Dealing with breach of confidentiality and unacceptable behaviour

Q. A PATIENT has written into the practice with a serious allegation. As practice manager I phoned her to discuss her letter and she claims one of our receptionists has started an affair with her estranged husband.

The patient also claims this receptionist has phoned her twice and threatened her. She says she is fearful of these threats and also wants to know how the receptionist got her number.

I have spoken to the receptionist who denied threatening the patient but admitted phoning the practice on her day off and asking a colleague to look up the number on the system. Her colleague advised that the receptionist made the two threatening calls from the reception area in front of her and two other colleagues.

The partners are furious about this and want to dismiss the receptionist immediately. How should I handle the situation?

A. This is a very serious matter and one that needs to be dealt with not only thoroughly but promptly too. As you have already spoken to the patient and gathered all the details, there is no need to involve her again at this stage, until the internal process has been completed.

Although the receptionist has acted in a way that is potentially gross misconduct, it is not possible to just dismiss her without the risk of losing an unfair dismissal claim for not following the correct process.

It would be recommended to invite the receptionist to an informal meeting and advise her that this matter needs to be investigated further and that she is being suspended on full pay whilst this is carried out.

In this case, it would be wise to remove her from the premises so that the other employees do not feel threatened by her while the matter is investigated. The colleague who gave out the number should be advised that she will be part of the investigation process for the receptionist but that she will also be subject to an investigation herself for giving out patient information and that formal action may be taken against her for breach of confidentiality.

Dealing with the receptionist first, the next stage of the process is to call in the colleagues who witnessed her behaviour and ask them for written statements detailing exactly what they heard being said to the patient. The employees should sign the statements indicating they are a true reflection of events and be advised that the statements will be used as part of any disciplinary procedures.

Once you have gathered and checked the statements for consistency, a disciplinary hearing should be set up with the receptionist and with partners who have not been involved in the investigation process.

The receptionist should be invited to the meeting by letter, giving her the right to be accompanied by a colleague or trade union representative. She should be given copies of the statements and any investigatory notes to give her time to prepare for the meeting and be advised in the letter that the outcome may lead to her dismissal from the practice for gross misconduct.

Depending on the outcome of the disciplinary, the partners may decide the receptionist's actions do amount to gross misconduct. In this case, they could dismiss her immediately with no notice.

In any case, the receptionist should be informed in writing of the outcome of the hearing and be advised of her right to appeal any decision made.

With regards to the colleague that gave the receptionist the number, an investigation should take place to ask her about this. If she admits to giving the receptionist the patient's number then that would be in breach of the practice's confidentiality rules. Such a breach would have to be dealt with by means of a disciplinary hearing and the worker should be advised of the outcome i.e. she may be issued with a final written warning.

Following these hearings, the patient should then be advised that the appropriate action has been taken against the staff members involved.

Such incidents like these cause a difficult time in the practice, but if you work through the disciplinary process, the matter should be resolved in a fair and reasonable way and should also ensure that the patient is confident that their complaint has been dealt with seriously and competently.