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Updated on 11 May 2018, 1146 views

The December 1997 Caldicott Report identified weaknesses in the way parts of NHS handled confidential patient data. The report made sixteen recommendations,one of which was the appointment of Caldicott guardians, members of staff with a responsibility to ensure patient data is kept secure.  It is now a requirement for every NHS organisation to have a Caldicott guardian.  The Guardians are responsible for ensuring that their organisation adheres to the Caldicott Principles.

The six Caldicott Principles are as follows:

  1. Justify the purpose(s) of using confidential information
  2. Every proposed use or transfer of patient-identifiable information within or from an organisation should be clearly defined and scrutinised, with continuing uses regularly reviewed, by an appropriate guardian.
  3. Do not use patient-identifiable information unless it is absolutely necessary
  4. Patient-identifiable information items should not be included unless it is essential for the specified purpose(s) of that flow.  The need for patients to be identified should be considered at each stage of satisfying the purpose(s).
  5. Use the minimum necessary patient-identifiable information that is required
  6. Where use of the patient-identifiable is considered to be essential, the inclusion of each individual item of information should be considered and justified so that the minimum amount of identifiable information is transferred or accessible as is necessary for a given function to be carried out.

Access to patient-identifiable information should be on a strict need-to-know basis

Only those individuals who need access to patient-identifiable information should have access to it, and they should only have access to the information items that they need to see. This may mean introducing access controls or splitting information flows where one information flow is used for several purposes.

Everyone with access to patient-identifiable information should be aware of their responsibilities

Action should be taken to ensure that those handling patient-identifiable information - both clinical and non-clinical staff - are made fully aware of their responsibilities and obligations to respect patient confidentiality.

Understand and comply with the law

Every use of patient-identifiable information must be lawful. Someone in each organsiation handling patient information should be responsible for ensuring that the organisation complies with the legal requirements.

Following a request from the Secretary of State for Health, Dame Fiona Caldicott carried out a further independent review of information sharing in March 2013 to ensure that there is an appropriate balance between the protection of patient information, and the use and sharing of information, to improve patient care.

More information is available at: