Health care practitioners have a duty of confidence when a patient discloses information to them.

‘Where it is reasonable to expect that information will be held in confidence, it:

  • is a legal obligation that is derived from case law;
  • is a requirement established with professional codes of conduct;
  • must be included within NHS employment contracts as a specified requirement linked to disciplinary procedures’ (Department of Health, 2003).

As stated above, confidentiality is a requirement of professional codes of conduct. The Code of Professional Conduct for Nurses, Midwives and Health visitors states that:

  • You must respect people’s right to confidentiality.
  • You must ensure people are informed about how and why information is shared by those who will be providing their care.
  • You must disclose information if you believe someone is at risk of harm, in line with the law of the country in which you are practising.

Also, the Nursing and Midwifery Council (NMC, 2021) Guidelines for records and record keeping state that:

  • You need to be fully aware of the legal requirements and guidance regarding confidentiality, and ensure your practice is in line with local and national policies.
  • You should be aware of the rules governing confidentiality in respect of the supply and use of data for secondary purposes.
  • You should follow local policy and guidelines when using records for research purposes.
  • You should not discuss the people in your care in places where you might be overheard. Nor should you leave records, either on paper or on computer screens, where they might be seen by unauthorised staff or members of the public.
  • You should not take photographs of any person or their family that are not clinically relevant.

Confidentiality rules governs all information from which a patient can be identified.

The NHS Code of Practice: Confidentiality (2003) states that key identifiable information includes pictures, photographs, videos, audiotapes or other images of patients. It goes on to say:

‘Information that can identify individual patients must not be disclosed for purposes other than healthcare without the individual’s explicit consent, some other legal basis, or where there is a robust public interest or legal justification to do so’ (Department of Health, 2003).

The issue of confidentiality also governs the storage of medical photographs in all formats. Practitioners must be aware that photographs form part of the patient’s confidential medical records. Therefore, photographs must be stored in an appropriate manner. Where digital photography has been used, the photographs must be stored in a format that ensures that access is restricted.

In conclusion, there are a number of important issues to consider when using photography in wound assessment. Practitioners must ensure that they are acting within the confines of their professional code of conduct, their employment contract, and the law, including local and national policies.