You are very welcome to be accompanied by a trusted friend or relative at your consultation if you wish, and this is all the more important if English is not your first language, or if you feel you might not be able to express what you need clearly to the doctor or nurse.
In additon, for intimate examinations, you will be offered the choice of having another professional surgery staff present at the examination. This is called chaperoning.
What is a chaperone?
A chaperone is present as a safeguard for both parties (patient and healthcare professionals) and is a witness to the conduct and the patients continuing consent to the examination or procedure.
The precise role of the chaperone varies depending on the circumstances. It may include providing a degree of emotional support and reassurance to patients but more commonly incorporates
- Providing protection to healthcare professionals against unfounded allegations of improper behaviour.
- Assisting in the examination or procedure, for example handing instruments during an examination or procedure.
- Assisting with undressing, dressing and positioning patients
A chaperone is NOT used to reduce the risk of attack on a health professional.
Who may Chaperone?
There are two main types of Chaperone: ‘formal’ and ‘informal’.
Informal Chaperones are family, friends or supporters of the patient invited by the patient to accompany them in the consultation. Many patients feel reassured by the presence of a familiar person. Clinicians will accept the patients' wish for an informal chaperone in almost all cases. The shortcomings of utilising informal chaperones include:
- They may not understand the boundaries between appropriate and inappropriate clinician behaviour within an examination or procedure
- They may not necessarily be relied upon to act as an independent witness to the conduct or continuing consent of the procedure.
Under no circumstances should a child be expected to act as a chaperone. However, if the child is providing comfort to the parent and will not be exposed to unpleasant experiences it may be acceptable for them to stay. It is inappropriate to expect an informal chaperone to assist in or take part in the examination or to witness the procedure directly.
A ‘formal’ chaperone implies a health care professional, trained as a chaperone. This person may be a receptionist, nurse or a healthcare assistant at the practice. This individual will have a specific role to play in terms of the consultation and this role should be made clear to both the patient and the chaperone. Chaperones must have sufficient training to understand the role expected of them and they must not be expected to undertake a role for which they have not been trained.
Protecting the patient from vulnerability and embarrassment means that the chaperone will usually be of the same gender as the patient. There may be occasions when no staff member of the same gender as the patient is available. On any such occasion, provided it is clinically appropriate to delay the examination / procedure, the patient will be offered the option to rebook for the examination / procedure at a time when a clinician of their choice is available. The patient always has the opportunity to decline a particular person as a chaperone if that person is not acceptable to them for any justifiable reason.
All Manor Park Medical Centre’s Chaperones receive full training from the lead practice nurse and are checked through the Disclosure and Barring Service. Whenever possible the chaperone should be of the same sex as the patient (although this might be difficult to achieve for male patients).
The patient being the same sex as the clinician should not preclude the patient being offered a Chaperone.
Role of the Chaperone:
- Providing the patient reassurance
- Helping the patient to undress or prepare, or helping with clothing or covers
- Assist with procedures (if a nurse or healthcare assistant)
- Helping with instruments
- Witnessing a procedure
- ‘Protecting’ a clinician
- Being able to identify unusual or unacceptable behaviour relating to a procedure or the consultation
- Being able to identify whether the implied or implicit consent given at the start of the procedure remains valid throughout, and determine whether the attitude of the patient or the clinician has changed
The Clinician will:
- Ask if the patient would like a trained chaperone during their examination/procedure;
- Inform the chaperone about the examination;
- Document in the medical records the name and attendance of a chaperone, or that a chaperone was declined.
The Chaperone will:
- Introduce themselves;
- Ask if the patient has given consent to the Chaperone’s presence;
- Ask if the patient requires any further information about the nature of the examination;
- Ask if the patient has given consent to the examination/procedure.
The Chaperone will stand within the privacy curtain and do all they can to make the patient feel comfortable. They should make eye contact with the patient without making them feel uncomfortable. They will reassure the patient if they sense signs of distress or discomfort and ask if you require the clinician to pause or stop.
At the end of the examination/procedure the Chaperone will:
- Ask the patient if they require assistance in getting dressed
- Provide privacy and dignity whilst they get dressed
- Ask when the patient is happy for them to leave the room
- Be available should the patient wish to speak with them after the examination/ procedure and before they have left the practice.