There are thousands of Caldicott Guardians in health and social care organisations across the UK. They share a common function, which is to make wise decisions about the use of people’s information. They balance the need to protect people’s confidentiality with the need to protect their welfare by ensuring that information is safely communicated among the various professional teams caring for an individual, sometimes across organisational boundaries. They bring to bear ethical as well as legal considerations, making judgements about real life human situations that could not be done by a machine.
However, Caldicott Guardians are not all the same. In a large NHS hospital trust, the Caldicott Guardian may be the medical director, director of nursing or a senior health professional, with wide-ranging professional responsibilities and supported by teams of people expert in information management and governance. In a local authority, the Caldicott Guardian may be a director of similar seniority and with similar support, but with different precepts regarding the consent needed from service users before information about them can be shared. There are Caldicott Guardians in hospices, clinics, care homes and prisons. They are appointed in GP practices, pharmacies and charities. They perform a key role in the largest of the organisations that govern the health and social care sector, but also in the smallest organisations. Some providers and commissioners are required by Government to appoint a Caldicott Guardian; others choose to do so because they want to do their best to look after people’s information legally and ethically.
Given this diversity, it is not possible to produce a single manual that would provide every Caldicott Guardian with everything they might need to know to perform effectively. The UK Caldicott Guardian Council (UKCGC) offers this relatively short guide in the hope that it will help in various ways: as a starting point for the newly-appointed Caldicott Guardian, as an aide memoire for the more experienced, and as a pointer to the possibilities for professional development and support.
At the outset, it is worth giving a word of warning. It is difficult to explain how rewarding the work of a Caldicott Guardian can be without giving examples of the activities of individual Caldicott Guardians. We have therefore included a number of profiles of people doing this important work. These are only examples: a case handled by a Caldicott Guardian in one sector may or may not have wider relevance in others. They are not presented as precedents to be followed: the skill of a good Caldicott Guardian is to apply wise judgement to the precise circumstances of each case.
An important message to Caldicott Guardians is that they are not alone. Regional and local networks are being established that can provide peer support. It is unrealistic to expect that every small organisation will have wide-ranging expertise in every aspect of information governance. Getting legal advice might put an unreasonable strain on hard-pressed budgets. However, help is often available. For example, the Caldicott Guardian in a GP practice in England may be able to access support from its Clinical Commissioning Group or Commissioning Support Unit. In some cases, there may be a problem without a “right” answer. In such circumstances the Information Governance Alliance (IGA) can be an important source of guidance, and UKCGC stands ready to use its members’ experience to offer advice.