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Health and Social Care

What are the Caldicott Principles? Principles of Caldicott


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The Caldicott Principles are a set of guidelines that organisations should follow to protect any information that could be used to identify a patient, such as their name or medical data. They also make sure that this information is only utilised and shared when necessary. There is a requirement for an existing and effective set of principles to ensure transparency in every institution, particularly in health and social care.

The health and social care sectors are critical to the lives and well-being of the general population. People always value their privacy and protection, whether it is public or private information.

They certainly do not want anyone to have access to their personal information, such as medical records, at any time. Because of the personal nature of healthcare, these sectors require even more attention as they deal with vital information about citizens. This is where the Caldicott principles come into the picture.

What are the Caldicott Principles?

Growing concerns about the use (or misuse) of patients’ data prompted England’s Chief Medical Officer to commission the Caldicott Report in 1997. The report’s full title is “The Caldicott Committee’s Report on the Review of Patient-Identifiable Information.” The framework set here later gave birth to the Caldicott principles. In fact, if you Google “Caldicott principles NHS,” you’ll find a detailed history on it.

He developed these principles primarily to address issues that the National Health Service (NHS) encountered when dealing with patient information and how technology affected inclusive processes.

Handshake after signing medical data form in hospital

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Our Dignity & Privacy course aims to help healthcare professionals promote and defend the dignity and privacy of people under their care. This course explains the meaning of dignity and privacy in the healthcare business and how the two are commonly confused. It also contains professional advice on how to build excellent working relationships with your service users, as well as an explanation of how to deal with obstacles to dignity and privacy in a care setting.

How Many Caldicott Principles Are There?

There are eight Principles of Caldicott that must be followed to ensure that patients’ information is kept private and used correctly.
The principles of caldicott are as follows:

  • Principle 1: Justify the purpose(s) for using confidential information
  • Principle 2: Use confidential information only when it’s necessary
  • Principle 3: Use the minimum necessary confidential information
  • Principle 4: Access to confidential information should be on a strictly need-to-know basis
  • Principle 5: Everyone with access to confidential information should be aware of their responsibilities
  • Principle 6: Comply with the law
  • Principle 7: The duty to share information for individual care is as essential as the duty to protect patient confidentiality
  • Principle 8: Inform patients and service users about how their confidential information is used

Now, let’s discuss these principles in some detail.

Female receptionist looking for files in clinic filing cabinet

Principle 1

All potential uses or transfers of sensitive information should be explicitly specified, examined, and documented, according to the first Caldicott Principle. Any ongoing uses must be assessed by an appropriate guardian on a frequent basis. This means that no confidential information about a patient should be shared unless it is in the patient’s best interests. Furthermore, the organisation should appropriately state the reasons for disclosing personal information about a patient.
In addition, a Caldicott Guardian must also oversee the handling of records and preserve the patient’s privacy.

Principle 2

The second Caldicott Principle concerns the use of confidential data. Unless absolutely necessary, any private data should not be included. And the justification for utilising or accessing information should be limited to the stated goals. Also, at each stage of achieving the goal(s), the necessity to identify persons should be considered, and alternatives should be employed when available.

More significantly, employees must be aware that disclosing personal information may jeopardise the patient’s safety. As a result, if the information isn’t required to protect the patient, it shouldn’t be shared.

Principle 3

Caldicot’s third principle attempts to guarantee that you should use confidential information as little as possible. When it becomes necessary to use confidential data, you must justify any information. To maintain patient confidentiality, you should supply only the least personally identifying data.

Principle 4

The fourth principle emphasises that private information should only be accessible to those who require it. And they only have access to the information they require. This may necessitate implementing access controls or dividing information flows that are used for several reasons.

Furthermore, patient information should not be shared with anybody who is not authorised to have it. Likewise, all organisations must safeguard all personal and confidential information at all times.

It is the responsibility of the health professional to reject unauthorised access to patient data if a non-recognised individual or organisation requests it.

Check out our other blog, “What are the Types of Observation in Health and Social Care?

Signing healthcare medical data form in clinic

Principle 5

The fifth Caldicott Approach asserts the responsibilities of those with confidential data access. As a result, you should take the required steps to guarantee that everyone who handles sensitive information is aware of their responsibilities and obligations to protect the privacy of patients and service users.

If it is necessary to divulge personal information, it must be in the patient’s best interests. Only authorised individuals with proper access should have permission to read confidential information. Health and social professionals must be aware of their responsibilities to preserve and respect the patient’s privacy.

Principle 6

Every utilisation of private information must be legal. Everyone who handles confidential information is responsible for following the law. As a result, they must guarantee that their use of and access to the information complies with the law. They must also follow the rules set forth in the laws and the common law.

Any use of personally identifiable data must be legal, according to the sixth Caldicott Principle. Every organisation should have a custodian who is responsible for ensuring the fulfilment of all legal obligations. This means that it is the guardian’s responsibility to ensure that the organisation should keep private personal data.

Principle 7

In the best interests of patients and service users, all health and social care providers should exchange sensitive information. And you must do it within the parameters of the Caldicott Principles. They must receive support from their employers, regulators, and professional organisations regulations.

There are times when it is acceptable to share patient information. Government entities or research agencies, for example, may request information. In such a case, any data provided must be anonymised and without identifying characteristics.

The police may also request that you release all patient details and information in some cases. But keep in mind that they’ll need a court order in this scenario.

However, there are times when we must ignore the responsibility of confidentiality. Principle seven’s goal is to demonstrate that sharing knowledge is often just as vital as maintaining secrecy in order to keep people safe.

Data Protection concept

Principle 8

The eighth Caldicott Principle argues that you should undertake all appropriate steps to guarantee that patients and service users receive the right information and have no shocks.  They should understand how and why you will utilise their personal information and options.

Depending on the application, these stages may differ. At the very least, this will entail making information available, relevant, and suitable.

You must do it in accordance with these principles and not in excess of what the policies allow. They must also supervise the flow of patient information, whether for research or for disclosure to the police.

Besides, check out our other blog, “Safeguarding in Health and Social Care Assignment – Free Download.

Caldicott principles apply to deceased

The Caldicott Principles are a set of guidelines designed to protect the confidentiality of patient information. Even after a patient has passed away, their information must still be treated with the same level of respect and privacy as when they were alive.

How to Apply Caldicott Principles?

All social and healthcare staff must adhere to the Caldicott Principles to maintain confidentiality. However, some people may still be unsure whether or not to provide patient information in specific circumstances. For example, principle 7 states that:

“The obligation to communicate personal information might be as important as the duty to respect patient confidentiality,”

Principle 7 does not, however, establish a clear line between when it is OK to share knowledge and when it is not. Instead, it simply indicates that, while maintaining patient confidentiality is essential, there are exceptions in the event of a breach of duty of care. Accordingly, we have discussed them below.

Here are several scenarios in which you should communicate patient information to avoid any misunderstandings.

  • For treatment, one should transfer the patient to another facility.
  • Someone is or could be in danger and requires assistance.
  • They may cause harm to another person.
  • You should stop a crime after receiving the information.
  • Even though a patient has died, a relative must be found.
  • The court or another legal body requested the information.
  • A significant crime has been committed, or a patient has been identified as a suspect in a crime.
  • Finally, it is legal.

The organisations should also appoint a Caldicott Guardian, as we’ve discussed above. Let’s give you an overview of this guardian.

Computer security concept showing locks on laptop’s keyboard

Caldicott Guardian

A Caldicott Guardian is someone who is in charge of keeping people’s health and care information private. The Caldicott Guardian is usually a board-certified or deputy-certified health practitioner.
As a result, the Caldicott Guardian should be in these order of importance:

  • A member of the health or social care organisation’s management board or senior management team.
  • A senior health-care or social-care worker.
  • A member of staff who is in charge of fostering clinical governance or something similar in the organisation.
  • Caldicott Guardians are necessary for all NHS organisations and local governments that provide social services. The UK Caldicott Guardian Council (UKCGC) is the national body for Caldicott Guardians.

What is Caldicott Guardian Responsible for?

Caldicott Guardians are in charge of defining local procedures for information disclosure, limiting access to patient information through rigorous need-to-know criteria, and assessing and evaluating patient information use on a regular basis. Caldicott Guardians also ensure that one should handle patient-identifiable data in a legal, ethical, and appropriate manner.

For both health and social care, the Caldicott Guardian’s responsibility encompasses all areas of data management, including the following laws:

  • Data Protection Act 2018
  • NHS Act 2006 (section 251)
  • Freedom of Information Act 2000
  • Human Rights Act 1998
  • Computer Misuse Act 1990
  • NHS Constitution (January 2009, updated February 2015)
  • NHS Information Governance


To wrap up, handling patients’ private information is not a trivial affair that anyone can handle irresponsibly. As a result, the Caldicott principles are here so that we can manage patient information and confidentiality issues in a more efficient manner.

Understanding the Caldicott Principles and correctly implementing them is crucial for a secure and dependable healthcare system.

Frequently Asked Questions [FAQs]

What is patient identifiable information in the Caldicott Report?

“Patient identifiable information” refers to any health or medical information about the patient, whether or not it links with a person.

Do Caldicott principles apply to deceased?

The Caldicott principles were designed to protect the confidentiality of living individuals. However, some organisations may choose to apply similar principles when handling information about deceased individuals out of respect for their privacy and the sensitivity of their personal information.

Who wrote the Caldicott principles?

Following an examination of how the NHS handled patient information, the Caldicott Principles were created in 1997. Dame Fiona Caldicott chaired this review. The Caldicott Principles were born out of the findings, which were six original principles relating to patient confidentiality.

What is considered a breach of patient confidentiality?

Disclosing any information regarding a patient is a breach of confidentiality. We can break confidentiality only:

  1. When it is in the best interest of the patient or the public,
  2. when it is mandated by law,
  3. when the patient consents to the disclosure

What does the Caldicott principles apply to?

The Caldicott Principles apply to any health and social care organisation that uses confidential information. These rules apply when sharing such information with other organisations or persons for reasons such as individual care or other purposes.

How can you improve patient safety and quality?

Ensuring that your organisation adhere to the Caldicott Principles is one of the ways that you can improve patient safety and quality.

What regulation does the Caldicott principles best align to?

The Caldicott principles are pretty similar to the General Data Protection Regulation or GDPR. However, the seventh Caldicott principle, “the obligation to share information might be as important as the duty to maintain patient confidentiality,” differs because the GDPR prioritises personal data and secrecy.

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