1.1 Identify own roles and responsibilities with regard to the current legislation, national guidelines, policies, protocols and good practice guidelines when obtaining an individual’s history.
My role and responsibility with regard to the current legislation, national guidelines, policies, protocols, and good practice guidelines when obtaining an individual’s history is of great importance. As a practitioner, I must comply with the relevant codes of conduct to ensure that my professional relationship with clients is both ethical and legal.
Legally, I have a duty under the Data Protection Act 1998 (DPA) and common law to protect personal data gathered from individuals during consultations. This includes information about medical histories, which can include mental health problems or anything else that would identify them in any way (Geoghegan et al., 2013). To protect client confidentiality during initial meetings, it is important to always remember that personal details shared should remain confidential unless permission has been given by an individual otherwise. It is also necessary for me to legally adhere to the Human Rights Act 1998, which gives all individuals the right to protection over their information/data collected while under care or any other scenario they may be involved in.
In addition, as a practitioner, I must comply with the current national guidelines and protocols set by the National Institute of Health Care Excellence (NICE). This guidance provides an essential source for standardising best practices in all care settings. The NICE CKS (Clinical Knowledge Summaries) was developed to support NHS professionals in making decisions on diagnoses and treatment pathways based on evidence-based research. Furthermore, within my role, I must also be aware that local policies/protocols may differ slightly from those recommended by NICE due to regional differences or additional needs that require adaptation.
To ensure best practice is maintained when obtaining an individual’s history, it is important that their rights are considered at every step during this process. This includes treating them with respect and dignity, showing empathy, and being sensitive about any difficult questions asked relating back directly to their medical histories if applicable. Taking into account cultural background should also be considered during the process to minimise any feelings of alienation or embarrassment on behalf of the individual. Furthermore, actively listening and allowing them to explain things in their own terms can also help build rapport and trust with clients).
In conclusion, it is my responsibility as a practitioner to ensure that current legislation and national guidelines/policies are adhered to when obtaining an individual’s history. I must also remember that individuals have the right to privacy protection while still being sensitive about any difficult questions asked regarding this matter so I may obtain all the necessary information from them with minimal risk or distress.
Other answers in the full document:
- 1.2 Explain the guidelines to be followed if the individual is unable to provide a relevant history.
- 1.3 Explain how to check a third party’s authority and ability to provide information about an individual.
- 1.4 Outline the steps to be taken to clarify and confirm any missing or ambiguous information in an individual’s history.
- 1.5 Explain own role and responsibilities in line with obtaining a client history.