Policy No:
IG09
Version:
2.0
Name of Policy:
Clinical Photography and Audio Visual
Recording of Patients – Confidentiality and
Consent Policy
Effective From:
22/11/2012
Date Ratified
Ratified
Review Date
Sponsor
Expiry Date
Withdrawn Date
07/11/2012
Health Informatics Assurance Committee
01/11/2014
Medical Director
01/11/2015
This policy supersedes all previous issues.
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
Version Control
Version Release
1.0
Sept 2005
2.0
22/11/2012
Author /
Reviewer
Ratified by /
Date
Authorised by
Trust Policy
Forum,
IG Committee,
Health
Records
Group
L. Hamill
Confidentiality
& Data
Protection
Group,
Health
Informatics
Assurance
Committee
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
Changes
(Please identify
page no.)
Sept 2005
Complete review
of all sections.
Amended format
in line with Trust
07/11/2012 standards.
Change of policy
number
(previously
OP28)
2
Contents
Section
Page
1.
Introduction ................................................................................................................. 4
2.
Policy Scope ............................................................................................................... 4
3.
Aim of Policy ............................................................................................................... 4
4.
Duties (Roles & Responsibilities).............................................................................. 4
4.1. Trust Board ......................................................................................................... 4
4.2. Chief Executive ................................................................................................... 4
4.3. Caldicott Guardian (Medical Director) ................................................................. 5
4.4. The Confidentiality & Data Protection Group (C&DP Group) .............................. 5
4.5. The Health Informatics Assurance Committee (HIAC) ........................................ 5
4.6. Information Governance Officer .......................................................................... 5
4.7. Information Asset Owners ................................................................................... 5
4.8. All Staff ............................................................................................................... 5
5.
Definitions ................................................................................................................... 5
6.
Clinical Photography and Audio Visual Recording of Patients .............................. 6
6.1. General Principles – Undertaking Recordings .................................................... 6
6.2. General Principles – Transferring Recordings .................................................... 6
6.3. Consent............................................................................................................... 7
6.4. Non-Clinical Photography ................................................................................... 8
6.5. Digital Images of Patients ................................................................................... 8
6.6. Copyright............................................................................................................. 9
6.7. Acquisition, Logging & Storage ........................................................................... 9
7.
Training ..................................................................................................................... 10
8.
Equality and diversity ............................................................................................... 10
9.
Monitoring Compliance with the Procedure ........................................................... 10
10. Consultation and Review ......................................................................................... 10
11. References ................................................................................................................ 10
12. Associated Documents ............................................................................................ 11
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
3
1.
Introduction
Photographs and video recordings of patients are an integral part of the delivery of
patient care and treatment. They may also be used for teaching, clinical research
and literature. Photographic recording techniques include photographic film, digital
image and video. Any such recordings (identifiable or non-identifiable) must only be
taken and used with appropriate consent.
Photographs, film and other any images which illustrate a patient’s condition or
aspect of their treatment, forms part of the patient’s health record. All health
records, and therefore, all illustrative patient images, are subject to the provisions of
the Data Protection Act 1998 because they fall within the definition of personal data
and sensitive personal data. Rights of confidentiality and consent must also be
considered.
2.
Policy Scope
This Policy covers all Trust sites and applies to any individual employed, in any
capacity, by the Trust including employees, students and third party contractors.
This policy excludes specialist forensic paediatrics, diagnostic or therapeutic
imaging, and CCTV.
OP72 – Education Audio Visual Policy deals with the recording of training sessions
within the Clinical Skills area of the Trust.
3.
Aim of Policy
This policy sets out the requirements for confidentiality and consent for creating and
using photography and audio visual recordings of patients under the care of the
Trust.
Patients would be unlikely to trust staff with personal information about themselves
and their clinical condition if they believed that it may be passed on to others without
proper controls. It follows that a high standard of security is required within the
Trust to store and maintain this personal information which includes any
photographs and audio visual recordings.
4.
Duties (Roles & Responsibilities)
4.1.
Trust Board
It is the role of the Trust Board to define the Trust’s strategy in respect of
information governance, taking into account the legal and NHS requirements.
The Board is also responsible for ensuring that sufficient resources are
provided to support the requirements of the strategy.
4.2.
Chief Executive
The Chief Executive is the named officer with responsibility for ensuring that
the Trust complies with its statutory obligations and Department of Health
Directives.
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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5.
4.3.
Caldicott Guardian (Medical Director)
As Caldicott Guardian, the Medical Director is responsible for ensuring that
the Trust processes satisfy the highest practical standards for handling
patient/personal information.
4.4.
The Confidentiality & Data Protection Group (C&DP Group)
The C&DP Group is responsible for the development of strategy and
guidance for the Trust in relation to all confidentiality and data protection
matters, and also operational support to the Trust on Information Governance
compliance. The C&DP Group reports to the Health Informatics Assurance
Committee.
4.5.
The Health Informatics Assurance Committee (HIAC)
The HIAC ensures that the Trust has a consistent and effective approach to
the management of the information assurance agenda such as the IG toolkit,
elements of CQC and NHSLA compliance. The HIAC reports to the Patients,
Quality, Risk & Safety Committee.
4.6.
Information Governance Officer
The lead Information Governance Officer is responsible for monitoring and
assisting the investigation of any relevant incidents reported through DATIX.
4.7.
Information Asset Owners
Information Asset Owners are responsible for carrying out spot checks within
the departments, wards etc which fall within their areas of responsibility.
4.8.
All Staff
All staff within the Trust are responsible for ensuring that they adhere to this
Policy at all times and ensure that personal identifiable information is kept
confidential and transferred appropriately.
Definitions
Recording
Meaning originals or copies of video recordings, photographs and other visual
images of patients but not including diagnostic or therapeutic imaging or CCTV
recordings of public areas in the Trust, which are the subject of separate guidance.
Personal Data
Data that relates to a living individual that can identify the individual from this data or
other information in the possession of the data controller.
Sensitive Data
Data that relates to a living individual that includes racial or ethnic origin, political
opinions, religious or other beliefs, trade union memberships, physical or mental
health condition, sex life, criminal proceedings or convictions.
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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6.
Clinical Photography and Audio Visual Recording of Patients
6.1.
General Principles – Undertaking Recordings
When undertaking any patient recordings, particular care must be taken to
respect patients’ dignity and privacy. There must be a fully justifiable purpose
for a visual image to be carried out. The following general principles apply to
the undertaking of recordings covered by this policy.

Seek permission to make the recording and get consent for any use or
disclosure

Give patients adequate information about the purpose of the recording
when seeking their permission

Ensure that patients give their permission willingly

Stop the recording if the patient asks you to, or if it is having an
adverse effect on the consultation or treatment

Do not participate in any patient imaging made against a patient’s
wishes

Ensure that the imaging does not compromise patients’ privacy and
dignity

Do not use the images for purposes outside the scope of the original
consent for use, without obtaining further consent

Make appropriate, secure arrangements for storage of visual images

Consent documentation must be held within the health record

All Trust staff undertaking recording on behalf of the Trust should be
aware that full copyright and reproduction rights are assigned to the
Trust

Only equipment owned by the Trust or other approved organisation
(e.g. universities in the case of research) may be used for undertaking
recordings.
6.2.
General Principles – Transferring Recordings
The transfer of photographs and audio-visual recordings must be governed
by clear and transparent protocols that satisfy the requirements of law and
guidance, and regulate working practices in both the disclosing and receiving
organisations. It is particularly important that those asked to transfer patient
media can be confident that high standards, agreed in advance, will apply
and that the media will be used only for agreed and legitimate purposes.
The Caldicott Principles outlined below will be applied to patient media flows
within the Trust and those passing to and from the Trust:

Justify the purpose(s) for using confidential media

Only use it when necessary

Use the minimum that is required

Access should be on a need to know basis

Everyone must understand his or her responsibilities and understand
and comply with the law
Staff should refer to IG07 – Caldicott & Safe Haven Procedure for further
details on how to transfer personal data.
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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6.3.
Consent
The practice of obtaining patient consent only in the case of full length or
facial photographs and audio visual recordings in no longer sufficient. It may
be possible to identify a patient from other distinguishing marks, e.g. tattoos
and birthmarks. For this reason the Trust has adopted a policy of obtaining
informed consent from all patients. The consent form for permission to record
patient images can be found in Appendix 1.
In order to comply with the law and ensure that the patients right of
confidentiality is respected the following is required:

The patient’s consent is obtained in writing for the original photograph
or audio visual recording and for its use as a part of
o
Clinical care.
o
Clinical care and teaching (anonymised) within the Trust or
associated Medical Schools.
o
Clinical care, teaching (anonymised) and professional
publication (anonymised)

Only authorised copies are made.
6.3.1. Consent Procedures
The following consent procedures must be followed:

The Photography and Audio-visual consent form (at Appendix
1), once signed, must be included in the patient’s health
records. The form allows the patient to consent to one further
use at the time of the original photograph. Details of extra use
should be explicitly stated. Patients must sign the form before
photography takes place.

In the case of minors, the person with parental responsibility
should sign the consent form. This single consent will be
adequate for the entire course of treatment where a child may
attend unaccompanied on future occasions, unless the minor
reaches the age of 16, when new consent is required. Rarely if
a minor is deemed competent they may sign a consent form
themselves (Gillick1). If the child is over 12 years old it is good
practice to gain their consent in addition to that of the person
with parental responsibility.

In the case of photography of minors and vulnerable adults. A
chaperone, who must be a health professional, must be present
to ensure that the correct photographs are taken ensuring the
protection of both the patient and photographer.

Photographs and audio-visual recordings of unconscious
patients may be taken provided that retrospective consent is
obtained. If not the media must be destroyed.
No photography or audio-visual recordings may be considered without
the appropriate consent. Consent is integral within the Trust Consent
to Treatment Forms:

Parental agreement to investigate or treatment for a child

Adults who are unable to consent to investigation or treatment

Adult patient agreement to investigation or treatment
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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In all other circumstances consent should be obtained by use of the
appropriate form as attached within the appendices of this policy.
In certain circumstances, e.g. suspected non-accidental injury to a
child where recording of the injury is demonstrably to the patients
benefit and where the person with parental responsibility will not give
consent, details of the case will be referred to Social Services by the
lead Consultant.
It is not permissible to alter any patient identifiable photograph or
audio-visual recording in any way to achieve anonymity and so avoid
the need for consent.
In cases where the patient has died prior to consent being obtained,
patient images may only be released with the consent of the
deceased’s personal representative. Where the personal
representative is not a relative, the permission of the next of kin should
be obtained, where possible.
If a consenting patient subsequently dies, the permission of the
personal representatives and the next of kin must be obtained for any
additional use outside of the existing agreement.
6.4.
Non-Clinical Photography
In cases where the patient is incidental to the photograph or audio visual
recording e.g. where the picture is to illustrate equipment set-up, consent to
appear in the photograph or audio visual recording is still required as detailed
above. The appropriate form at Appendix 2 or 3 should be used.
Accidental photography or video recording of subjects who have not given
their consent must be avoided. Images which have been inadvertently
recorded should be destroyed unless deleterious to the care of the subject
patient.
Members of staff who appear in photographs are deemed to have given their
consent to the photograph and any subsequent uses.
Where photographers from outside of the Trust take photographs:

They may only be introduced to Trust premises with the authorisation
of the Head of Communications or the appropriate Director.

Contracts must address patient confidentiality and ensure that
copyright over the pictures are retained by the Trust.
6.5.
Digital Images of Patients
It is recognised that while digital images are intrinsically no different to
traditional photographs, they are easier to copy in electronic form and at
greater risk of image manipulation and inappropriate distribution. Particular
care must be taken to protect the confidentiality and integrity of the image.
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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Digital images must not be altered in any way (including file compression)
before storage.
Images of patients may only be transferred and stored on personal
computers for use in Ethical Committee approved and registered research
projects or for the preparation of teaching materials for as stated in section
6.3.1.
Before leaving the employment of the Trust, staff must erase any patient
images stored on personal computers unless specific permission to retain the
images for teaching purposes has been obtained.
6.6.
Copyright
The Trust holds the copyright of all photographs and video recordings of its
patients.
Where images are published copyright must be retained by the Trust and
must not pass to the publishers as the Trust may find that it is unable to
protect patient interests in future publication.
Junior doctors or others who may acquire copies of photographs during the
course of their duties may retain these for teaching purposes, but must
undertake only to use then within the terms of the original consent (see
6.3.1). Copyright and reproduction rights remain with the Trust.
6.7.
Acquisition, Logging, Storage & Destruction
All staff undertaking the creation, storage, destruction or retrieval of images
must be trained in these procedures.
All photographs and video recordings must be logged in the health record
and must be available for disclosure if required. The completed consent form
must also be kept in the patient’s health record.
Photographic negatives or audio video recordings must be securely stored in
the originating department.
For photographic transparencies and audio-visual media a second copy must
be made at the time of development to be used as a master copy. This must
be stored securely in the originating department. Where it is impossible to
obtain a master copy the original photograph or tape should be regarded as
the master and duplicates made as necessary.
For digital images the original file, without manipulation or compression, must
be written to electronic media and stored. Appropriate media includes CDROM or a central file server. The storage of digital images on personal
computers is not permitted except as stated in 6.1. For retrieval purposes
each image should be given an identifiable filename, incorporating the patient
number and date of photography.
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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Images taken for clinical purposes should be destroyed in line with the
Records Management Policy (IG05). Any images taken and used for
teaching purposes should be destroyed after use in accordance with the IT
Security Policy (OP6b).
7.
Training
Information Governance training including Data Protection and Caldicott and Safe
Haven principles will be provided to all staff as part of their induction training.
Refresher training will be provided as part of the Trust’s annual statutory and
mandatory training programme.
8.
Equality and diversity
The Trust is committed to ensuring that, as far as is reasonably practicable, the way
we provide services to the public and the way we treat our staff reflects their
individual needs and does not discriminate against individuals or groups on the
grounds of any protected characteristic (Equality Act 2010). An equality analysis
has been undertaken for this policy, in accordance with the Equality Act (2010).
9.
Monitoring Compliance with the Procedure
Monitoring compliance with this procedure will be the responsibility of the
Information Governance Officer and Information Asset Owners. This will be
undertaken by:
Standard / process /
issue
Compliance with
following the Procedure
10.
Monitoring and audit
Method
By
Committee Frequency
Monitoring
IG
Confidentiality Monthly
and
Officer & Data
investigation
Protection
of DATIX
Group
related
incidents
Spot checks IAOs
Confidentiality Annually in
carried out
& Data
each
to check
Protection
department
procedures
Group
/ ward
being
followed
Consultation and Review
This Procedure has been reviewed by the Confidentiality and Data Protection Group
and approved through the Health Informatics Assurance Committee.
11.
References


Data Protection Act 1998
Caldicott Principles
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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12.
Associated Documents

IT Security Policy (OP6b)

Information Security Policy (IG02)

Records Management Policy (IG05)

Freedom of Information Policy (IG04)

Information Governance Strategy (IG01)

Confidentiality Code of Conduct (IG06)

Caldicott & Safe Haven Procedure (IG07)

Information Risk Policy (IG03)

Pseudonymisation Policy (IG08)

Education Audio Visual Policy (OP72)
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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Appendix 1: Consent form for use when recording patient images
Gateshead Health NHS Foundation Trust
Recording of Patient Images
Gateshead Health NHS Trust gives you the right to control the future use of photographs
or videos taken of you during the course or your treatment.
We would like you to have some: (please tick)

medical photographs


video recordings

taken for your case note record and/or for teaching of medical, paramedical and nursing
staff and medical students.
Your consent limits their use to these purposes only.
Should we wish to use your image in any other way, (for example in a medical textbook)
we will seek your permission to do so.
Consent to photographic or video recording
I have read understood and accept the above statement, and I consent to my image being
recorded for these purposes.
Patient Name:
Patient signature:
Signature of Parent/Guardian:
(If appropriate)
Date:
Minors and Vulnerable Adults
A health professional, who acts as chaperone, must be present when photographing
minors and vulnerable adults.
Chaperone Name:
Chaperone signature:
Job Title
Date:
In addition I consent to photographs being taken for the purpose of (please tick)
Clinical care.

Clinical care and teaching (anonomised) within the Trust or associated
Medical Schools.

Clinical care, teaching (anonomised) and professional publication
(anonomised)
As explained to me by:

Patient signature:
Signature of Parent/Guardian:
(If appropriate)
Date:
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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Appendix 2: Sample wording of release of images for additional purposes
Gateshead Health NHS Foundation Trust
Request to release patient images
This wording should be adapted as appropriate to the current situation. If it is possible to
be specific about the use of patient images it is advised that a detailed explanation be
given.
I agree to appear in photographs to be taken for Gateshead Health NHS Trust for
information and publicity purposes. I understand that they may be used in articles seen by
the general public or in medical textbooks on general sale.
Patient Name:
Patient signature:
Signature of Parent/Guardian:
(If appropriate)
Date:
This consent form should be filed in the patient case notes and a copy sent to the relevant
department prior to undertaking the photography/video recording.
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
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Appendix 3: Consent form for use when recording patient interactions with other
individuals
Gateshead Health NHS Foundation Trust
Recording of Patient Interactions with other individuals
Gateshead Health NHS Trust gives you the right to control the future use of photographs
or videos taken of you within the Trust
We would like you to have some: (please tick)

 medical photographs


video recordings
taken to assist us in the care/treatment of:
Hospital Record Number
Patient Name
Your consent limits their use to these purposes only.
Consent to photographic or video recording
I have read, understood and accept the above statement and I consent to my image being
recorded for these purposes.
Name:
Signature:
Address:
Signature of Parent/Guardian:
(If appropriate)
Relationship to Patient/Client:
Date:
Minors and Vulnerable Adults
A health professional, who acts as chaperone, must be present when photographing
minors and vulnerable adults.
Chaperone name:
Chaperone signature:
Job Title
Date:
Clinical Photography and Audio Visual Recording of Patients
– Confidentiality and Consent Policy v2
14