The following advice will help clinicians who are requesting any form of direct photography of a patient.
- Who can request clinical photography?
- Locations and appointments
- Operating Theatre photography
- Explaining to the patient
- Consent levels
- The unconscious patient
- Incomplete Request Cards
- Turn around, collection and delivery times
- Can clinicians take their own photographs?
Requests may come from any member of the clinical staff, but must be approved by the consultant in charge of the case.
Clinical photography is available on all sites throughout the Cardiff & Vale University Health Board. The Media Resources Centre has dedicated studio facilities at UHW, the Dental Hospital, University Hospital Llandough, Cardiff Eye Unit and the Welsh Institute of Dermatology. Although we can photograph patients in any ward, clinic or treatment area, for best results, and where practical, we prefer to photograph them in our own studios.
Patients at UHW and the Dental Hospital can be referred at any time without an appointment during normal working hours. Dedicated photographers work at the Eye Unit and Dermatology serving specific clinics and anyone requesting photography outside these clinic commitments should contact our Photography Co-ordinator on Tel: 029 2074 4601 at UHW.
For photography at the University Hospital Llandough, requests should be made by contacting ext. 725498 from UHW. Pre-booking for clinical photography may be necessary as the Llandough photographer also covers Rookwood, Barry and St David's Hospitals as well as other non-clinical commitments on these sites.
Please note that the Media Resources Centre does not have the facilities for removing and redressing open wounds. Patients with dressings should be photographed on the ward or clinic at a time arranged with the nursing staff.
Requests for photography in the Operating Theatres at UHW are normally arranged with our Photography Co-ordinator on Tel: 029 2074 4601. Please give us fifteen minutes notice prior to needing the first photograph. Major operative sequences and requests for Llandough Operating Theatres should also be pre-booked, if possible.
Requests must be made using the 'Request for Clinical Illustration' Card (called the 'Request for Clinical Photograph' Card in the Dental Hospital). Patient's details must be completed in full, preferably using a bar-coded patient addressograph label on all parts of the card.
- The reason for the photography e.g. case-notes, teaching or both.
- The diagnosis and the areas to be photographed, along with any specific instructions.
Please use BLOCK CAPITALS. Illegible writing can lead to delays in processing the request.
Clinicians are responsible for obtaining informed consent from the patient to use the photograph for their specified intentions.
Clinicians must explain to the patient the reason the photographs are being requested and when and where they are likely to be used. Patients are sometimes nervous of being photographed and should be given the opportunity to ask why such records are being made and how they will be seen. When given this information, most patients are happy to consent to photography, particularly if they feel it will help in the training of doctors and other healthcare professionals. The photographer will check the level of consent signed with the patient and ask if they have any further questions. Where practical, patients will receive an information leaflet explaining about consent, recording the level to which they have consented and details of what they need to do should they subsequently wish to withdraw their consent. If during this explanation the patient changes their mind about the level of consent that they have signed up to, the photographer will record this, act on the patient's wishes and then inform the requesting clinician.
Cardiff and Vale University Health Board operates a three level Consent Policy for the use of clinical illustrative recordings:
Level 0 is for the patient's case-notes only.
Level 1 permits the images to be used for the case-notes and teaching within the healthcare environment.
Level 2 consents for the images to be used in a medical publication. Patients giving this level of consent must be aware that the images may be seen by the general public and once published cannot be withdrawn.
In accordance with guidelines for the Welsh Assembly Government and the General Medical Council, the notion of whether a patient can be identified has been dispensed with. All patients should be considered as identifiable from any of their photographs.
In the case of children under the age of 16, a parent/guardian should sign consent on their behalf. A child under the age of 16 can give and withdraw consent themselves, if the clinician considers them to be competent to make a fully informed decision. A clinician can request photographs of any patient, including a child, without their parents/guardian's consent, e.g. as in the case of a Non-Accidental Injury (NAI), if the clinician feels it is in the best interest of the child for those photographs to be made. However, it is good practice to keep the parents/guardians fully involved with the situation and gain their consent to take photographs whenever possible.
Photographs of an unconscious patient, or patient who is unable to give informed consent, can be taken for records only if the clinician believes it to be in the patient's best interests that a photographic record be made. Should the clinician require the photograph for any other purpose, e.g. teaching, consent must be obtained from the patient when they either recover consciousness or are able to do so under the definitions stipulated in the Mental Capacity Act (2005).
The patient has the right to withdraw their consent to the images being used for any purpose at any time. This includes the right to have images in their medical records destroyed.
If a Request Card does not specify 'case-notes' or 'teaching', then A4 prints for case-notes will be produced.
If consent has not been obtained or signed by the patient, the photographer will discuss consent where possible, but photographs will be produced for case-notes only until consent for further use is obtained by the clinician.
Clinical photographs for patient case-notes are produced as quickly as possible and returned to the ward for insertion in the case-notes or returned to the clinician's secretary in the case of out-patients. Digital image files produced at UHW, University Hospital Llandough and Glamorgan House should be available on a CD within 5 days of production and should be collected from the Media Resources Centre facilities at these sites.
Whilst it is best practice to use qualified medical photographers to photograph patients, it is appreciated that this is not always possible. The Cardiff and Vale University Health Board therefore has a policy that allows clinicians to take their own medical photographs. This policy requires all those individuals photographing patients to register their activity, recording where and how both the images and consent forms are stored. This policy is available on the Cardiff and Vale intranet site or from the Media Resources Centre.