Medicals and your Medical Data
A foster carer’s guide to medicals and your medical data
Introduction to the foster carer’s guide to medicals and your medical data
Foster carers undergo a medical to become an approved carers, then have regular 3 yearly medicals throughout their careers. This guide will help you understand how it works, what happens and your data protection and GDPR relating to your medical records and reports.
How does it work?
You go to your GP for the medical, they will have been sent documents by your local authority or agency.
They will then return the completed medical documents to County Medical Advisor/designated authorised person in your local authority or the Medical Advisor/designated authorised person in your agency.
The Medical Advisor/designated authorised person will then assess the medical report in relation to you being fit to foster. Any new information that may impact your ability to foster should be sent to your fostering team manager by the advisor.
What the policies say
Why is this information needed?
- This information is collected in line with the relevant fostering and adoption regulations for England, Northern Ireland, Scotland and Wales.
- Prospective foster carers, adopters and other carers looking after children need to have robust physical and mental health to be able to parent these vulnerable children.
- The information requested on Form AH is required in order to secure the future well-being of any child placed.
- Special consideration may need to be given to health-related lifestyle factors which may have implications for a placement. It is important that agencies satisfy themselves that applicants are robust enough to meet the demands of parenting on a daily basis, and in the case of adoption and long-term placements, have a reasonable expectation of retaining health and vigour to support children to adulthood.
- Age is relevant but more significant will be specific medical factors and health-related lifestyle factors such as smoking, alcohol consumption, gross obesity, diet and exercise. These need to be looked at alongside other positive attributes that applicants may have to offer to a child or children.
Who should complete the form?
- Part A should be completed by the agency and the entire form given to the applicant.
- Part B should be completed by the applicant and the entire form is given to their GP. Applicants are asked to provide information about their health and lifestyle. This will be considered alongside medical information from the GP.
- Part C should be completed by the applicant’s own GP and the entire form sent to the County Medical Adviser or Agency Medical Advisor/designated authorised person (who must be a specialist). It should be completed by the applicant’s own GP unless special circumstances indicate that another doctor has better knowledge. The purpose of the completion of the medical report on the applicant is to obtain accurate and up-to-date information, based on medical examination and medical facts from records, on the applicant’s individual and family health history and current physical and mental health.
- Doctors are not being asked to make a decision as to the suitability of the applicant, but to provide sufficient accurate and detailed information to enable the medical adviser to advise the agency on the health of the applicant.
Doctors are instructed to ensure this form is returned to the named Agency Medical Advisor/designated authorised person and no one else.
- The agency Medical Adviser may be contacted if the doctor completing the form wishes to discuss any issues arising from the health assessment or report.
Interpretation of Adult Health Report by agency Medical Adviser
- The agency Medical Adviser should take account of medical history, current health and health-related lifestyle factors and evaluate these carefully to provide advice to the agency on the implications of an applicant’s health history. The impact of health conditions on activities of daily living may be more important than the condition itself.
- The agency Medical Adviser should be well informed about the implications for adoption and fostering of a variety of factors, including chronic conditions, treated cancer and psychiatric history.
- For adoptive applicants, current treatment for infertility, the implications of infertility and perinatal loss will need consideration, so full details including termination of pregnancy should be provided.
- Assessing an applicant’s mental health may involve consultation with an adult psychiatrist and close liaison with the social worker assessing the case who will have further information gained through the applicant and from interviews with referees. As with any health issue, this needs careful assessment and liaison with adult specialists and social workers for further information.
- In the case of complex health issues, written permission should be obtained from the applicant for further information to be sought. Applicants should be reassured that the information obtained will be dealt with in the strictest confidence and will be used only to inform the process of assessment of approval.
- Health reports form part of the applicant’s case record and the relevant regulations for each country in the UK provide for the agency to treat such case records as confidential.
- The Medical Adviser’s summary forms the basis from which medical information on prospective adopters and foster carers are to be included in the written assessment reports provided for adoption and fostering panels.
- Whilst the applicant gives permission for the agency to have information regarding their medical history and this can be shared within the agency on a need-to-know basis, this does not permit information about an applicant to be shared with their partner.
- The information regarding one applicant is confidential to that applicant and this confidentiality must be respected. In the event of the information provided indicating any concerns as to the applicant’s suitability, the Medical Adviser should discuss these with the agency.
- Medical reports and all information about prospective foster carers are subject to the Data Protection Act 2018, which grants people (including applicants) the right to see the personal information held about them, under section 45. This Act does not apply in the case of applicants to adopt because adoption agency records are exempt from the provisions in section 45 about subject access.
Your right to rectification
Under Article 16 of the UK, GDPR individuals have the right to have inaccurate personal data rectified.
This includes medical records and reports. Below is the link to the ICO (Information Commissioner’s Office) to your right to rectification including how it works and what to do to challenge it.
The ICO Bolton Borough Council Ruling
In May 2019 two foster carers won an ICO ruling against Bolton Borough Council. The carers were shocked to discover that their medical reports were sent to the doctors by their council accompanied by an SAE (self-addressed envelope) addressed to the general fostering offices and could be opened by anyone.
They discovered that it wasn’t an error and that all foster carer’s medicals were being sent back to the offices and not to the County Medical Advisor/designated authorised person as they should.
The carers approached Bolton to point out that this was in breach of GDPR and their private data and was told that it wasn’t and as a consequence, anyone in the fostering offices (SWs, Admin, managers etc) could look at it.
Many carers have since come forward to say how many of their SSWs and managers, panels and in one case an admin employee, who seems to have easy access to their entire medical records and history.
The Bolton foster carers won this case.
Ruling, action and outcome.
The ICO determined that the Council had not complied with their data protection obligations. This was because their personal data was not shared securely with the necessary security measures in place and information was sent to social workers before the Medical Advisor. They ruled it insufficient when considering the Council’s data protection obligations.
They determined that their current lawful basis for processing information in that manner was not sufficient nor compatible with their processing.
The ICO said that they have not complied with the following:
Article 5(1)(f) Data Protection Principle (Security): This says that personal data shall be processed in a manner that ensures appropriate security of the personal data, including protection against unauthorised or unlawful processing and against accidental loss, destruction or damage, using appropriate technical or organisational measures. Essentially, the purpose of the ‘security principle’ is to ensure that personal data is kept securely and is protected from damage or unauthorised access and in this case, the ICO ruled that Bolton had not complied.
The ICO ruled that the Council had not complied with their data protection obligations and requested they take immediate action.
They requested an immediate review of their lawful basis for processing personal data in this manner and asked that they ensure members of staff are aware of their obligations to protect special category data sufficiently.
The ICO wrote to Bolton and made recommendations about their processes and provided guidance to members of staff to ensure that the processes are adequate in the future.
Bolton Borough Council immediately changed their policy and ensured that the return envelopes given to the doctors for medical reports went, confidentially, to only the County Medical Advisor and that carers’ data and the GDPR regulations were followed.
The Council then confirmed in writing to the ICO that they had changed their previous process and have put significant changes in place to ensure they comply with the General Data Protection Regulation (GDPR).
What to watch out for
- Make sure the return address on the doctor’s envelope is to the County Medical Advisor/designated authorised person, or specialist agency medical advisor/designated authorised person.
- Your medical reports should not be returned to the providers’ offices or social workers in a self-addressed envelope to either them, the team or the admin.
- They should be going to the County Medical Advisor/designated authorised person and that person, who is qualified, then reads the report and advises if there is anything in there that could prevent the carer from either being a foster carer or in the case of the 3 yearly carers medical, anything that could impact on their fostering going forward.
- Your medical report should be safely and securely stored with the County Medical Advisor or the LA/Agency.
- Your medicals should be accurate, if not exercise your right to rectification.
- If you feel you have been discriminated against in any way contact the union or your support.
The ICO ruling against Bolton Borough Council in full
From: [email protected] <[email protected]>
Sent: 31 May 2019 14:33
Subject: Your ICO Complaint [Ref. XXX]31 May 2019
Case Reference Number XXX
Dear Mr and Mrs XXX
I am writing to you with the outcome of your complaint that Bolton Borough Council’s Adult and Children Services (‘The Council’) did not share your personal data securely when sharing medical information with Social Care Workers prior to Medical Advisors during the Foster Care process.
You have stated that the special category data was shared insufficiently when being directed without an address, to Social Care Workers for their review. I understand that you raised additional concerns, you state that the Council deliberately falsified addresses so that medical history was diverted to Social Workers instead of Medical Advisors.
The ICO’s role
Part of our role is to consider complaints from individuals who believe there has been an infringement of their data protection rights.
The law says we must investigate data protection complaints to an appropriate extent. We will put most of our effort into dealing with matters we think give us the best opportunity to make a significant difference to an organisation’s information rights practices.
Depending on the circumstances, we will decide whether or not to take action against the organisation and what form our action will take. We do this by taking an overview of all concerns that are raised about that organisation with a view to improving their compliance with the data protection framework. Our decision will not affect your ability to enforce your rights through the courts.
The ICO have pursued your case and reviewed the information available to us. It is our view that the Council have not complied with its data protection obligations. This is because your personal data was not shared securely with the necessary security measures in place and information was sent to Social Care Workers before the Medical Advisor had made the necessary review. The ICO has highlighted that this is insufficient when considering the Council’s data protection obligations.
Furthermore, upon review of the Council’s information rights practices, the ICO also determined that their current lawful basis for processing information in this manner was not sufficient nor compatible with their processing.
Additionally, our view is that they have not complied with the following principle:
Article 5(1)(f) Data Protection Principle (Security)
This says that personal data shall be processed in a manner that ensures appropriate security of the personal data, including protection against unauthorised or unlawful processing and against accidental loss, destruction or damage, using appropriate technical or organisational measures.
Essentially, the purpose of the security principle is to ensure that personal data is kept securely and protected from damage or unauthorised access.
As I am of the view that the Council have not complied with their data protection obligations, the ICO has made a further action request for immediate consideration by the Council.
We have requested that they review their lawful basis for processing personal data in this manner and asked that they ensure members of staff are aware of their obligations to protect special category data sufficiently.
We have written to them and made recommendations about their processes and provided guidance to members of staff to ensure that the processes are adequate in the future.
The Council have confirmed to us that they changed the previous process and have put significant changes in place to ensure they comply with the General Data Protection Regulation (GDPR).
Finally, if you want a more final determination then you have the right to take proceedings to court if you believe your information rights have been infringed. This means that if a court is satisfied that the individual’s rights have been infringed it may order the controller or processor in question to take steps to comply with its data protection obligations.
Please be advised that this is not a process with which the Information Commissioner’s Office is able to assist and we recommend that you seek independent legal advice if you wish to pursue this course of action.
Please be advised, we keep a record of all the complaints raised with us about the way the Council process personal information.
The information we gather from complaints may form the basis for action in the future.
Thank you for bringing this matter to our attention.
Information Commissioner’s Office
Direct dial number: 0330 313 1799
For information about what we do with personal data see our privacy notice.
If you would like to provide us with feedback about our services, please let me know.
Information, help and support
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Corambaaf Form AH, adult health report and guidance
https://corambaaf.org.uk/sites/default/files/electronic-forms/SAMPLE%20CoramBAAF%20Form%20AH%202022.pdf (Form now updated to)
ICO – Article 16, right to rectification