Notifying, reporting and the law

Notifiable diseases

• Notify on clinical suspicion. Do not wait for laboratory confirmation.
• Urgent cases are reported to the local UKHSA health protection team by telephone within 24 hours, with the written form within 3 days.
• Examples: meningitis and meningococcal septicaemia, measles, mumps, rubella, whooping cough, scarlet fever, diphtheria, tuberculosis, food poisoning, typhoid, cholera and acute hepatitis.
• Hantavirus disease was added to the list in England on 18 May 2026.
• HIV is not notifiable by clinicians in this way, although it is reported for surveillance.
• Contacts of meningococcal disease: a single dose of ciprofloxacin, ideally within 24 hours, arranged with the health protection team.

Children at risk

• Immediate danger: call the police on 999.
• Risk of significant harm: refer to local authority children's social care the same day, and discuss with the named or designated safeguarding lead.
• Information can be shared without consent when it is needed to protect a child.
• Do not tell the parents about a referral if it would increase the risk to the child, hinder an investigation or cause delay.
• Sexual activity under 13 is rape in law and always needs a safeguarding referral.
• A child who discloses abuse: listen, avoid leading questions and record their exact words.

Female genital mutilation

• If a girl under 18 tells you she has had FGM, or you see signs of it, you must report it to the police yourself, on 101.
• The duty is personal. It cannot be passed to a colleague or the safeguarding lead, although you should tell them too.
• Report as soon as possible, best practice by the close of the next working day, and never later than one month.
• FGM is illegal in the UK, including taking a girl abroad for it. It is also child abuse, so safeguarding procedures apply as well.

Adults at risk and domestic abuse

• Adult safeguarding in England is under the Care Act 2014. The local authority leads a section 42 enquiry.
• Ask the adult what they want (Making Safeguarding Personal). Refer without consent if others are at risk, a crime is involved, the person lacks capacity or is being coerced, or it is in the public interest.
• Domestic abuse: ask in private, without the partner. High-risk cases, found with the DASH checklist, are discussed at a MARAC.
• Forced marriage: see the person alone and do not involve the family. The Forced Marriage Unit can help.
• Modern slavery: refer through the National Referral Mechanism.
• Radicalisation: the Prevent duty, for support rather than punishment.

The police

• Gunshot and knife wounds: tell the police, usually without naming the patient at first.
• Disclosure without consent is allowed only when the law requires it or it is justified in the public interest, for example to prevent serious harm or a serious crime.

Driving and the DVLA

• It is the patient's duty to tell the DVLA about a condition that affects driving.
• The doctor tells the DVLA without consent only if the patient keeps driving after being advised and warned. Tell the patient before contacting the DVLA, and confirm in writing afterwards.
• Common rules for car drivers:
• First unprovoked seizure: 6 months off driving if no cause is found.
• Epilepsy: 12 months seizure-free.
• Stroke or TIA: 1 month.
• ACS treated by successful angioplasty: 1 week if the ejection fraction is at least 40%, otherwise 4 weeks.
• Persistent alcohol misuse, or dependence without high-risk features: at least 6 months of controlled drinking or abstinence. Dependence with withdrawal seizures or medically assisted withdrawal: at least 1 year of abstinence.
• Licence renewal is at 70, then every 3 years.

Deaths

• Verify death after at least 5 minutes of observation.
• Since 9 September 2024, every death in England and Wales is reviewed by a medical examiner or a coroner.
• The MCCD can be completed by any doctor who attended the patient during their lifetime. It goes to the medical examiner, who sends it to the registrar.
• Registration is within 5 days of the registrar receiving the MCCD.
• Report to the coroner when the cause is unknown, or the death may be from violence, self-harm, poisoning, neglect, a medical procedure, an industrial disease, or happened in state detention, including under the Mental Health Act.
• Implanted devices such as pacemakers are recorded on the MCCD and removed before cremation if hazardous.

Medicines and safety

• Yellow Card: report suspected adverse drug reactions to the MHRA. Patients can report too.
• Never events and serious incidents are reported through the organisation's incident system.
• Duty of candour: when something goes wrong, tell the patient, apologise, offer a remedy and explain the effects. An apology is not an admission of liability.

Records and requests

• Subject access requests are answered within 1 month.
• Insurers need the patient's written consent before receiving a report.
• Confidentiality continues after death.
• The Caldicott Guardian protects patient information in each NHS organisation. Share the minimum information necessary.