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Data Protection — DFSRH MCQ

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HardData ProtectionDFSRH

A 34-year-old woman submits a subject access request for the complete record held by an integrated sexual health service, including “anything another person has said about me”. During review, the clinician identifies a telephone note made 8 months earlier. The caller, who identified herself as the patient’s sister, alleged that the patient’s partner was pressuring her to have sex with other people for money. She asked that her involvement not be revealed and supplied her name, contact details and contextual information likely to identify her. The clinician subsequently assessed the patient alone. The patient denied coercion, demonstrated capacity and disclosed no safeguarding concerns; the assessment and safety-netting were documented. She was not told about the call. The electronic export permits line-by-line redaction. The responsible clinician considers that learning of the allegation may cause anger and distress but is not likely to cause serious physical or mental harm to the patient or another person. Which is the most appropriate response to the subject access request?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Disclose the patient-related allegation and subsequent assessment, while redacting the caller’s identifiers and contextual details that could reveal her identity.

Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as D · D = shown as E

The allegation and the service’s resulting assessment are personal data relating to the patient and fall within her right of access. Their third-party origin does not justify withholding the entire entry. However, the caller’s name, contact details and identifying contextual information are confidential third-party data unknown to the patient; these should be redacted where the patient-related content can be meaningfully separated. The redaction decision and rationale should be documented, while the original clinical record remains intact. A is incorrect because subject access does not automatically entitle the patient to unknown third-party identifiers or confidential information. B is disproportionate: the remainder of the record and separable patient-related content should not be withheld pending consent. C is an initially plausible confidentiality response, but it wrongly treats the source of information as determinative; information about the patient may still be disclosed after appropriate redaction. D misapplies the health-data exemption. Foreseeable anger, upset or stress is insufficient: withholding requires a clinical judgment that disclosure would be likely to cause serious physical or mental harm. E therefore best reconciles the patient’s access right with protection of the caller’s confidentiality.

Reference: Access to patient records through the NHS App (7 May 2026) — https://digital.nhs.uk/data-and-information/information-governance/guidance/access-to-patient-records-through-the-nhs-app Redaction (13 March 2025) — https://www.england.nhs.uk/long-read/redacting-information-for-online-record-access/