Disposing of confidential information / Staff Training

I have just read an article about a NHS hospital that has had medical records of several patients found “blowing around in the street”

here is the link


This story brings my thoughts back to a time in the surgery when I arrived at work early one morning to find several torn up pieces of paper littering the car park around the back of the surgery building.

On investigating what it was I was mortified to see that the litter contained  patient information – by sheer luck it was a wet day and the information was wet and had fact stuck fast to the ground and it was in torn up pieces – but I could still identify some patient information. I searched the grounds and by sheer luck there was only a few pieces that I found – I went over to the bin area and found that the lid to the bin had blown up, the bin was in fact full and the contents had blown out. The bin contained more patient information.

I made sure that every bit of patient information was removed from the bin and brought back inside and I investigated straight away why that information had found its way into the bins.

I discovered what had happened. We had a new member of staff join the Reception team the day before. She was working the late shift with one other Receptionist and the new Receptionist had not been shown where the confidential waste was to go so she disposed of the information in the normal office bin. The older serving Receptionist had printed off the next days surgeries (this was always done in case of a power cut and we would at least have a list of patients due into surgery the next day) That day’s list would then be destroyed.

There were numerous large marked containers around the surgery for all confidentiality waste to go into. The Receptionist gave the lists to the new Receptionist “thinking” the new Receptionist would know where it had to go – the new Receptionist had never worked in medical field before and had no idea of confidentiality and what it really meant,  something that we all take for granted.

Our cleaners were also excellent and if they were ever in doubt about putting something in the normal bins they would ask someone. This particular day we had another cleaner covering as our usual one was on holiday.

A team includes everyone even the cleaners. In my experience including the cleaners in certain training sessions and keeping them updated with certain changes in the Surgery definitely helps in many way.

I completed an incident report form and I discussed this with staff at our next Team Meeting.

A big error made and we were completely at fault. This incident highlighted we cannot take anything for granted, especially when it come to new staff – training is vital, and so in ongoing training for older serving members of the team, and if you employ cleaners perhaps they should be included in confidentiality training, and if you have contract cleaners ensure that they are fully aware of confidentiality. It might save a lot of problems if something like this should happen.

I have recently completed confidentiality training to a organisation (not healthcare) and used this incident in the training sessions  – several people over the two courses admitted that they didn’t destroy customer confidential information and just put it in the normal bins and agreed they would all be shredding all their confidential information from now on.


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2. DNA – The Reception Team Member


Referring back to my blog on DNA appointments I received a lovely reply from a Reception Team Member who works for a surgery that has approx 25,000 patients.

She too spoke of the frustration that DNA appointments can cause on a daily basis. She now had a system in place at the end of the day where she gets her team to first checks who made the appointment, and whether the patient has already booked. The team approach the patient in a positive manner (ie not guns blazing) as she agreed there could be an error on the surgery in not cancelling the appointment. People will also respond better when someone is approaching them in a positive manner.

The team asks the patients why they DNA their appointment, and in many cases they are extremely sorry for missing their appointments.

I think this is an excellent exercise as it can flag up several issues

  • It can let the patient know you are monitoring the appointments system – especially for those patients that just have not “bothered” to cancel their appointment.
  • It could flag up that patients perhaps are cancelling their appointments and they are not being cancelled on the system
  • Are appointments being booked too far in advance (ie 6 monthly BP checks, or diabetics checks – if so how could your surgery best deal with this.
  • Could highlight the importance of giving out appointment cards whenever possible.
  • Could highlight those few that are constantly not turning up for appointments.

When speaking to the patients regarding their DNA try to get the reasons why in a positive way and look at ways of improving the amount of DNA’s that your surgery has.

What would be helpful would be when you are talking to the patients if it is the first time you speak to them about their DNA you could explain that you are trying to look at the amount of DNA’s and at ways of decreasing these and their feedback on why they DNA would help with this exercise. Explain if patients cancel their unwanted appointments then this will free up appointments for other patients – which could be them. This was it will turn the telephone conversation into a positive one instead of a negative one.

But I am sure by getting a phone call regarding a DNA will certainly get a patient thinking more carefully next time if they simply do not want the appointment and hopefully they will phone to cancel the appointment.

Thank you for your feedback and hopefully this will help other surgeries in dealing with their DNA’s.