If patients wish to restrict the use of material they should get agreement in writing from the programme maker and owners, before recording begins.

The BMA takes the view that consent should be periodically renewed, giving the option to withdraw material from use or limit its future use. Especially young people.

Read the full guidance for further details.

 

Phone and audio recordings

The monitoring of phone calls is subject to the Telecommunications Act 1984, which ensures that every effort is made to inform callers that their call might be recorded.

Callers to GP practices and to medical advice lines should be informed that their call may be recorded. Covert recordings of calls from individual patients should not be made.

Medico-legal purposes

Phone calls can be recorded for medico-legal purposes. Patients need to be told that conversations are being recorded and why. A failure to do so could mean that these recordings are unlawful. Information should also be available concerning how long recordings are kept and how patients can access them.

Sharing recordings

The BMA encourages doctors to share information with patients whenever possible. Recordings form part of the patient’s medical record, and could be accessible under GDPR.

Consultation recordings

​The BMA supports patients recording a discussion with a healthcare professional when a diagnosis or course of treatment is being discussed. It can help patients to understand and recall facts. 

 

Making recordings covertly

Patients should be informed of any use of CCTV.

There may be exceptional circumstances where covert surveillance is acceptable if there is no other way of obtaining information which is necessary to investigate a serious crime. It could also help to protect someone from serious harm, eg if it's suspected a child is being harmed by a parent or carer.

Authorisation must be sought from a relevant body in accordance with the law.

 

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Deceased patients

The duty of confidentiality continues after a patient has died. If a recording was made of a patient, doctors should follow a patient’s known wishes after their death. 

If the recording will be in the public domain or the patient is identifiable, consideration needs to be given to asking the patient’s family. Legal advice should also be sought.

 

Storing and disposing of recordings

Recordings made as part of the patient’s care form part of the medical record and must be treated in the same way as other medical records

For recordings made for secondary purposes the GMC advises that doctors must be satisfied ‘that there is agreement about the ownership, copyright, and intellectual property rights of the recording’. Further advice can be sought from a Caldicott Guardian.