Shared confidentiality and the care team: what a psychologist can pass on in France

Shared confidentiality (secret partagé) is the possibility, set out in article L1110-4 of the French Public Health Code, for professionals who care for the same person to exchange or share only the information that is strictly necessary for the coordination or continuity of that person's care. The care team (équipe de soins), defined in article L1110-12, is the setting in which this sharing is simplest.

What can a psychologist in France tell the GP, the psychiatrist, the school or the family? Here are the texts, a letter outline and a checklist. Quotations from French texts are our translation. For the general rules, see professional confidentiality for allied health professionals in France.

What the law says about shared confidentiality

Under section I of article L1110-4, confidentiality covers "all information about the person that has come to the knowledge of the professional" and "applies to all professionals working in the health system".

• Exchange (II). A professional may exchange information about the same person with identified professionals, provided they all take part in that person's care and the information is "strictly necessary for the coordination or continuity of care, for prevention or for their medico-social and social follow-up".
• Sharing (III). Within the same care team, professionals may share the strictly necessary information. It is then "deemed to have been entrusted by the person to the whole team".

The French digital health agency (Agence du numérique en santé) sums up the difference. Exchange is about "clearly identified" recipients, while sharing means information "made available to several professionals". A letter addressed to a named doctor is therefore closer to an exchange. The texts do not always draw a sharp line between the two.

The text adds two safeguards. Between professionals who are not in the same care team, sharing information "requires the person's prior consent, obtained by any means, including electronically". And the person is told of their right to object to the exchange and sharing, a right they can use "at any time" (IV).

The care team, three ways to belong

Article L1110-12 defines the care team as a group of professionals who take a direct part, for the same patient, in a diagnostic or therapeutic act, disability compensation, pain relief or prevention of loss of autonomy, or in coordinating several of these acts. On top of that, one of three conditions must be met.

• 1° The same organisation. Working in the same health establishment, the same social or medico-social establishment or service, or in a cooperation, shared-practice or coordination structure that appears on a list set by decree.
• 2° Recognition by the patient. The patient has recognised you as a member of their care team, and comes to you for consultations and acts prescribed by a doctor to whom they have entrusted their care.
• 3° An organised group. Working in a group that includes at least one health professional, with a formal organisation and practices that follow specifications set by order of the health minister.

What this means depending on where you work

• In private practice, on your own. You may fall under 2° if the patient recognises you as a member of their care team and comes to you for sessions prescribed by a doctor to whom they have entrusted their care. Otherwise, we suggest you treat yourself as outside the care team and apply the prior consent rule.
• In a maison de santé or centre de santé. Point 1° covers structures "that appear on a list set by decree". We suggest you check with your structure that psychologists are recognised as members of the care team.
• In a hospital or a CMP (public mental health clinic). If you work in the same health establishment as the other professionals and take part in the patient's care, 1° may apply. In a CMP, we suggest checking this with your management.

Mon soutien psy, a change on 1 October 2026

Since 1 October 2026, article L162-58 of the French Social Security Code states that "psychologists chosen by the patient to carry out these sessions belong to the patient's care team under the conditions set out in article L. 1110-12 of the Public Health Code". On this point, the text says nothing more. See also what is changing in Mon soutien psy in 2026.

The psychologist, a professional in the other category

Article R1110-2 sorts the professionals who may exchange or share information into two categories. The first covers the health professionals listed in part four of the code, doctors among them. The second covers, among others, at 2° b, "osteopaths, chiropractors, psychologists and psychotherapists who are not otherwise health professionals". Psychologists are therefore in the second category and doctors in the first.

Telling the patient before an exchange

Under article R1110-3, I, a professional who wants to exchange information with a professional from the other category first informs the person. They explain the nature of the information to be exchanged, and either the identity of the recipient and their category, or the recipient's role within a precisely defined structure. Within a care team, section II of the same article also requires prior information of the patient and refers to the recommendations of the Haute Autorité de santé on which categories of information are accessible.

In practice, before writing to the GP, tell the patient what you will send and to whom. We suggest noting this in the patient file, with the date.

Staying within the double limit

Article R1110-1 sets a double limit on any exchange or sharing. First, only the information strictly necessary for the coordination or continuity of care, for prevention or for medico-social and social follow-up. Second, the scope of your role.

The French Code of Ethics for Psychologists, in its 2021 version, points the same way. Its article 8 says the psychologist "shares only the information strictly necessary for the professional purpose". Its article 15 says that conclusions sent to a third party "only include the psychological elements on which they are based if necessary" and that "the agreement of the person concerned or their prior information is required".

Practical cases

A letter to the GP

Depending on your situation (2° of article L1110-12 or Mon soutien psy), you may belong to the patient's care team. Tell the patient what you will write. Then keep the letter to what helps the doctor coordinate, for example the fact that therapy is taking place, its frame, the broad lines of progress and anything you may expect from the doctor. Our psychologist letter to GP template covers the format.

An exchange with a psychiatrist

A psychiatrist is a doctor, so in the other category. The same rules apply. For a phone call, we suggest noting afterwards in the patient file what was passed on.

A request from a school

None of the texts cited here places the school among the members of the care team. To be safe, we suggest sending nothing without the prior agreement of the patient and, for a minor, of the holders of parental authority, giving the document to the family rather than to the school, and keeping to what is useful, with no clinical content. A simple attestation of attendance is often enough.

The family

The family is not the care team. Section V of article L1110-4 provides for one specific case. In the event of a serious diagnosis or prognosis, the family, relatives or the trusted person may receive the information they need to give the patient direct support, unless the patient objects. Only a doctor is authorised to give this information, or to have it given under their responsibility. With an adult patient, we suggest saying nothing to a relative without the patient's explicit agreement.

What goes into a letter, and what stays out

A letter is written for a specific reader and purpose, unlike your session notes. See also how to structure your session notes.

Letter outline

• Header. Your name, title, registration number and contact details, the date, the recipient and the subject.
• Context. How long you have been seeing the patient, at whose request, and the fact that the patient knows about this letter.
• Frame of therapy. Session frequency, type of support, expected duration.
• Information useful to the recipient. In general terms, progress and the points that concern their own work with the patient.
• Request or proposal. An opinion, a referral, coordination.
• Closing and signature.

Checklist before passing anything on

• I know whether we are in the same care team (organisation, prescription, Mon soutien psy) or not.
• The patient knows what I am sending and to whom. Outside the care team, they agreed before it was sent.
• The patient has not objected.
• Each piece of information is necessary for the coordination or continuity of care, and falls within my role.
• No extracts from notes, no quotes, no information about third parties.
• The way the letter is sent protects its confidentiality.
• The information given to the patient, and their agreement where needed, are noted in the file with the date.

How Delta helps

Delta is the clinical assistant for mental health and allied health professionals. It also drafts letters, attestations and assessment reports, adapted to your profession. We suggest reading each letter and removing what is not necessary before sending it. Sending it and informing the patient remain your responsibility. Data is hosted in France by an HDS-certified host, the patient's name and identifying information are pseudonymised before the AI step, and the data is never used to train a model. See our clinical document templates.

Sources

• French Public Health Code, article L1110-4 (version in force since 4 August 2021) and article L1110-12, Légifrance (in French).
• French Public Health Code, articles R1110-1, R1110-2 and R1110-3, Légifrance (in French).
• French Social Security Code, article L162-58, version in force since 1 October 2026, Légifrance (in French).
• Agence du numérique en santé, Les données de santé dans l'accompagnement médico-social, explanatory sheet, March 2023 (in French).
• Code de déontologie des psychologues, consolidated version of September 2021, document published by the Syndicat national des psychologues (in French).