Audio-recording your consultations with NHS doctors

[nolegion]

Trying to ensure the production and preservation of accurate and timely medical information. A few suggestions:-

 

1. Insist on receiving copies of all communications between heathcare professionals in respect of you as a patient, as and when you become aware they are likley to be sent. The DoH ‘policy’ can be found here:-

 

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4086054.pdf

 

In my analysis, this policy ‘right’ was created in fear of a statutory right being created if it wasn’t. But it’s funny how seldom this free entitlement is clearly and prominently spelled out in practice leaflets\hospital brochures etc.

 

2.1 From GP to specialist: make sure it is a copy of the dated letter as sent, not of an unaddressed\ undated draft which you may well otherwise be offerered. Nothing stops you writing to the specialist adding to or contradicting anything you don’t think is properly stated in the letter of referral. Take a further copy of your letter with you to the appointment with the consultant (in three years time) just in case it somehow didn’t get onto your hospital notes first time.

 

It should perhaps be added that GPs hate this because, amongst other things, you will get to see how much time elapses between your appointment with them and despatch of your copy of the letter to the consultant - and consequently just how far the GP letter has been ‘routinely’ back-dated, which it will be.

 

2.2 From specialist to GP: I have some experience of consultants\hospital based-staff trying to create ‘difficulties’ for patients who ask to be sent copies directly, particularly of test results (eg. biopsy\endosocopy etc)

 

After all, the system for this is that you can only find out if you have eg cancer by hanging on the telephone for ages during (limited) working hours eventually to be met by a rude and offhand secretary saying, ‘ It doen’t seem to be in yet, try wasting more of your and your employer's time later’, while in fact the result has been sitting on the golf-playing GP’s ‘side table’ for several days but it’s a bit ‘iffy’ and requires a letter to you which the GP can’t be bothered to write yet - isn’t it?

 

No. If you meet any resistance at all eg.”Can’t really do that, you see it’s not a really a letter as such, just a print-out”, or ,“We have to write back to the GP first - you see the professional position is that you are actually referred by them,” declare a communications embargo: tell the consultant\hospital thatyou forbid any communication, letter, telephone-call, follow-up of any sort, except directly to you. You are fully entitled to do this, and even if you are feeling pretty ‘ropey’ the shock value will rouse your spirits.

 

See the General Medical Council’s publication ‘Good Medical Practice’ para. 52:

 

“52. If you provide treatment or advice for a patient, but are not the patient's general practitioner, you should tell the general practitioner the results of the investigations, the treatment provided and any other information necessary for the continuing care of the patient, unless the patient objects.”

 

http://www.gmc-uk.org/guidance/good_medical_practice/working_with_colleagues_sharing_information.asp

 

The idea, of course, is promptly to re-arrange the consultant’s ideas about sharing information i.e promptly to send you a copy as originally requested - but I wish I had been a fly on the wall in the appointment with a rude an arrogant (and medically wrong) little GP with whom a patient of my acquaintance discussed a test result which the patient held but the GP had not seen.

 

3. Of course, record all your appointments. Of the many, many reasons which patients may have for wishing to do this, the evidential power of a recording of how you have been treated cannot be overemphasised in ensuring the accuracy of medical records.

[nolegion]

This is from a U.S webite to which I had better not provide a link. It’s entirely ‘free,’ but it includes advertisement of its corporate enterprise, which might be thought to infringe CAG rules. Be that as it may, I don’t see how it can be faulted for the advice presented - in principle.

 

In practice, I think it remains to be seen how quickly practitioners, on either side of the Atlantic, are in fact going to grow up and accept that patients have a perfect right to record how they are treated (no matter why patients might wish so to do, cancer or otherwise).

 

“…

Tape record your doctor’s appointment

 

Patients that are going through the many treatments to slow, control or eradicate cancer are stressed, exhausted and not able to remember many of the conversations they have throughout a rough day. Doctor appointments can flood you with information that is hard to remember and may be vital to your health and your treatment. Tape record your doctor’s appointment to have a recording that you can replay several times to be able to receive all of the information you were given.

 

Stress, exhaustion and medications sometimes make it impossible for a patient to remember all the information they are given through their health care practitioner. There are some patients who have one or more doctors depending on the various types of cancer they might have. Rather than relying on a memory that has undergone stress, exhaustion and under the influence of medication, a tape recording device can make the patient’s life much easier.

 

Doctors that are conveying a large amount of information, technical or not, would much rather their patients record the appointment than have the patient misunderstand or forget an important step. Take your tape recorder with you and get that appointment conversation on tape so you are able to refer to it when you are rested, not so stressed and not under the influence of medication. Your doctor will not mind one bit and will probably encourage you to carry the tapes of other appointments so that everyone is able to stay coordinated in the care they provide.

…”

 

It's heplful, but,"Your doctor will not mind one bit, and will probably encourage you..."…?...mmm…

[nolegion]

Like many of us, I expect, I have been saddened to learn of Jamie Merrett’s dreadful plight, over the last couple of days. That’s the tetraplegic chap who was clearly, valiantly, fighting for something still resembling a life, but was all but done for by his ‘care’. See eg:-

 

http://www.medicalnewstoday.com/articles/205715.php

 

The incident - which was caught on Mr Merret’s webcam - took place in January 2009, I read.

 

It occurred to me to check something. At that time the Primary Care Trust involved (Wiltshire PCT also known as NHS Wiltshire) had a ‘Vexatious Complainant’ policy in place - including the classification of someone who makes a recording of their care, as ‘vexatious’: see earlier posts in this thread.

 

And from the facts as reported that would have made Mr Merret a’ vexatious complainant’ - and thus to be dismissed with contempt.

 

The Trust’s Complaints Policy was amended earlier this year, and the ‘vexatious-by-recording’ classification now no longer applies to an NHS Wiltshire patient.

 

Should it really take this sort of tragedy, this confrontation by evidence, to make a change?

[My Turn]

Like many of us, I expect, I have been saddened to learn of Jamie Merrett’s dreadful plight, over the last couple of days. That’s the tetraplegic chap who was clearly, valiantly, fighting for something still resembling a life, but was all but done for by his ‘care’. See eg:-

 

http://www.medicalnewstoday.com/articles/205715.php

 

The incident - which was caught on Mr Merret’s webcam - took place in January 2009, I read.

 

It occurred to me to check something. At that time the Primary Care Trust involved (Wiltshire PCT also known as NHS Wiltshire) had a ‘Vexatious Complainant’ policy in place - including the classification of someone who makes a recording of their care, as ‘vexatious’: see earlier posts in this thread.

 

And from the facts as reported that would have made Mr Merret a’ vexatious complainant’ - and thus to be dismissed with contempt.

 

The Trust’s Complaints Policy was amended earlier this year, and the ‘vexatious-by-recording’ classification now no longer applies to an NHS Wiltshire patient.

 

Should it really take this sort of tragedy, this confrontation by evidence, to make a change?

 

NHS Wiltshire may not be able label a complainant who wishes to make an accurate recording as vexatious but they muddied themselves in another way to do with Mr Merret's sad case. When I heard this news story MHS Wiltshire were declining to comment on it in any way because they were "anticipating legal action".

 

I don't really know if this excuse is normal these days but I had always thought the usual excuse for failing to comment on a matter was to point to actual legal action.

 

My Turn

[nolegion]

I had an opportunity for a longish chat with a like-minded follower of this thread’s topic yesterday, on the strength of which I was prompted to wonder if it might be worth emphasising this business about your medical notes and recording consultations.

 

To my way of thinking they are very much related themes, and if one expression were to unite them it would be: ’monitor your care.’

 

As some have discovered to their cost, your medical records can stick to you like glue for a very long time (except when they have been left on a train or have otherwise been conveniently lost or destoyed); and despite changes in the law got under way over 25 years ago the medics’ officious, self-important secrecy and claptrap - which results in the parodic ‘everyone can see your temperature chart but you’ - still persists, and very obviously so, today.

 

If there is something inaccurate, inadequate, out of date, deceitful, pejorative, or just flaming rude - you name it, many of us have seen all that and more - then any time you see a medic those record entries may be being taken into account, and you will be unaware that what the other side of the consulting room is reading was ever written in the first place.

 

Nowadays, if you can possibly find the time and, regrettably, money, I unhesitatingly recommend you obtain and keep filed ALL your medical records now. And yes that means even if things are going swimmingly, right now. If things get more tricky later, it’s a relatively easy task to ask for an update to your copy records as from any given date - and that can save a lot of valuable time and money when the chips are down.

 

As regards recording, the overwhelming point is that if you seek correction of your records you will, frankly almost invariably, be fobbed off, belittled, stonewalled and generally mucked about unless you can refer to evidence. And there isn’t anything quite like the recording of relevant consultation(s) in your pocket when it comes to evidence.

 

This post is long enough, but I can spell out ‘a happy story’ in due course as regards changing medical records - for once without worrying about client confidentiality, because the patient was myself a few years ago, and the recording worked like a knife through butter.

 

For background reading on access to medical records, including reference to patient-required corrections, the best, detailed, free, on-line compendium of which I am aware is the DoH’s guidance to NHS bodies:-

 

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_112916

 

 

(although, in my oh-so-humble-opinion, there are some of points that should be quarrelled with in it).

Edited October 30, 2010 by nolegion
typo

[nolegion]

Further to my last post…

 

I have been burgled twice in my life and both times I did everything wrong. It took ages for the (undeniable) evidence of intrusion actually to ‘sink in’; I touched far too many things and moved a couple; I got flustered and spoke gibberish to the police. Then I got, utterly uselessly, extremely angry…etc... twice. Some people just don’t learn.

 

Now turn that around, and imagine GP behaviour when ‘intruder’ recording patient says after a routine ‘heist’ (i.e. getting his copy medical notes file up to date) that he is not satisfied with the ‘haul’. It just isn’t up to scratch. Some of it is counterfeit. There are things missing which should have been available for the taking. It’s much the same.

 

You can encounter disbelief and anger that any mere patient should actually demand to have accurate records.

 

I wrote to the ‘executive partner of a surgery specifying, word by word, the fresh entries I required made in my medical records, and made it clear that I would take the recordings that backed me up to court if they didn’t send me copies of the records as amended within 28 days, notwithstanding the fact that the amendments involved necessarily reflected very poorly on one or two of the doctors concerned. My records were duly annotated, exactly as specified, and I got the copies.

 

I do not believe for one second that would have happened if I hadn’t already told them I record all consultations with doctors. And no-one even asked to listen to the recordings themselves.

 

Truly, there is a moral in this. Record all your consultations. It is not an overstatement to say that, in certain circumstances, your life could depend on it.

Edited October 31, 2010 by nolegion

[nolegion]

In a duly childlike fashion, I like the hours between 12.00midnight and 2.00am on the morning the clocks go back in the UK. One is living in a time part of which sorta never happened. It ought to be declared a midnight feast of fools, or Saturnalia for webbish insomniacs.

 

I’d like to say I could dig up something particularly silly from my antiquack database and post it just after (the first) 1.00am. But then, at my age, I’m just as likely to lose concentration and drop off. If so, goodnight.

 

(But do shove something dumb here, if you feel like it, for later cheerful reading.)

[nolegion]

Text provided to me from a well-known medics only website:-

 

 

"Audio recording of all consultations [edit ] 13/08/2010, 16:30

 

In the last year I have had a run of what I can only describe as bizare complaints; and have come up with a solution.... I think, or maybe not.

 

The most recent being a total dressing down from the daughter of an elderly patient, who I had seen the previous week for …………….[edit] , apparently for telling her…………[edit]. Apparently she was in tears all weekend because of me, now moved off my list. Can't believe the daughter…[edit]. Have had a number of similar ones this year.

 

I was trying to work out how to protect myself from this sort of thing and thought what about simply recording all consultations? Simple audio recording on the computer kept for say a month then deleted. Seems to be plenty of software out there capable of doing it.

 

Obviously would need consent for this, a simple notice in the waiting room should cover it. I think.

 

Has anyone else ever done this or looked into doing this sort of thing?

Am I just being totally paranoid and over-reacting??

 

0 colleagues voted this a quality posting. Add my vote."

Edited October 31, 2010 by nolegion

[nolegion]

And the time-stamp if you post now is...

[nolegion]

Given the Shipmans, Ubanis and mid-Staffordshires of this world, the failings of the GP the subject of this post may seem relatively slight. However, the behaviour of the doctor, as reported by the patient and the subject of the investigation, ranged over more matters than those excerpted below, and the case will always stick in my mind because it was, in my view, partly some covertly-recorded evidence which helped turn the tables in the complaint to the Healthcare Commission, as it then was.

 

I was provided with a link to the full, now freely-available, on-line article only this w\e - along with some colourful ‘artwork’, but I’m still trying to work out how to deal with the latter.

 

As utterly inadequate as the (underfunded and wretchedly-managed) Healthcare Commission mostly proved in practice as a patients’ complaints handling body, in theory it was a step in the right direction; and its role at least began ostensibly to comply with the Bristol Royal Infirmary Inquiry’s demand for independent investigation of serious complaints - though it had a million miles to go in terms of staffing, training, asessment skills, speed of action, communication, transparency etc. etc.

 

Now, save for the complete waste-of-time-and-space Parliamentary & Health Ombudswoman, there is no semblance of any independent third party investigation of medical misconduct in individual patient-originated complaints, at all. (The GMC’s just a national disgrace, keeping the unspeakable in work and putting sticking-plasters on the dead.)

 

What chance, today, of getting a GP publicly ‘written-up’ for rudeness? And do you see it as lilkely that any of the new ‘GP consortia’ would ever take a single step in that direction?

 

Not what the doctor ordered

 

Europe Intelligence Wire

 

March 03, 2006

 

(From Bristol Evening Post)

 

By Katharine Barker: A NORTH Somerset doctor has been referred to health bosses after a patient complained about his service.

 

Dr Richard Lawson was the subject of an investigation by the Healthcare Commission - an independent body set up to improve the quality of healthcare - after an official complaint was made against him by a patient suffering with depression.

 

The complaints included that Dr Lawson, a GP at The Surgery in Station Road, Congresbury, repeatedly interrupted his patient, was rude, and sat with his back to him when he entered the room.

 

The patient also complained that Dr Lawson, also a former parliamentary candidate for the Green Party in Woodspring, had not prepared sufficiently for the consultations, by not checking that medical notes had arrived from his previous GP.

 

Following its investigation the Healthcare Commission said….

 

…it has contacted North Somerset Primary Care Trust about Dr Lawson.

 

In its report, [the] Healthcare Commission case manager…said: "My clinical adviser's view was that the few consultations that there were… started off very badly…”

 

"I am of the view that… there are changes that Dr Lawson and the practice could make to improve the way in which they communicate with patients…”

 

The report also recommended that the practice could improve its process of providing patients with test results.

 

It said: "The clinical adviser stated that he considered there to be enough evidence to suggest that the consultation were not handled with any degree of expertise…

 

However, the clinical adviser concluded that Dr Lawson's failings were not bad enough to justify a referral to the GMC."

 

Dr Lawson declined to comment to the Post about the Healthcare Commission report….

 

 

[For full article, see:- - http://www.accessmylibrary.com/coms2/summary_0286-13772753_ITM]

[Panthro]

nolegion, apologies for not reading your entire post it is very comprehensive with lots of links to evidence etc. and deals with a wide range of issues branching out from the original post.

 

As for recording conversations, as a nurse I would welcome that for the opposite reasons to your; aggressive bordering on the abusive relatives, patients denying we had told them something or fabricating details. I'd hope you'd agree (maybe you wouldn't) that most health care professionals are honest and open with their patients negating the need to record conversations. Basically, what I am getting at is that it works both ways. Indeed if it was to become common (recording GP consultations for instance) then the GP would be foolish not to offer the best evidence-based advice. Of course raises the question of would they release the tapes/transcripts. They can lose medical records so why not these?

 

I'm just thinking out loud here

[nolegion]

That’s the spirit, Panthro. You are clearly a professional taking the line, ‘We should have nothing to hide,’ which, in my view, must be right.

 

Whether the NHS can be trusted to take recordings themselves (where appropriate), is indeed another matter. As regards GPs, see, for instance, this article and the reader response:-

 

http://www.healthcarerepublic.com/news/1024057/GPs-back-routine-taping-consultations/

 

 

Given, amongst other things, the existing inability to manage health records properly, I think some patients could well be reluctant to agree.

[nolegion]

This was the response given by the Dept.Work & P to a Freedom of Information Act request last week:

 

“ The process relating to recording of medical assessments is currently being reviewed by DWP and Atos; the Commercial Management of Medical Services team is responsible for this activity. In the interim a temporary arrangement is in place to enable customers to request an audio recording.

 

This request should be made through the Jobcentre Plus office that administers your claim (who will be responsible for making the arrangement); and should also be stated on the IB/ESA50. The request for a recording should not delay the arrangement of a medical assessment.

 

Medical Assessment recordings will be made on a dual tape machine, with one copy being given to the customer and one being retained securely on a customers file within the DWP.”

 

(Information gratefully received fom:

 

http://benefits.tcell.org.uk/sites/default/files/documents/WCA%20Recording/FOI%201671%20Response.pdf )

 

No charging of the claimant. No expenditure for the claimant. No ‘consent’ of the ‘healthcare professional’ required. No delay. No reports by Atos to the DWP of ‘failure to submit’ to a medical. No tripe about the small print in the Atos contract.

 

Just an entitlement for the claimant to a free, full, record of the highly personal assessment and often crucial interview.

 

The expression ‘climb down’ comes strongly to mind, and about flaming time too.

[nolegion]

Some details as regards the DWP\ATOS climb down on the score of benefits claimants being able to have a recording of their ’work capabilty assessments’ (= medicals) :-

 

i) It is very nearly 3 years ago (19 11 07) the DWP declared that a claimant who insisted on recording his interview had ‘failed without good cause to submit himself for a medical examination’.

 

(This is spelled out in: http://www.administrativeappeals.tribunals.gov.uk/judgmentfiles/j2663/CIB%203117%202008-01.doc )

 

ii) The DWP would still like that to be a tenable position, but they have just had to back down, irretrievably, in my opinion. According to the FoI response cited in my preceding post the ‘interim’ postion is, now, that a claimant can - entirely at his or her own option, not DWP\ATOS’s - insist on having a recording of the medical made, without having the claim process in any way delayed, at no expense to the claimant ,and with the claimant being provided with a copy of the recording by the 'healthcare professional' on the way out. It will be in C60 old- fashioned cassette format. (So much for the ridiculous requirements that, "the recording must be made by a professional operator, on equipment of a high standard, properly calibrated by a qualified engineer immediately prior to the recording being made". ESA Handbook.)

 

iii) According to some reports the DWP\ ATOS will still try to decline to conduct a medical if the claimant or accompanying friend tries to take a recording themselves. How utterly fatuous. I have no doubt that claimants will treat that contention with contempt it deserves and continue to record covertly if they so wish, in addition to requiring a copy recording from the DWP|ATOS ‘hcp’ ‘overtly’. It has been and remains not illegal so to do.

 

iii) It is part of the current DWP\ATOS contract that the ‘healthcare professional’ wears a name badge. A claimant is also entitled to a copy of the assessment report prepared by the ‘hcp’.

 

iv) At last, therefore, a claimant has an entitlement to a full record of who said what, when ,and why, and will certainly be able to use that (if it is genuinely relevant) in any appeal against a refusal of benefits.

 

There is, I am happy to say, no room for doubt about any of the above and the volte face has already been reflected in letters to claimants from Atos\Jobcentres when people say they want a recording. I was looking at such a letter this afternoon.

 

There is also, however, currently, at least one curious outstanding point. If you go to the DWP website, look for eg. Freedom of Information, arrive at ‘Information Finder, navigate your way through ”policies and procedures”\”internal guidance” to ”recordings by customers during telephone calls, interviews etc.” you will find NO information available online - just a telephone number to ring. Gotta be the right place to ask.

 

But if you ring that (0191 21 66020) you will find some very polite and friendly people: who say they know NOTHING about the fundamental change in policy described.

 

Last week, I ventured to suggest they might like to mail me with details of a DWP contact who did know something about it. Cheerfully agreed. Nothing received.

 

No wonder it took 3 years.

I wonder what will happen tomorrow when I telephone (for the third time) and ask if they would now object to my recording my continuing telephone queries with them.

 

 

(See http://www.dwp.gov.uk/freedom-of-information/information-finder/our-policies-and-procedures/internal-guidance/310.shtml)

[nolegion]

It would appear that the DWP is playing ‘fast and loose’ as regards the current about turn on recording medicals. They are not publishing the current revised procedure\policy.

 

Only if you happen to be ‘in the know’ and write on both your ESA form and by letter to your Jobcentre that you require a recording well before before the medical, will they back down - and then you will get a copy tape free on leaving. Given that, amongst other things, many people, right now, will have put in their forms a long time ago and may be summarily required to attend a medical at short notice, this is, in my opinion, a disgrace.

 

They won’t even send you a copy of the FOI response already happily obtained and (’privately’) published here:-

 

http://benefits.tcell.org.uk/sites/d...20Response.pdf

 

(If that link fallsover for any reason, this one sometimes works:-

 

https://docs.google.com/leaf?id=0B1e...ut=list&num=50 )

 

 

A colleague of mine has been ringing round and the response from eg. the ‘commercial management’ telephone number given on the response above linked will say that if a claimant wants to know the current ‘policy’ (which may change, it’s only ‘interim’) they would have to put in their own FOI request which (‘it coming up to Christmas and all’) might take somewhile to be responded to - and almost certainly not till way after the required date for a claimant’s medical.

 

I think it reasonable to suggest that they are on the back foot, in a total ‘muddle’ with their medical services contractor, and probably trying to arrange for some backdoor legislation to prop up their position while no-one is looking.

 

OK everyone then. Please will anyone with 5 minutes to spare put in an FOI request. It’s free, can be done by email and the email destination address is:

 

dwp.medicalservicescorrespondence@dwp.gsi.gov.uk

 

 

and arrange to go on doing so as soften as possible until the DWP actually takes steps proactively to inform all claimants of the law and practice to which it claims we are subject.

 

All you have to do is give a valid name and email address, and spell out what you want, eg. “What is the current policy on getting an ATOS medical recorded?”- though more detailed and inventive enquires would certainly aid the case as well.

 

If you’ve got 10 minutes you could also try testing whether the view on that telephone number is likely to change under presssure, should you have a moment during ‘office hours’…

 

(And, if you are feeling public spirited, there’s always the very useful ‘whatdo theyknow’ site as well. It’s a charity so I hope it’s within the rules to refer to it here:-

 

http://www.whatdotheyknow.com/ )

 

It’s taken years of grinding battle to dent the outrageous DWP|Atos ‘policy’. We should capitalise on the situation now.

 

I emphatically try not to do this as a rule, but just for once I’m posting this in both the Benefits and the NHS threads I started. Please, just a few minutes…one email…a quick call.. and report how you get on?

Edited November 17, 2010 by nolegion
to include link for 'whatdotheyknow'; approved in t'other forum

[nolegion]

It might be worth mentioning I had to phone those well known ‘medical disservices’ people, last week. Nothing I can do, write in triplicate, or scream at them and the DWP, can convince them they have a doctor's certification of an incurable, progressive and fatal disease which means my sister will never fill in a form again, let alone attend a ‘medical’. (She is in hospital and has been for months.)

 

As I have done in the past (and metioned earlier in this thread), as soon as I had given the National Insurance No. and succinctly stated the position, I said I was recording the call.. Previously, I have had the phone put down on me at this point.

 

Last week, I didn’t - indeed I was expressly told ‘ that’s not a problem, Mr ------.’

 

Probably just a new operative who hasn’t been fully trained in how to be hostile to customers yet, and yes, I know it’s best to wait for more evidence and not to turn one winter swallow into a heatwave, but it is also just possible that the change in approach to recording at the DWP could be filtering ‘down the line’. Just could be.

[Sarahrookley]

If I may throw another point of view into this discussion (please)... I am not a doctor, but as a counsellor, I have for several years asked my clients whether they wish to record our sessions. Since people tend to come to me in varying states of distress (not unlike many worried people visiting their GP), I am aware that concentration and the ability to retain information can be in short supply. It is in both our interests that clients should gain something from their sessions with me, and the option to record what has been said has proved to be an extremely valuable tool for both myself and those who come to me for help.

 

With few exceptions, my offer to record the sessions has been accepted and welcomed. With the opportunity to go over what has been discussed - sometimes several times - when people are at home and feeling more relaxed, they have been able to reflect on our conversations, and develop their thoughts and prepare a little of what they would like to talk about when we next meet.

 

The decision rests entirely with the client whether they wish to make a recording of our time together, and if they ask for this to be done, they then have the choice as to whether they would like to take a hard copy and have the recording deleted, or whether they are happy for me to keep a record for my own use.

 

From my own point of view, if permission is granted for each of us to retain an audio transcript, this can also be extremely useful. I do not like to take written notes during a counselling session as I feel that it is important to maintain eye contact, watch body language, etc, - and it can be distracting to see a pracitioner writing mysterious scribblings, the contents of which the client can only imagine! Whilst I attempt to commit to memory such details as dates, the names and ages of relevant family members, etc., and write up my notes as soon as the person leaves, there is always margin for error. How much more open if both the therapist and the person seeking help can hear an unedited version of their time together.

 

Am I very naive in my view that a competent practitioner, confident in their work, would have no objection to their consultation being recorded?

[nolegion]

Hi sarahR. I agree with you every step of the way and in my oh-so-humble opinion there is nothing naive at all in thinking that someone ‘confident in their work’ should have no objection to a consultation’s being recorded.

 

I think this would be readily and properly understood by members of any mature profession - other than all too many medics (and their employers), it would seem. I am adding your descriptions of ‘mutual benefits’ to my growing list of the same, as well

 

At the beginning of this now very long thread, a contributor (Sali) suggested that the hostility from practitioners to the idea of being recorded which patients had encountered was probably ‘born from fear.’

 

Seems to me that expressing this (to a practitioner) as, ‘You need the confidence not to worry about it,’ is a very positive (counsellor’s?!) way of negotiating the stumbling block. Way to go.

[nolegion]

The legislation which brought the current ‘sickness benefit’ (Employment Support Allowance with the ATOS computer-driven ‘medical’\Work Capability Assessment) regime into force stipulated that there should be an annual report into its efficacy. The first such report (by a Prof. Harrington) has now been published and hot on its heels today (23rd November) the DWP minister (C. Grayling) makes certain announcements.

 

The DWP website reports:-

 

 

‘ The Harrington Review, published today, includes evidence from health and disability groups and has made substantial recommendations including:

• Dealing with the complexities of cases involving mental health and similar issues by creating a network of "mental health, intellectual and cognitive champions" in each Atos Medical Examination Centre to spread best practice and build understanding of these conditions;
  
• Strengthening the checks and balances in the system by placing the Jobcentre Plus Decision Maker at the heart of the process;
  
• Improving communications and the level of support provided to those who undergo a WCA; and
  
• Ensuring the Atos assessment is transparent by, subject to an initial pilot, recording all assessments.‘
  

And:

 

‘Chris Grayling today pledged to accept all the recommendations from the review.’

 

(from: http://www.dwp.gov.uk/newsroom/press-releases/2010/nov-2010/dwp160-10-231110.shtml )

 

Anybody spot at the flaws in this?

[My Turn]

Ensuring the Atos assessment is transparent by, subject to an initial pilot, recording all assessments.

I like the sound of that although I wonder if the claimant will be given a copy of the recording made by the assessors. In fact, I wonder if the intention is to retrospectively correct any erroneous assessment.

 

My Turn

[nolegion]

Well, indeed, My Turn. What is the current ‘regime’?

 

It does seem that the DWP\Atos are frankly in pathetic disarray about this. Even before they were made formally to back down by the Harrington report, they had been forced to accept a revision to the pervious regime by saying:

 

“The process relating to recording of medical assessments is currently being reviewed byDWP and Atos; the Commercial Management of Medical Services team is responsible for this activity. In the interim a temporary arrangement is in place to enable customers to request an audio recording. This request should be made through the Jobcentre Plus office that administers your claim (who will be responsible for making the arrangement);and should also be stated on the IB/ESA50. The request for a recording should not delaythe arrangement of a medical assessment. Medical Assessment recordings will be made on a dual tape machine, with one copy being given to the customer and one being retained securely on a customers file within the DWP.”

 

This was on 01 11 10: see the FOI repsonse I linked here on 17 11 10 above. (This one sometimes works if the principal one doesn’t:https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0B1etSkG73JvjMjliYzc3MjMtZjRkMi00YWExLWFjN2EtMmE4MGRiMGY3ZDdm&hl=en&authkey=CKPyr_kF )

.

 

However if you look at a response of the DWP made last Friday (10 12 10) to a further FoI request (submitted by a Mrs Taggart whom, I confess, I know well,) you will see that while reference is made to a ‘pilot study’ to be carried out next year, the recording rules reiterated are those that applied prior to November ie subject to ‘ healthcare professional’ consent and cost burden = effectively, you can’t get a recording. (Go to the excellent What do they know? site to track this down.)

 

The DWP is also in time default in answering more extensive FoI requirements on this issue at that site, and elswhere, as I am aware from ones I have myself submitted and persuaded other people to.

 

This confusion is compounded by the fact that ‘on the ground and at the coal face’ of this, there are clearly claimants who are in fact insisting on what we might call the ‘November regime’ who are indeed getting a recording made by Atos (at the claimants’ request) but are then being confronted with a purported requirement to sign a copyright agreement, by means of which Atos, in my in opinion fatuously, seek to restrict what a claimant can do with any recording provided. (This is reported on in some detail at the well-known site-we-don’t-mention.)

 

I call it ‘fatuous’ because such a silly manouevre overlooks that fact that claimants are now increasingly aware that it is not illegal to take a recording covertly on whatever gadget you happen to have in your pocket.. So, if Atos refuse to give you the tape because you won’t be bullied into signing their specious text, rely on your own ‘unrestricted’ recording. There can be no subsequent argument that it was not agreed that the medical should be recorded, and both ‘sides’ have a copy of the recording. So ‘go away’ (or other univerbal expressions to that effect) can be applied to whichever poodle lawyers of the ‘medical services provider’ dreamt up that idea.

 

It’s a shambles, but the claimants are now winning whether DWP\Atos like it or not.

[nolegion]

I will supply links to the following once am sure of them. It appears however that the DWP has now responded to a further FoI request by saying:

 

Until the pilot in 2011 has been concluded and evaluated Atos Healthcare has reverted to their earlier policy on recording assessments.

 

If this is accurate - and it appears to stem from the same valiant souce which helped dent the you-can’t-do-this policy - it is a disgrace.

[My Turn]

Nolegion, thank you for the information in your post of 12th December 2010. Your links and also the documents you mention relating to Mrs Graham (at the "What Do They Know?" site) are very interesting.

 

The sad thing, as you point out, is that all the new generous sounding statements are still subject to the doctor's consent. Unfortunately there don't seem to be any rules about what the doctor is obliged to consent to, or about what reasons he has to give, or about how an appeal against his decision may be launched.

 

That trick you mention to get the claimant to grant copyright to ATOS/DWP is just a defensive manoeuvre and seems to have little justification behind it.

 

Nonetheless the tide of obstruction to recordings seems to be turning, albeit slowly.

 

My Turn

[nolegion]

Thanks for that, My Turn.

 

Five weeks ago I asked people on line and off it to put in Freedom of Information requests to the DWP about their purported rules regarding the recording of medicals. The statutory time for compliance is 20 working days and it is this week that some of the reponses are are seeing the light of day. I think I have thanked everyone who has let me know about what they took the trouble to do, individually, but if there is anyone I have missed who follows this thread: thank you. Truly, it all helps - and there is no reason not to go on putting such requests in! Be ‘inventive’ in your appraoch

 

For immediate purposes I would like to consider the one put in by a Mr Fyl at the excellent whatdotheyknow site. (S Fyl is a lawyer and well known to me.) I extract some of the DWP response of 13 12 10 below.

---------------------------------------------------------------------------------------------------------

 

(Fyl Q(s)

 

“You requested full details, policies, memoranda or other information on or with regard to:-

 

1 Whether the DWP will currently try in any way to prevent a claimant overtly taking their own audio-recording of his or her medical assessement;

 

2 If the answer to the above is ‘yes’, full and specific details of any statute, regulation or other legal provision or ruling which the DWP claims supports any entitlement whatsoever on the DWP’s part to try prevent a claimant’s so proceeding;

 

3 Whether the DWP acknowledges that it would NOT be in any way illegal or unlawful for a claimant to record such an asessement covertly.

 

If the answer to 3 is ‘no’ (the DWP does not so acknowledge), full and specific details of any statute, regulation or other legal provision or ruling which the DWP claims supports such a contention.”

 

(DWP A(s)

 

“In response to Qs 1, 2 & 3 It is not reasonably expected that an individual acting on behalf of DWP would be aware that a customer is overtly recording a conversation or assessment.

 

However if conversations are overtly recorded and they are then published on the internet then the customer will have exceeded the private and domestic use of information that they would be allowed by the Data Protection Act 1998.

 

There is also the possibility that they could record other customers’ information which is not acceptable.”

-----------------------------------------------------------------------------------------------------

 

I guess few would need commentary from me to understand that the DWP response is pathetic, risible, but just to fire off a few, short, late-night observations with regard to the three sentences of the DWP response:-

 

(i) If someone conducting a medical assessment cannot be ‘reasonably expected’ to be aware that someone is overtly recording the interview then perhaps they couldn’t be reasonably expected to observe that the claimant is blind or one-legged either.

 

(ii) The DWP was not asked anything about publishing recordings on the internet. Whether or not there is any legal validity in what they claim (which is to say the least debatable, and as followers of this thread will know, not agreed by eg the Medical Protection Society, one of the world’s largest medical insurers) the statement is irrelevant as to the legality of taking a recording in the first place.

 

(iii) If a recording claimant could sufficiently overhear another claimant’s private medical interview such that he could obtain a recording of some or all of it, it would be ATOS who would be acting unacceptably (indeed disgracefully) by conducting assessments in such a way, not the recording claimant.

 

The DWP are clutching at straws and making themselves a laughing stock. And you will note that they have found nothing to say which in any way suggests that taking a covert recording would be illegal. Silly asses.

[My Turn]

Five weeks ago I asked people on line and off it to put in Freedom of Information requests to the DWP about their purported rules regarding the recording of medicals. The statutory time for compliance is 20 working days and it is this week that some of the reponses are are seeing the light of day. I think I have thanked everyone who has let me know about what they took the trouble to do, individually, but if there is anyone I have missed who follows this thread: thank you. Truly, it all helps - and there is no reason not to go on putting such requests in! Be ‘inventive’ in your appraoch

 

Nice work, NoLegion. I wonder what a Freedom of Information request would reveal if the DWP and the NHS were asked to provide:

 

(1) Minutes of all meetings in which the topic of recording a medical consultation was discussed.

 

(2) Legal advice which the organisations had received about recording consultations. (I would like to think such legal advice is not classified as privileged client information.)

 

(3) The outcomes of all individual cases in which a client/patient was discovered to be recording without permission.

 

Interestingly enough, the General Medical Council too is required to answer Freedom of Information requests. I wonder what the GMC would say if they were asked for information on the same topics above.

 

My Turn