After a patient has died, GP practices are often approached by relatives, carers or officials asking for confidential information about the patient.

Reasons might include:

they may want to better understand what happened leading up to the death
they may wish to make a complaint about the care the patient received
they may want the information as part of a possible claim
they may be challenging the patient's will
they may need the information to complete official documents - for example, for family members may wish to make an insurance claim on a cancelled holiday.

It can be very difficult to know when it is appropriate to disclose information and how much to disclose in response to a request.

You also need to know the legislation relevant to this area and what the GMC expects.

GMC guidance

The relevant provisions are set out in the GMC's Confidentiality: good practice in handling patient information (2017, last updated 2024), paragraphs 134-138.

134. Your duty of confidentiality continues after a patient has died.

135. There are circumstances in which you must disclose relevant information about a patient who has died. For example:

a. when disclosure is required by law

b. to help a coroner, procurator fiscal or other similar officer with an inquest or fatal accident inquiry

c. on death certificates, which you must complete honestly and fully

d. when a person has a right of access to records under the Access to Health Records Act 1990 or the Access to Health Records (Northern Ireland) Order 1993, unless an exemption applies

e. when disclosure is necessary to meet a statutory duty of candour.

136. In other circumstances, whether and what personal information may be disclosed after a patient's death will depend on the facts of the case. If the patient had asked for information to remain confidential, you should usually abide by their wishes. If you are unaware of any instructions from the patient, when you are considering requests for information you should take into account:

a. whether disclosing information is likely to cause distress to, or be of benefit to, the patient's partner or family

b. whether the disclosure will also disclose information about the patient's family or anyone else

c. whether the information is already public knowledge or can be anonymised or de-identified

d. the purpose of the disclosure.

137. Circumstances in which you should usually disclose relevant information about a patient who has died include:

a. the disclosure is permitted or has been approved under a statutory process that sets aside the common law duty of confidentiality, unless you know the patient has objected (see paragraphs 103-105)

b. when disclosure is justified in the public interest to protect others from a risk of death or serious harm

c. for public health surveillance, in which case the information should be anonymised, unless that would defeat the purpose

d. when a parent asks for information about the circumstances and causes of a child's death

e. when someone close to an adult patient asks for information about the circumstances of that patient's death, and you have no reason to believe the patient would have objected to such a disclosure

f. when disclosure is necessary to meet a professional duty of candour (see paragraphs 100 and 101)

g. when it is necessary to support the reporting or investigation of adverse incidents, or complaints, for local clinical audit, or for clinical outcome review programmes.

138. Archived records relating to deceased patients remain subject to a duty of confidentiality, although the potential for disclosing information about, or causing distress to, surviving relatives or damaging the public's trust will diminish over time.

Legislation

The relevant legislation is:

Access to Health Records Act 1990 - applies in England, Scotland and Wales.
Access to Health Records (Northern Ireland) Order 1993 - applies in Northern Ireland.

Both Acts give a deceased patient's 'personal representative', someone with the consent of the personal representative and anyone who may have a claim arising out of the patient's death, a right to make an application for the patient's medical records. Access should be limited or refused in certain situations (see below).

Terminology and why it is important

'Personal representative' is the term used in the legislation and means the person or people who deal with the estate of a deceased person.

If there is a will, the personal representative is known as an executor. If there is no will (or if the deceased did not appoint executors) the personal representative is called an administrator.

Relatives and others often think in terms of 'next of kin' (NOK). But whether someone was named NOK, or had power of attorney before a patient died, is not the same as being the personal representative - although they might also become the personal representative after the patient's death if, for example, they are named as the executor of the will.

Responding to requests for information

A request for copy records or information about one of your patients who has died can seem confusing because of the various routes to disclosure.

Here are some general guidance points, but MDU members should call us if you are ever unsure how to deal with a request.

A request for information about the circumstances surrounding death

Usually, if an individual close to the deceased asks for information to help them understand the circumstances of the death, you can respond in keeping with the GMC guidance set out above, without asking them to make an application under access to health records legislation.

A request for copy records under Access to Health Records legislation, made by the personal representative

The personal representative can request records without providing a reason.

Access should be limited or refused if:

there is evidence the patient would not have expected the information to be disclosed
if the disclosure is likely to cause serious harm to anyone else
if it would also disclose information about a third party (other than a health professional involved in the care) who does not consent
if it would disclose information that is not relevant to any claim that may arise out of the patient's death (if the applicant is not the personal representative)
if it predates 1 November 1991 in England, Scotland and Wales (unless earlier records are required to understand subsequent entries).

Access must be refused to records containing a note, made at the patient's request, stating they did not wish access to be given on an application under this legislation.

Applying these exemptions appropriately can be challenging and it can sometimes be difficult to know whether an entry amounts to a note in the record declining disclosure after their death. MDU members are encouraged to call us for advice before responding to these requests.

A request for copy records under Access to Health Records legislation, made by someone who is not the personal representative

An application for copy records might come from a solicitor, and insurance company or an individual (such as a relative) who is not the personal representative of the deceased. The applicant should explain why they want copy records (for example, to pursue a claim), and what records they want.

If the applicant provides you with evidence of consent from the personal representative, it is reasonable to disclose relevant information (as long as none of the conditions for limitation/refusal apply - see above).

Sometimes there are concerns such as:

the reason for requesting records may be unclear,
there may be no consent from the personal representative,
you may be aware of a dispute between family members (for example, over a will)
you may have other concerns

Managing these requests in a sensitive way can be challenging, but remember your role is to assess the requests and respond in a manner that this consistent with the GMC guidance and law. MDU members should call us for individualised advice where you have concerns.

Confidentiality and disclosing information after death

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