This summarises the steps relating to the procedural and ethical requirements for the closure of a medical practice. The following guidelines, though not authoritative, provide sound ethical and procedural guidance for closing a practice.
Informing patients of closure of practice
In terms of section 10.5 of the HPCSA’s Guidelines on the Keeping of Patient Records, whenever a medical practitioner in private practice wants to close his/her practice, he/she shall inform his/her patients within 3 months of the closure, that:
- The practice is being closed as from a specific date;
- Requests may be made that records be transferred to other health practitioners of their choice;
- From the date of closure, the records will be kept in safe-keeping for a period of at least twelve (12) months by an identified health care practitioner or health institution with full authority to deal with the files as he or she may deem appropriate, provided the provisions of the rules on professional confidentiality are observed.
When a request is made by the patient for the transfer of records to another health practitioner of the patient’s choice, the medical practitioner must obtain a consent form from the patient to transfer copies of the patient’s medical records to the patients’ new service providers and place a dated copy of the consent form in the patient’s medical record.
Confidentiality and Patients’ Records
Compliance with Section 10.5 does not mean that once the 12 months has lapsed that the original patient records should be destroyed. Section 9 of the HPCSA’s Guidelines states that, once 12 months has lapsed:
- Health records should be stored for a period of not less than six (6) years as from the date they became dormant;
- For mentally incompetent patients, health records should be kept for the duration of the patient’s lifetime.
Section 9 of the HPCSA’s Guidelines also states that “For minors under the age of 18 years, health records should be kept until the minor’s 21st birthday because legally minors have up to three years after they reach the age of 18 years to bring a claim.” This should be followed, (although it is pointed out that, in terms of the Prescription Act 68 of 1969, claims by minor patients may prescribe prior to the period mentioned in the Guidelines, depending on the particular circumstances of each case).
Section 9 of the HPCSA’s Guidelines provides that health records should be stored in a safe place and, if they are in electronic format, safeguarded by effective passwords.
In the event that the closure of the medical practice pertains to a psychiatric one and given the sensitivity of psychiatric records, they should only be released to either another psychiatrist whom the patient will now be consulting alternatively the patient’s general practitioner.
By the same token, and in accordance with section 3.12 of the Guidelines in Psychology, it is necessary to continue to treat as confidential information regarding a patient after the professional relationship has ceased and to plan in advance for the protection and safekeeping of the patient’s records. Although this is a guideline specifically for psychologists, all medical practitioners would be well advised to take cognisance of the above.
Continuity of care
There is nothing barring a medical practitioner from providing a patient with a copy of his/her last script in order for the patient’s treatment to continue in circumstances where the practice has just closed. However, a patient or someone authorised in writing to do so by the patient should be the one to collect a copy of the last script.