Criterion 4.3 asks you to describe the potential tension between maintaining an individual’s confidentiality and disclosing concerns, and it sits in the Level 3 communication unit of the Level 3 Diploma in Adult Care and related Level 3 adult social care qualifications. This guide explains what your assessor expects, gives you a structure and model paragraphs, and shows how to link your answer to real situations from your own work setting.
What criterion 4.3 asks you to do
The verb is describe. You are not being asked to list laws or define confidentiality (that is 4.1). You need to show that you understand why a care worker can feel pulled in two directions: the individual has a right to privacy and trusts you with personal information, but you also have a duty of care and a duty to safeguard. When you learn something that suggests the individual or someone else is at risk of harm, keeping quiet may protect trust but leave people unsafe, while sharing may protect people but damage the relationship.
A good answer names the tension clearly, explains both sides, gives realistic examples from adult care, and shows how the tension is resolved in practice: by following agreed procedures, sharing only what is necessary with the right people, and recording what was shared and why.
Where 4.3 sits in the unit
In the Level 3 adult care communication unit, 4.3 belongs to the learning outcome on confidentiality. Wording varies slightly between awarding organisations, but the criteria usually look like this:
| Criterion | What it covers |
|---|---|
| 4.1 | Explain the meaning of the term confidentiality |
| 4.2 | Ways to maintain confidentiality in day-to-day communication |
| 4.3 | The potential tension between maintaining an individual’s confidentiality and disclosing concerns (to agreed others) |
| 4.4 | How and when to seek advice about confidentiality |
If you are on the newer Level 3 Diploma in Adult Care introduced from 2024, the same idea appears in the unit Effective Communication in Adult Care as criterion 6.4, “Explain the potential tension between maintaining an individual’s confidentiality and disclosing concerns”. The content of this guide applies to both; the newer version uses “explain”, so add a little more on why the tension exists.
How your assessor judges 4.3
| Element | What it asks | How to evidence it |
|---|---|---|
| The two duties | Show you understand the right to confidentiality and the duty to disclose | One short paragraph on each, linked to your role |
| The tension | Describe why they can conflict | Explain the effect on trust, dignity and safety |
| Examples | Apply it to adult care | Two or three anonymised workplace situations |
| Managing it | Show safe practice | Policy, need-to-know sharing, telling the individual where safe, recording |
How to answer 4.3: a suggested structure
- Open with the tension in one sentence. Confidentiality builds trust; disclosure protects people from harm; the two can pull against each other.
- Explain the individual’s right to confidentiality. Refer to the common law duty of confidentiality, Article 8 of the Human Rights Act 1998 (respect for private and family life), the Data Protection Act 2018 and UK GDPR, and your employer’s confidentiality policy.
- Explain the duty to disclose. Your duty of care, safeguarding duties under the Care Act 2014, and the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England. Note that confidentiality is not absolute: information can be shared where there is a risk of serious harm, a legal requirement, or the person consents.
- Describe two or three situations where the tension appears (see examples below).
- Show how you manage it. Follow the safeguarding procedure, report to your manager or safeguarding lead, share only what is necessary, tell the individual what you are doing and why unless that would increase the risk, and record the decision accurately.
- Close with the impact. Handled well, the individual can keep trusting the service even when information has been shared.
Example paragraph: In my role as a senior carer, residents often confide in me because they trust me to keep what they say private. This trust matters because it helps them feel respected and more willing to talk about their needs. However, confidentiality is not absolute. If a resident tells me something that suggests they, or another person, are at risk of harm, my duty of care and the safeguarding procedure require me to pass this on to my manager. The tension is that the resident may feel let down and may stop confiding in staff, yet keeping the information to myself could leave them unsafe. I manage this by never promising total secrecy, explaining at the start that I may need to share information to keep people safe, and sharing only the relevant facts with the agreed people.
Worked example: a mini case analysis
Use a short case like this to show you can apply the criterion rather than repeat theory.
Situation: Mr A, who has capacity, tells a care worker that his son has been taking money from his bank card. He asks the worker not to tell anyone because he does not want his son “in trouble”.
| Step | What the worker considers |
|---|---|
| Right to confidentiality | Mr A has capacity and has asked for privacy. Sharing without good reason would breach trust and his right to private life. |
| Concern | Financial abuse is a recognised category of abuse under the Care Act 2014 statutory guidance. Mr A may continue to lose money, and other people could be at risk. |
| The tension | Respecting his wishes protects his autonomy and trust; disclosing may protect his finances and wellbeing but could upset him and damage the relationship. |
| Action | The worker does not promise secrecy, tells Mr A that she has to pass on concerns about abuse, and reports to the manager or safeguarding lead the same day. |
| Proportionate sharing | Only the facts relevant to the concern are shared. The safeguarding lead decides on next steps and Mr A’s views are taken into account (Making Safeguarding Personal). |
| Recording | The worker records what Mr A said in his own words, what she did, who she told and when. |
Other situations you can describe
- An individual mentions thoughts of self-harm and asks you not to tell their family.
- A colleague’s poor practice puts residents at risk and you are asked to “keep it between us” (whistleblowing, protected by the Public Interest Disclosure Act 1998).
- A relative phones and asks for medical details about an individual who has not consented to information being shared with them.
Common mistakes that cost marks
- Defining confidentiality at length but never describing the tension itself.
- Saying you would “always keep information secret” or “always tell the manager everything”; both ignore the balance the criterion is testing.
- Promising an individual you will keep a secret. Assessors look for the opposite: being honest that some things must be shared.
- Quoting old or wrong legislation, such as the Data Protection Act 1998 instead of the Data Protection Act 2018 and UK GDPR.
- Using real names or identifiable details from your workplace in the answer, which is itself a confidentiality breach.
- Leaving out recording and reporting, which is how the tension is managed in practice.
How to make your answer stronger
Diploma criteria are not graded Pass, Merit or Distinction, but a well-developed answer is easier to sign off first time. Link each point to your own role and setting, explain the consequences for the individual on both sides (loss of trust versus risk of harm), and refer to your employer’s confidentiality and safeguarding policies by name. Mention the Caldicott Principles, especially the principle that the duty to share information can be as important as the duty to protect confidentiality. If your assessor observes you in practice, your written answer should match what you actually do.
FAQs
Is confidentiality ever absolute in adult care?
No. Information can be shared when the individual consents, when the law requires it, or when sharing is needed to protect the individual or others from serious harm. You should share only what is necessary, with people who need to know.
Should I tell the individual before I disclose a concern?
Usually yes, and it helps keep trust. The exception is when telling them could increase the risk, for example if it might alert an alleged abuser. Your safeguarding lead can advise.
Who are the “agreed others” in 4.3?
The people your organisation’s procedures say you can share information with, such as your line manager, safeguarding lead, the individual’s GP or the local authority safeguarding team, depending on the situation.
How long should my answer to 4.3 be?
Most assessors expect around 250 to 400 words, or a professional discussion covering the same points. Quality matters more than length: one clear example linked to your role is worth more than a page of theory.
Need one-to-one support from a subject specialist? Our BTEC Level 3 Health and Social Care assignment help service covers planning, feedback on drafts and referencing.
If you are working through the rest of this unit, see our guide to 2.1 legislation, policy and codes of practice on equality and diversity and 3.2 procedures if an accident or sudden illness occurs. If you need feedback on a draft, you can get expert help with your BTEC assignment.
