Where does the RCVS stand on sharing client financial information

Re: Where does the RCVS stand on sharing client financial information

Adi Nell — Mon, 03 May 2010 14:37:08 GMT

Hi, Alan,

My understanding is similar to Neil's: you can share the information as long as it's not malicious or intended to punish the client. What you're doing is providing a statement of fact that you could defend and one that has immediate consequences for the other vet.

ProfCon (eventually) gave advice along the lines of the above, too. It took a while, but we got there in the end. Getting a lawyer to give a firm opinion on something can be pretty tricky! Let's hope the GtPC will be clearer on this in its next incarnation....

Best,

Adi

Re: Where does the RCVS stand on sharing client financial information

Ian Mostyn — Sat, 01 May 2010 19:56:39 GMT

I rang the prof conduct department about 6 weeks ago on this very matter. They wouldn't (or couldn't) give me a straight answer and decided to answer a different question instead. Basically, they told me if I didn't want to include details of a bad debt, I didn't have to. Not what I asked as I wanted to include it. Surely if the Registrar is a trained solicitor, she could give us some definitive advice?

Ian

Re: Where does the RCVS stand on sharing client financial information

philip goddard — Sat, 01 May 2010 17:11:42 GMT

[quote user="alan hough"]I would appreciate if any current memebers of the RCVS and this years candidates could state what the RCVS position is relating to the following situation.[/quote]

Hi Alan,

Just been made aware of your posting as the RCVS stuff was on a different section until 5pm last night.

RCVS Councillors may not automatically know what the position is unless they are involved in the right bit of RCVS. Jill is an excellent example of one who is informed as she can quote what has actually happened at PI.

On a position such as this, the best way forward in general may be to telephone professional conduct (prof con) who in general are very happy to help. That doesn't mean you will get a straight answer though as it is a very legal question you are asking, and these are difficult to answer for sure unless a case has been heard on that specific point before, in which situation there has been precedence so a fairly definitive answer can be given (unless it goes to a higher court in which case it could be overturned).

So for RCVS the bottom rung is prof con interpreting the Guide to Professional conduct and guessing how it would be interpreted at PI. Next would be a PI member guessing how GtPC would be interpreted, or better saying how it was interpreted on a previous occassion. Above PI is DC, and you cannot second guess DC as they are a separate entity who make a ruling based on the evidence seen. This gives a degree of uncertainty unless a previous DC has given a ruling on the same point. Then above all else is Privy Council who could overturn the DC decision. As far as I know this problem has only gone to PI level. You may have noted an absence of Councillors on the above (apart from those on PI or DC).

I did look at this particular issue a long time ago and can confim what others have said re sharing financial information. It is helpful to put it into your terms and conditions, and I seem to remember that it can make a difference how you have registered for data protection, but the best way forward is to try to get the client's permission accepted or denied, and if denied you can truthfully say that the client has denied you permission to share the financial information, which says a lot. Of course, if 'bad debtor, do not dispense antibiotics until bill paid' is in the clinical notes, that could solve the problem.

Don't know if you wanted an answer from me as the voting has finished so we are now ex-candidates and the successful ones not yet elected so none of the current cohort meet your criteria!. Hope all goes well.

Regards

Philip Goddard

Re: Slightly confused-where does the RCVS stand?

Utlendigur — Sat, 01 May 2010 13:45:02 GMT

Just wondering how passing clients on to a debt collection agency stands with client confidentiality?

Re: Slightly confused-where does the RCVS stand?

alan hough — Sat, 01 May 2010 11:27:13 GMT

[quote user="Bob Partridge"]

Our DPA form was passed by RCVS PIC staff.

The "confidentiality" bit of the GTPC is very all embracing. Technically you should not reveal that Mrs Smith is even a client. As the current GTPC stands it would certainly appear to be a breach of client confidentiality to reveal that they were bad debtors.

This is why we took the DPA Registration (notifying that we woudl pass on financial details) and constructed our Release Form to allow us to reveal stuff to next vet.

I can understand VetDebts wantng to create a commercial business out of this - but a cheap DPA registration and sensibly constructed DPA release form woudl appear to be all you need.

[/quote]

Hi Bob

Thank you for that reply. Would you be enclined to post a copy your DPA release form on this forum so others could see how to construct a legally and RCVS safe one?

I am slightly unsure why stating that financial information will be divulged ,along with the clinical history to a requesting vet only (not the general public) , in a business's Terms and Conditions is not enough? Surely when a person registers with you as a client they are entering into an agreement with the business to adhere to its Terms and Conditions of Business?

It is interesting the 3 very different interpretations of this issue by Jill, Neil and Bob.

If the " confidentiality " is that over embracing in the GtPC surely this could be reduced to allow the profession to operate in more realistic way, whilst still affording enough protection of our clients details from being disclosed to the general public but allowing the necessary transfer of information between members of our profession to safeguard our businesses-is this an unreasonable request?

I really would like to hear what other vets feel about on this issue

Alan

PS this is not relating to a current real sitaution but just an issue that I would like some clarification from the RCVS on. Some clear "does and donts "from the RCVS rather than unclear politically correct "Guidance" would be a welcome change I personally feel.

Re: Slightly confused-where does the RCVS stand?

Bob Partridge — Fri, 30 Apr 2010 23:48:51 GMT

Just had a quick look at the Information Commission Office web site & can't find a listing for VetDebts Ltd as having registered under the DPA.

The lawyers (who share the same address) are registered - but not VetDebts

Re: Slightly confused-where does the RCVS stand?

Bob Partridge — Fri, 30 Apr 2010 23:27:59 GMT

Appreciate that VetDebts are looking to have a commercial angle on this.

On a personal note - I suspect that simply revealing information about a clients financial status to another party would be a breach of the DPA. VetDebts terms of business appear to uphold that view in that they require clients to be notified in advance that information may be revealed.

Our approach was to register under DPA & to clearly state that we would transfer financiial information. Any client moving to another vet is asked to sign a DPA release for the history to be sent to another practice. Many "clinical histories" will contain "personal" information (O's mother is ill, so can't collect, £'s problems so pay next week etc) - if a client refuses to sign a DPA release - we do not send the full history (which would include financial information - debt collection letters etc) - but would give a summary over the phone if required by neighbouring practice. Neighbour practice would also draw their own conclusions about clients refusal to sign DPA release.

Ourt DPA re3lease also contains the option to levy a small charge for the printing of the history (as allowed by DPA). We only ever levy this charge if an outstanding amount is due to the practice. The release & our T&C's also clearly state that monies paid to the practice are allocated against oldest invoices & that new invoices are regarded as unpaid until whole debt is cleared. This way someone with an outstanding account has to clear the account before the invoice for the history printout is paid off (i.e. we don't print the history unless account cleared.) This gets around the client who had a series of expensive blood tests or histo performed and doesn't pay - but expects the results of the tests to be made available to next vet.

Animal welfare is not compromised - as the new vet can happily repeat the tests (& get the client to pay) - but why should client benefit from us paying for external lab fees & getting no payment?

Our DPA form was passed by RCVS PIC staff.

This is why we took the DPA Registration (notifying that we woudl pass on financial details) and constructed our Release Form to allow us to reveal stuff to next vet.

I can understand VetDebts wantng to create a commercial business out of this - but a cheap DPA registration and sensibly constructed DPA release form woudl appear to be all you need.

Re: Where does the RCVS stand on sharing client financial information

Jill Nute — Fri, 30 Apr 2010 18:23:54 GMT

As I sit on PI it is probably not appropriate for me to say more than I have, can I suggest that this might be an appropriatesubject for more guidance in the imminent revision of the GtPC , as it appears to be a problem for practitioners?

Re: Where does the RCVS stand on sharing client financial information

Hannah Wynne Richards — Fri, 30 Apr 2010 17:43:22 GMT

Isn't it awful that the poor veterinary surgeon has been defrauded by a dishonest member of the public, who probably had no intention of paying in the 1st place, and then has to worry about Professional Misconduct if he/she tries to protect a neighbour from a similar fate !!!!!!!!!!!!

Wynne

Re: Where does the RCVS stand on sharing client financial information

Arlo Guthrie — Fri, 30 Apr 2010 17:15:53 GMT

Here's a reply posted to the RCVS forum by Neil Smith...

[quote user="Neil Smith"] From my own experience on PIC it was generally considered acceptable from a professsional point of view to pass on information about bad debts as long as it was both accurate and not done maliciously. If both practices subscribed to credit reference agencies would this information not be available anyway?

Neil[/quote]

Re: Where does the RCVS stand on sharing client financial information

Gordon McLean — Fri, 30 Apr 2010 17:15:02 GMT

Hi Alan
Its not quite as cut and dried as that. In theory the answer, is seems, would be yes BUT in practice it will probably take a disgruntled client suing a vet to prove it once and for all. As I mentioned the Data Protection Act is very broadly written - so a specific interpretation is almost impossible to prove without some sort of actual case.

The Vetdebts approach mitigates the risk by a) not sharing the information generally ie you have to search for a specific client. b) its only available to members hence limited access and c) we are not publishing the results in a public forum - only to members local to the vet in question essentially.

Its important to appreciate that Vetdebts is based on a specific written response from the Information Commissioner, advice from our solicitors and a considerable amount of research. IF you are unsure you should take legal advice from your own solicitor. Your original question was based on the RCVS response - again I would ask them for a specific written response if you are unsure.

The ramifications for getting this wrong could be considerable so please take care if your about to publish sensitive information about identifiable individuals.

Gordon

Re: Where does the RCVS stand on sharing client financial information

alan hough — Fri, 30 Apr 2010 15:00:48 GMT

[quote user="Gordon McLean"]

G: I have no idea about RCVS rules BUT from the DPA perspective it depends on the terms Vet B has in place with their clients. IF Vet B has informed his/her clients that they will disclose to other vets how they run their account then they will have no problem. However if not Vet B will be in breach of the Data Protection Act because they do not have permission from the client to disclose the information. The medical history is not a problem because by presenting to Vet A and asking them to obtain a history they have given implied permission.

G: The problem both the RCVS and Information Commission have is the Act is not very specific. We took many months to get a definitive written answer to this question and the key points seemed to be:
a)   Make sure clients are aware of what information you intend to share in your terms and conditions
b)   Ensure the information is accurate and proportionate - very important dont take it as a ranting opportunity !!
c)   The Data Protection Act is not a debtors charter nor should it be used to shield them from their financial responsibilities.

[/quote]

Hi Gordan

Thanks a million for your reply and for clearing up the isses relating to the Data Protection Act.

So if all practices around the country issued an amended copy of their Terms and Conditions of Business outlining to all their clients that their financial account details can be shared with other vets upon request then there would be no breach of the DPA and the bad debtors would find it very difficult to continue obtaining "free" veterinary care for their animals- am I correct Gordan?

I know there quite a number of practice owners on this forum of various sizes and types of practices, could some of them please comment if they already have such a provision in their Terms and Conditions of Business?

If you do have you found it useful in helping control bad debts?

If you dont have such a provison, would you now consider including one and informing all your clients of the change?

Alan

Re: Where does the RCVS stand on sharing client financial information

Gordon McLean — Fri, 30 Apr 2010 14:28:57 GMT

Hi All
Alan's initial question is pretty well exactly why we set Vetdebts up in the first place. Principally to enable Vets to work together using our database to report problem clients to other members and to check new clients who present for treatment before they are formally taken on. The fact that we also chase debtors with solicitors is incidental they key point is prevention is better than cure.

To take Alan’s example specifically

Vet A recieves a request from an animal owner to register with his/her practice as a new client ( not an instance requiring emergency treatment). Vet A then contacts the animal owners previous vet, Vet B, for a clinical history ,as per the Guide to Professional Conduct.

Vet A then asks Vet B what the animal owner's financial history with Vet B's practice has been and if the owner has been a problem payer/outstanding balance. Vet B informs Vet A that the animal owner has always been a problem payer and has a large outstanding balance with the practice.

Vet A thanks Vet B and declines the animal owner as a client.
Question 1: Is Vet B in breach of some/any rules of the RCVS ( As from what I can understand from Gordans post there is no breach of the Data Protection Act-hope thats correct Gordon-forgive me if I'm wrong)

Question 2: Will the RCVS entertain any complaint made form the animal owner against either Vet relating to the above situation?

In the ideal world every Vet practice would be a member of Vetdebts and as a result clients would very quickly get used to the idea that owing the vet is a bad idea. We are in the process of contacting every single vet practice/group to encourage them to get “Vetdebts Protected” Its our belief that IF you could check a client in advance you wont take the debts on and hence the problems will gradually disappear.

Re: Slightly confused-where does the RCVS stand?

Arlo Guthrie — Fri, 30 Apr 2010 14:07:28 GMT

[quote user="alan hough"]Whilst I appreciate you are the only person to have replied to my question from the many RCVS council members/candidates on this forum, [/quote]

Sorry Alan, only just posted an announcement about this thread in the RCVS forum, so candidates will only just have been notified of its existence!

Re: Slightly confused-where does the RCVS stand?

alan hough — Fri, 30 Apr 2010 13:59:35 GMT

Jill

Whilst I appreciate you are the only person to have replied to my question from the many RCVS council members/candidates on this forum, I wish you could explain why the above situation would breach client confidentiality. The client has already agreed to Vet A obtaining their clinical records, how does obtaining a understanding of their financial history with Vet B's practice constitute a breach of confidentiality?

Also if vets were to inform clients, via a letter detailing a change to the Practice's Terms and Conditions of Business,that any debts over 30 days old could be shared with other vets, would that be in breach of the "Guide to Profressional Conduct"?

Does the RCVS not have a responsiblilty to vets to protect the profession from exploitation by clients who effectively "steal" our profession's services and drugs by non-payment?

Re: Slightly confused-where does the RCVS stand?

Jill Nute — Fri, 30 Apr 2010 13:39:11 GMT

GtPC part1D 2a"....a veterinary surgeon must maintain client confidentiality" Complaints will reach the PIC once they have been received by the Prof Con dept, checked that they fall within the jurisdiction of the RCVS, been assessed by a veterinary surgeon on PI as having the potential for SPMC & passed for case examination by another VS + lay observer members of PI, one or both of which will have felt referral to the full PIC was justified with a potential for SPMC..

Re: Slightly confused-where does the RCVS stand?

alan hough — Fri, 30 Apr 2010 11:56:23 GMT

Hi Hanna

From Vetdebts Terms and Conditions

"9.1.3 If you obtain or choose to buy our Chargeable Services through our Site then you will ensure that all your customers are aware that the customer data is likely to be disclosed if the debts are over 30 days or more. All such information collected by us shall be referred to in these terms and conditions as ��Personal Information'.

From this surely it would be possible for all veterinary practice owners to inform all their clients that if they have debts over 30 days old that their customer data could be disclosed-the vets do not have to ask the clients consent, merely infrom them of what may occur if that have debts over 30 days.

If this approach is acceptable by the RCVS ( would appreciate other RCVS council members/candidates to express their opinion) then surely all veterinary practices could severly reduce those clients that persistantly run up bad debts from doing so with other local practices. To me this seems like a very straight forward thing to do and 99% of clients will have no objection as they pay their bills on time and have nothing to hide, and if a small amount of clients object then I would be inclined to no longer have them/accept them as clients as they are probabaly the problem payers.

I personally would have an issue with allowing a fellow vet, be it a competitor in the local area or not, to knowingly take on a client whom I know to be a problem payer and bad debt. In these tough economic times these bad debtors can be the breaking of a practice espically a start up practice. The veterinary profession historically I feel has allowed these habitual bad debtors to have all the power as they freely swap between practices running up debts they never intend to pay.I personally feel the above change in how vets operate their business would go along way to removing this power from these bad debtors.

Re: Slightly confused-where does the RCVS stand?

Hanna Bennett — Thu, 29 Apr 2010 20:05:07 GMT

Gordon Maclean was referring to the service his company provide (VetDebts) which requires the client to have given consent for their financial ifnormation to be disclosed before it is discussed with another vet.

Re: Slightly confused-where does the RCVS stand?

alan hough — Thu, 29 Apr 2010 17:56:17 GMT

Hi Jill

Thanks for your reply but I still am not clear what the RCVS would be investigating.

Could you please explain what part of the Guide to Professional Conduct is been breached in the above situation and under what instructions the PI committee would be investigating

Thank you

Alan

Re: Where does the RCVS stand on sharing client financial information

Stuart Jackson — Thu, 29 Apr 2010 17:48:59 GMT

If Vet A was to simply state that they were not able to divulge their financial ralationship with that client, then Vet B could be re-assured that that relationship was not mutualy beneficial!
Stuart

Re: Slightly confused-where does the RCVS stand?

Jill Nute — Thu, 29 Apr 2010 17:33:37 GMT

Cases have been referred to PI committee where financial information has been passed between practices without the clients consent. The way to proceed safely is for Vet B to get the prospective client to sign that they wish Vet A to disclose the clinical AND financial records relating to the case to Vet B, Good Luck!