Worked Examples: A Friend Asks You to Look Up a Patient's Records

This lesson works through detailed scenarios involving one of the most commonly tested SJT themes: inappropriate access to patient records. These scenarios test your understanding of confidentiality, professional boundaries, and the courage to say no — even to people you care about.

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Why This Scenario Is So Common in the SJT

Record access is a perfect SJT topic because it tests multiple principles simultaneously:

• Confidentiality — Patient records are confidential
• Professional integrity — Accessing records without a clinical reason is dishonest
• Courage — Saying no to a friend is difficult
• Proportionality — The response must match the situation
• Understanding of the law — Data Protection Act 2018, NHS access policies

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Key Principles to Apply

Before working through the scenarios, remember these core rules:

1. Accessing a patient's records without a legitimate clinical reason is a breach — regardless of whether you share the information
2. The breach occurs at the point of access, not at the point of sharing
3. Every access to NHS records is logged and auditable — there is no way to look at records undetected
4. It does not matter who asks — friend, family member, colleague, or senior doctor — if there is no clinical reason, you must not access the records
5. Your GMC registration (or future registration) can be affected — this is treated as a serious integrity issue

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Scenario 1: Your Best Friend Asks About Their Own Records

The Situation

Your best friend from school is admitted to the hospital where you are on placement. They text you: "Hey, I'm on Ward 12. Can you check my blood results? The doctors haven't been round yet and I'm anxious."

Analysis

This feels harmless — they are asking about their own records, and they are genuinely anxious. However:

• You have no clinical role in their care
• Accessing their records would be a breach of data protection
• Their care team will communicate their results in due course
• Your desire to help does not override the rules

Worked Response (Appropriateness Format)

Action A: Log into the hospital system and look up their blood results, then text them the numbers.

Rating: Very inappropriate This is a clear breach of data protection and confidentiality policy. You have no clinical reason to access their records. The fact that it is their own information does not give you the right to access it outside your clinical role.

Action B: Explain that you cannot access their records, but suggest they ask their nurse or use the bedside call button.

Rating: Very appropriate This respects the confidentiality framework while addressing your friend's anxiety. You are redirecting them to the appropriate source of information.

Action C: Ask a colleague on Ward 12 to check the results and relay them to your friend.

Rating: Very inappropriate This is still inappropriate — you are facilitating access to records outside the normal care pathway, and you are involving another person in the breach.

Action D: Visit your friend on the ward during your break to provide emotional support, without accessing any records.

Rating: Appropriate, but not ideal Visiting a friend is a kind and human thing to do, and it may help with their anxiety. However, it is not ideal because you should be mindful of the professional-personal boundary, and your visit does not address the underlying request.

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Scenario 2: A Family Member Asks You to Check on a Relative

The Situation

Your aunt calls you. She is worried about your grandmother, who was admitted to your hospital yesterday. She asks: "Can you just pop in and see how she's doing? Maybe check what her diagnosis is?"

Analysis

• You are not part of your grandmother's care team
• Accessing her records or seeking clinical information about her is not appropriate
• Your aunt's concern is understandable, but the proper channel is to contact the ward directly
• You may visit your grandmother as a family member — but not in a clinical capacity

Worked Response (Most/Least Appropriate Format)

Which is the MOST appropriate action?

A. Access your grandmother's records on the hospital system to reassure your aunt B. Call Ward 12 and identify yourself as a medical student to ask for an update C. Explain to your aunt that you cannot access the records, and suggest she or another family member calls the ward directly D. Ask the registrar on your current ward to look up your grandmother's records for you

Answer: C is the MOST appropriate. You are directing your aunt to the correct channel while maintaining professional boundaries.

Which is the LEAST appropriate action?

Answer: A is the LEAST appropriate. This is a direct breach of data protection. You have no clinical role in your grandmother's care.

Why B and D Are Also Wrong

• B is inappropriate because identifying yourself as a medical student to gain access to information about a family member is an abuse of your position — even if you do not access the electronic records directly
• D is inappropriate because you are asking a colleague to breach confidentiality on your behalf — they have no clinical role in your grandmother's care either

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Scenario 3: A Fellow Medical Student Asks You to Look Up a Celebrity

The Situation

A celebrity has been admitted to your hospital. It is all over the news. A fellow medical student says: "Go on, just look up what ward they're on — I won't tell anyone."

Analysis