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A Concerned Relative

A common scenario in general practice - and a classic choice for both the GP training selection centre and the CSA exam (remember that??!) is when someone contacts the GP to discuss their concerns about a relative.

It might be an elderly family member in decline who isn't keen on doctors or someone they live with who won't admit they have a drink problem. It could have legal consequences, they might disclose that their relative continues to drive when they have a medical condition that would disqualify them from getting behind the wheel, or the health problem may raise a safe-guarding concern.

These scenarios always raise considerable challenges around confidentiality: can you say anything at all about their relative? Can you listen? How will you record the consultation? Will you be able to record it in the notes? Are there any urgent safety concerns? How do you act on their concerns when you are limited in this way? Are there any times when you would have to break confidentiality? With no neat NICE guideline to turn to, the latest Two Houses Consultation guide tries to tackle some of these issues.

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