This article reports on the issues relating to obtaining informed, signed consent for a study of paediatric high-dependency care and provides practical guidance on confidentiality for health service researchers. Consent and confidentiality are not new concepts but recent changes to the legislation and guidance offered from nursing and medical regulatory bodies have caused concerns and confusion for researchers with respect to both issues. Balancing health service research and the development of services against the requirements of patients for confidentiality is essential yet challenging. This was a time consuming, costly exercise. Resource implications may ultimately mean that studies which are of benefit to patients in relation to the delivery of their care may not be undertaken. Health professionals need to be continually updated and made aware of the legislation and confidentiality requirements for health service research involving the collection of patient-identifiable details.