What legal and ethical obligations do I have as a GP when a patient discloses a sexual assault?

When a patient discloses experiencing sexual assault, a general practitioner (GP) has both legal and ethical obligations to ensure the patient's safety, confidentiality, and access to appropriate support. First, the GP must maintain patient confidentiality and only share information with the patient's consent, unless there is a significant risk of harm to the patient or others, in which case disclosure may be justified in the public interest or to protect vital interests. The GP should reassure the patient that they believe them, that the assault is not their fault, and that they have a right to safety. Immediate risk of harm must be assessed; if present, emergency services (999) and safeguarding teams should be contacted, ideally with the patient's consent. If no immediate risk is identified, the GP should provide a basic safety plan, manage any physical injuries, and arrange appropriate referrals or admissions based on clinical judgement. The GP should avoid advising the patient on specific actions such as leaving a partner unless the patient is ready and supported. Accurate and careful record-keeping is essential, as medical records may be used as evidence in legal proceedings, but records must be managed to avoid increasing risk to the patient, for example, by accidental discovery by a perpetrator. The GP should provide information about local and national support services and consider referral to specialist domestic abuse or sexual assault support agencies. Multi-agency working is important to ensure comprehensive care and protection. For children and young people, confidentiality and consent must be handled sensitively, ensuring privacy and considering best interests, with information sharing only when necessary to protect the child or others.

These obligations are grounded in UK legal frameworks and ethical guidance, including the NHS Code of Practice on Confidentiality, GMC guidance on confidentiality, BMA reports on adults at risk, and NICE public health guidance on domestic abuse and safeguarding

¹,²,³,⁴.