Introduction
A chaperone is present as a safeguard for all parties (patient and health professionals) and is a witness to the conduct and the continuing consent of the procedure.
Guidelines
Before conducting any intimate examination, the clinician will follow this guidance:
- Explain to the patient why the particular examination is necessary and what it entails so they can give fully informed consent
- Record the consent discussion in the notes, along with the identity of the chaperone or if a chaperone was offered but declined
- If possible, use a chaperone of the same gender as the patient
- Allow the chaperone to hear the explanation of the examination and the patient’s consent
The above guidelines are to remove the potential for misunderstanding. However, there will still be times when either the Clinician, or the patient, feels uncomfortable, and it would then be appropriate to consider using a Chaperone.
If necessary, where a Chaperone is not available, the consultation/examination will be rearranged for a mutually convenient time when a Chaperone can be present. If the seriousness of the condition means a delay is inappropriate, this will be explained to the patient and recorded in their notes. A decision to continue or not will be reached jointly.
Who can act as a Chaperone?
A variety of people can act as a Chaperone in the practice, but staff undertaking a formal Chaperone role will have been trained in the competencies required.
The staff member will be comfortable acting in the role of Chaperone, and be confident in the scope and extent of their role. They will also have received instruction on where to sit/stand and what to watch and listen for. A Chaperone will document in the patient notes that they were present, and detail is any issues arose.
Confidentiality
- The Chaperone will only be present for the examination itself, with most of the discussion with the patient taking place while the Chaperone is not present.
- Practice staff are bound by the NHS’s confidentiality standards
Procedure
- The Clinician will contact reception to request a Chaperone
- Where no Chaperone is available, a Clinician may offer to delay the examination to a date when one will be available, as long as the delay would not have an adverse effect on the patient’s health
- If a Clinician wishes to conduct an examination with a Chaperone present but the patient does not agree to this, the Clinician will explain clearly why there is a need for a Chaperone to be present. The Clinician may choose to consider referring the patient to a colleague who would be willing to examine them without a Chaperone, as long as the delay would not have an adverse effect on the patient’s health
- The Clinician will record in the notes that the Chaperone is present, and state their name
- The Chaperone will remain in the room until the Clinician has finished the examination
- A Chaperone will attend inside the curtain/screened-off area at the head of the examination couch and observe the procedure
- The Chaperone will reassure the patient if they show signs of anxiety or discomfort
- The Chaperone will make a record in the patient’s notes after examination. The record will either state that there were no issues, or give details of any issues that occurred
- The patient can decline a Chaperone, and if so this will be recorded in the patient’s medical record