Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Urgent information despite incomplete consent
Credible information about imminent serious harm, a missing dependent, dangerous access to means or acute incapacity may require prompt verification and proportionate sharing before ordinary consent discussions can be completed.
Action: Address immediate safety, seek the person's agreement where practicable, share only information necessary with those able to reduce the danger, and record the public-interest, safeguarding or best-interests rationale. Continue to listen to information offered by others even when confidentiality prevents disclosing patient details in return.
Synopsis
Use consented and, when justified, proportionate collateral information to establish baseline, chronology, function, treatment response and risk while protecting confidentiality, documenting source reliability and preserving the person's own account.
Ask the person's permission to contact named supporters and explain what questions will be asked, what may be shared and why the information could help.
Collateral history is especially valuable for baseline function, onset, fluctuation, previous episodes, treatment response, adherence, substance use, risk behaviour and the effect on dependants.
Create a dated longitudinal timeline rather than averaging episodes into a static label; include recovery periods, interventions, medicine changes and social transitions.
Key red flags
A sudden departure from baseline sleep, speech, spending, self-care, cognition or behaviour can reveal mania, delirium, intoxication or relapse that is not apparent in one calm interview.
Investigation priorities
01
Consent and scope discussionFirst step
Agree who may be contacted, topics that may be discussed and information that may be returned.
Management branches
Routine collateralAgree contact and obtain specific evidence
Longitudinal or functional information would materially improve assessment or care.
Explain the value of collateral, identify suitable sources and agree the scope of contact with the person.
Ask for dated observable changes, baseline, treatments, risks and strengths rather than inviting a global character judgement.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.