Consent policy 

 We treat patients politely and with respect, recognising their dignity and rights as individuals. We encourage patients to be involved in decisions about their care and, before embarking on any aspect of patient care, we seek their consent to do so – recognising the rights of patients to decide what happens to their bodies and to refuse advice or treatment.

Valid consent

For consent to be valid it must be given voluntarily by an appropriately informed person who has capacity to consent to the proposed treatment. Those with capacity to consent include:

• The patient
• Someone with parental responsibility for a patient that is under the age of 18
• Someone authorised to do so under a Lasting Power of Attorney (LPA)
• Someone who has authority to make treatment decisions as a court appointed deputy.

If a young person (aged 16-17 years) is capable of giving consent, it is not necessary to obtain consent from a parent. If a child under 16 years has sufficient understanding and intelligence of what is involved in the proposed treatment (ie is Gillick competent), the child may be competent to consent to treatment. However, it is good practice to involve the family in the decision-making process, unless the young person or child wishes to exclude them.

Capacity

When assessing a patient’s capacity to make a decision for themselves, ensure that they can

• Understand the information that you are giving them
• Retain the information for long enough to make the decision
• Use the information to make a decision
• Communicate their decision (verbally or non-verbally).

Some patients may be able to consent to some treatment, but not to other treatment and may better at making decisions at some times but not at others. It is important that, for these patients, you assess their ability to take the decision in question and record your conclusions in their clinical notes. Be aware that pain, tiredness, medication, panic and confusion may temporarily affect a patient’s capacity to consent.

Relevant information

A person cannot consent to treatment if they have not been fully informed.  Make sure that the patient is given sufficient information and in a way that they can understand. Consider inviting them to bring a friend or relative to the appointment so that they can review what was discussed when they have left the surgery.

Your discussions with the patient should explore what they want to know to help them make their decisions and explain:

• The type and extent of treatment being proposed
• Why you think that the treatment is necessary
• The advantages and disadvantages of the treatment
• What alternatives are available
• Any significant risks and side-effects
• What might happen if the treatment is not carried out
• The patient’s freedom to choose, even if their choice is not your preferred option
• The patient’s right to change their mind and withdraw consent at any time.

Always make sure that the patient understands whether they are being treated under the NHS or privately and what the costs will be. Where a patient embarks on a course of treatment, you should give them a written treatment plan and cost estimate.

Where changes to the treatment plan are needed, you must obtain the patient’s agreement and consent, including to any changes in the costs and give them an amended treatment plan and estimate.

Time to think

Ask patients what they think of the proposed treatment and encourage them to ask questions. Aim to give honest and full answers. Patients may need to discuss their treatment more than once; encourage them to write down any questions that they want to ask to ensure that nothing is forgotten. You must always allow patients time to make their decisions, even if this means deferring the treatment.

Voluntary decision making

Decisions about their care must be made by the patient, and without pressure.  You should make sure that the patient understands that they can refuse to give their consent to the treatment and that they can change their minds at any time – even after the treatment has started.

Although the patient does not need to give a reason for refusing treatment or for changing their mind, understanding their concerns will allow you to give them the best advice and make sure that the patient understands that the consequences. You must make a full record of your discussion with the patient in their clinical notes.

Date: 01/04/23

Review date:01/04/24