Faouzi Alam is Caldicott Guardian for Cheshire and Wirral Partnership NHS Foundation Trust, which provides care across a wide catchment area for people with mental health problems, learning difficulties, eating disorders, and drug & alcohol issues. It also manages community physical health services and primary care for a population of more than one million. Faouzi is a consultant psychiatrist who cares for people who suffer from first episode psychosis. He is also the Trust’s medical director and responsible officer.
Faouzi believes that this combination of clinical work and medical management gives added credibility to his Caldicott role, but also poses some challenges not least because of time constraints. He says: “As is the case with many medical directors and nursing directors, the role of a Caldicott Guardian is an add-on. This might seem a disservice to the Caldicott cause, but with the right support it is a great advantage.” In Faouzi’s case, a close working relationship with the trust’s information governance lead, Gill Monteith, provides the teamwork needed for effective implementation of the Caldicott principles.
Together they provide a focal point for the resolution and/or discussion of information governance issues, which include maintaining service users’ confidentiality and safeguarding individuals while promoting appropriate information sharing within and outside the Trust. They work with other care providers and linked agencies to enable better sharing of relevant information about patients, in a manner that facilitates joined-up care across institutional boundaries while ensuring that patients’ legal rights and the Caldicott principles are maintained. For example, they attend external meetings to arrange system-wide information sharing for the Cheshire Care Record, a summary record of GP information and several local trusts’ information. Gill produces information sharing agreements and checks those received, prior to formal sign off by Faouzi.
They have regular monthly meetings to ensure implementation of Caldicott 2 and to devise action plans for implementation of the EU’s new General Data Protection Regulation and the National Data Guardian’s recommendations. They discuss specific cases, for example breaches of confidentiality and the approach to be taken. They ensure the approach to information handling is communicated to all staff.
Faouzi sees education as key to promoting the Caldicott function; he provides teaching to new recruits and a session for junior doctors at each induction. He also works to develop the information sharing needed to establish a “triangle of care” by involving carers more fully in interactions between patients and professionals.
Faouzi devotes at least half an hour a day to the role of Caldicott Guardian. He says that working as Caldicott Guardian in a mainly mental health trust brings some interesting challenges, especially around issues of mental capacity and information sharing. It is well understood that every patient is presumed to have capacity unless proven otherwise. However, complexities may arise when patients with severe mental illness, learning difficulties, lack of capacity, and a complicated family life are detained in hospital with significant risk issues. Clinicians may have to take very difficult decisions about sharing the necessary information, justifying the purpose, giving access to the right people to view sensitive data and complying with the law — all at the same time.
Faouzi is a member of the UK Caldicott Guardian Council. He always champions mental health issues and brings a psychiatrist’s perspective when the council discusses difficult cases requiring an expert opinion.