It's common for GP practices to receive requests from one or both estranged parents, asking for the disclosure of medical records or other confidential information about their child.

These requests must be handled sensitively and correctly. Either parent might take issue with a disclosure - or a refusal to disclose - and make a complaint as a result.

It's important for doctors to be aware of the law and their rights and responsibilities when responding to these requests. Here are the factors you need to take into account.

Jump to:

What is parental responsibility?
Who has parental responsibility?
The child's capacity to consent to the disclosure of their records
The child's best interests
Should you tell the other parent?
Third-party information
Questions and answers
Practice checklist

What is parental responsibility?

Anyone with parental responsibility for a child has a right to request access to information in that child's medical records.

Parental responsibility is a legal term. In England and Wales it is defined in the Children Act 1989 as "all the rights, duties, powers, responsibilities and authority which by law a parent of a child has in relation to the child and his [sic] property".

In Scotland, parental responsibility is defined under the Children (Scotland) Act 1995, and in Northern Ireland by the Children (Northern Ireland) Order 1995.

There is more information on the UK government's website about who has parental responsibility in the various parts of the UK.

Who has parental responsibility?

Birth mothers automatically have parental responsibility, as do fathers married to the child's mother at the time the child was born.

Additionally, in Scotland, a father has parental responsibility if he was married to the mother when the child was conceived or married her at any point afterwards.

In Northern Ireland, as above, a father has parental responsibility if he was married to the mother at the time of the child's birth. In addition, if he married the mother after the child's birth, he will have parental responsibility if he lived in Northern Ireland at the time of the marriage.

When the father is not, or was not, married to the child's mother at the required time(s), he has parental responsibility if he is named on the birth certificate.

This has not always been the case and has only applied since law changes that took place on:

1 December 2003 in England and Wales
4 May 2006 in Scotland
15 April 2002 in Northern Ireland.

Step-parents and civil partners do not automatically have parental responsibility for their partners children even if they are significantly involved in their upbringing. They can however acquire parental responsibility by entering into a Parental Responsibility Agreement with the child's mother and anyone else who already has parental responsibility, or by obtaining a Parental Responsibility Order from the Family Court).

Same-sex parents will both have parental responsibility from the birth if they were civil partners or married at the time of treatment (such as donor insemination or fertility treatment).

If the couple are not civil partners or married, the non-biological parent can acquire parental responsibility by being named on the birth certificate, by entering into a Parental Responsibility Agreement with the birth mother, or by applying to the Family Court for a Parental Responsibility Order.

Parents do not lose parental responsibility if they divorce. However, it can be restricted by the court. If a child is adopted, the birth parents will lose parental responsibility for their child and the adoptive parents gain full and exclusive parental responsibility.

A local authority gains parental responsibility for a child in the following circumstances.

In England and Wales: when a court issues a Care Order under Section 31 of the Children Act 1989 placing the child in the care of the local authority.
In Scotland, when a child becomes 'looked after' under the Children (Scotland) Act 1985.
In Northern Ireland, Care Orders are issued under the Children (Northern Ireland) Order 1995 when a court decides the child needs to be taken into the care of a Health and Social Care (HSC) trust for their safety and well-being.

It's important to recognise that in most cases, where a local authority acquires parental responsibility for the child in the above circumstances, it does not automatically remove parental responsibility from the parents/others.

A child's testamentary guardian, special guardian or other person given a residence order also has parental responsibility.

Removing parental responsibility from an individual is usually only considered by the UK courts in exceptional circumstances, as it is a serious step that directly affects a child's welfare.

See also our quick guide to parental responsibility.

The child's capacity to consent to the disclosure of their records

Although someone with parental responsibility can request access to a child's medical records, the child may have the capacity to decide for themselves if they want the requested information to be disclosed to the specific individual.

The GMC's guidance 0-18 years explains when considering such requests doctors should take into account the views of a child who has capacity to be involved in such decisions.

Usually, the parents will have the child's best interests at heart and the doctor should then encourage the child to involve the parents in their care and allow access to the records.

A child or young person with capacity to make decisions about these matters has the legal right to access their own health records, and to allow or refuse* access by others, including their parents.

* You might receive a request to override a competent child's refusal to share the content of their clinical records in the public interest. If this happens, you're advised to contact the MDU.

In assessing whether a young person has the capacity to make the decision at the time it needs to be made, a doctor must make sure the child understands the nature, purpose and possible consequences of agreeing to, or refusing, disclosure.

To have capacity to make a specific decision, the young person must be able to:

understand, retain, use and weigh the information they are given that is relevant to the decision which needs to be made and;
communicate their decision.

The presence or absence of necessary capacity does not entirely depend on the child's age. It rests more on their ability to understand and weigh up the relevant factors and options.

In England and Wales, a young person of 16 and over can be presumed to have capacity to consent. Below this age, they may have capacity, depending on their maturity.

In Scotland, a child over 12 years old is presumed to have capacity to consent to decisions in relation to the disclosure of their medical records, although they could achieve capacity earlier or later than this.

The child's best interests

GMC guidance states that a doctor may allow someone with parental responsibility to access a child's medical records if the child or young person consents, or if they lack capacity and providing the disclosure doesn't go against the child's best interests.

However, the guidance also says: "If the records contain information given by the child or young person in confidence you should not normally disclose the information without their consent."

It may also be justifiable to disclose confidential information about the child to a third party who does not hold parental responsibility, providing this is clearly in the child's best interests.

Should you tell the other parent?

When one parent asks the practice to disclose information about the child, there is no obligation to seek consent from the other parent, or to tell the other parent that you have received the request.

However, it may be wise to make sure the other parent is aware of the request, so that you can take into account any objection they may make and the reasons for it.

It is important to recognise that you are not requesting permission or consent of the other parent to disclose the requested information, rather, you are simply seeking their views on it to allow you to make a decision.

Proof of parental responsibility

If you feel there is any doubt that the person making the request has parental responsibility for the child, you can ask to see a copy of the child's birth certificate and/or the parents' marriage certificate, or a letter from the person's solicitor confirming their parental responsibility status.

Remember that it's possible for parental responsibility to have been removed after the date of these documents.

If you are in any doubt that the person making the request is the individual named on the birth certificate, marriage certificate or letter from a solicitor, you can of course ask the individual to provide proof of identity.

Third-party information

Third party information may appear in a child's records. Before disclosure, you should consider seeking consent from the third party to disclose their information. If you can't get consent, the information may need to be anonymised or appropriately redacted before any material is shared.

Data protection law allows data controllers limited discretion to disclose third party information without the consent of the third party in certain circumstances.

Generally, if you can't comply with a request for records without disclosing information relating to another individual who can be identified from that information, then you may include the third-party information in the material disclosed to the requester if:

the third party has consented to the disclosure; or
you consider that it is reasonable in all the circumstances to supply the information to the requester without the consent of the third party.

Questions and answers

I don't know the estranged father. Do I need proof of identity?

You have a responsibility to satisfy yourself that the person requesting access has the right to do so, on the basis of having parental responsibility and that he is the individual he claims to be. This may require you to ask to see proof of identity, and/or evidence of parental responsibility.

The father is also a patient at the practice. The mother says he doesn't have parental responsibility, although he insists he does. Can we ask the mother to provide proof that the court has withdrawn his parental responsibility?

Your priority is to consider and act in the best interests of the child at all times.

Where you have reason to doubt that an individual currently has parental responsibility, you're advised to clarify that and this can include requesting information from another party if necessary. If the mother says it has been removed by the court, you can ask her to show you evidence of this.

The father wants us to let him know every time the child attends the surgery. Do we have to comply with his request?

A father with parental responsibility has a right to request access to their child's records, but that right does not extend to compelling the practice to inform him each time the child attends.

This can be explained to the father and if you are comfortable to do so, you could encourage the parents to communicate with each other, in the interests of their child.

However, you could consider a compromise (in the best interests of the child) by asking the father to request an update at mutually agreed reasonable intervals. This would be particularly appropriate if the child spends time in the care of the father, and has ongoing health issues.

The father has just been released from prison. The mother thinks he may use disclosure of their young child's records to find out where she lives. She feels vulnerable to physical attack. If he contacts the surgery, what can we say?

Although a father with parental responsibility has a right to request disclosure of his child's records, information should be withheld if disclosure would be contrary to the best interests of the child or if disclosure could lead to serious harm or be unreasonable to a third party.

We would always advise the home address of one parent is redacted from copies of the child's records disclosed to the other parent. It would be entirely reasonable to remove the mother's registered address from any copy records disclosed in this situation.

Practice checklist

Does the person requesting information have parental responsibility for the child? If in doubt, ask to see a copy of the child's birth certificate and/or parents' marriage certificate, or a solicitor's letter.
Does the child have capacity to consent/refuse to consent to the disclosure? If so, have they provided their consent?
Would it be contrary to the child's best interests to disclose the requested information to the individual who is asking for it?
Have you considered informing the estranged partner about the nature of this request and seeking their views?
Is there third-party information in the records? If so, you should consider obtaining consent from the third party for their information to be disclosed to the person who has made the request. If they do not wish their information to be disclosed, have they provided their reasons for objecting?
If no consent can be obtained from the third party, can the information be anonymised or appropriately redacted?
The child's GP should be involved in the decision about whether or not to disclose.
All decisions and details of what has been disclosed to whom and why should be recorded in the child's medical notes.

Children whose parents are separated

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