Optimising patients for surgery is an essential part of good medicine and requires a team approach. In recent years there have been improvements in perioperative iron management as a result of the National Blood Collaborative, in which St Vincent's and Lismore Base took part. The improvement has occurred because of improved co-ordination and communication between the GP, surgeon and the pre-operative clinics.

A difficulty sometimes encountered by the pre-op clinic at LBH is getting current health information on their more frail patients. This information is usually sent to the surgeon by the GP but may not in turn reach the pre-op clinic.

North Coast GPs are increasingly being requested to send down a faxed health summary to various departments at the hospital, most notably pharmacy and the pre-op clinic. While this is not a problem for most, some practices are concerned about the release of this information particularly since the recent enactment of the Mandatory Data Breach Notification legislation.

They see these requests as requiring the written consent of the patient to release this information to a third party and quote the RACGP Standards for General Practices in support of their position.

Some have argued that this as an overly strict interpretation of the intent of the law and the Standards. Section of the RACGP Privacy and Managing Health Information in General Practice paper (May 2017) states:-
"Health information may be used or disclosed for another ‘secondary’ purpose where the patient would reasonably expect a use or disclosure related to their healthcare."

The Office of the Australian Information Commissioner has specifically addressed the sharing of information with other health providers without consent. It states:-
The Privacy Act is not intended to impose unnecessary administrative burdens on providers, or to inconvenience patients, by requiring consent every time health information is appropriately shared with another provider, or otherwise handled in the delivery of healthcare. At the same time, the Privacy Act seeks to ensure that individuals retain appropriate control over how their information is handled, including ensuring that it is not handled in ways that an individual would not expect.”

Past experience suggests that most patients believe information is readily shared between all members of the medical team. They are often, unpleasantly, surprised when information about a recent medical episode is not available.

It is therefore perfectly acceptable for GPs to release information to the clinics at the hospital when requested and without specific consent but the GP should make sure that they do not send any information that the patient would not wish released and which does not compromise perioperative care.

 Good clinical practice requires that all appropriate patient information be readily distributed between all medical members of the treating team. The recent legislation does not negate this in any way.