Chaperone Policy

1.1 Policy Statement

At Forrest Medical Centre, all patients will routinely be offered a chaperone, It is a requirement that, where necessary, chaperones are provided to protect and safeguard both patients and clinicians during intimate examinations and or procedures.

All clinical staff and chaperone trained non-clinical staff may at some point be asked to act as a chaperone at. Therefore, it is essential that clinical and non-clinical personnel are fully trained and aware of their individual responsibilities when performing chaperone duties.

The importance of a chaperone should not be underestimated. Children and young people, their parents, relatives and carers should be made aware of the policy and why this is important.

1.2 Status

The organisation aims to design and implement policies and procedures that meet the diverse needs of our service and workforce, ensuring that none are placed at a disadvantage over others, in accordance with the Equality Act 2010 . Consideration has been given to the impact this policy might have with regard to the individual protected characteristics of those to whom it applies.

This document and any procedures contained within it are non-contractual and may be modified or withdrawn at any time. For the avoidance of doubt, it does not form part of your contract of employment.

2 Policy

2.1 Raising Patient Awareness

Patients are to be advised that a chaperone is ‘an independent person, appropriately trained, whose role is to observe independently the examination/procedure undertaken by the doctor/health professional to assist the appropriate doctor-patient relationship

At Forrest Medical Centre, a chaperone poster is clearly displayed in the waiting area, in all clinical areas and annotated in the organisation leaflet as well as on the organisation website.

2.2 Personnel Authorised To Act As Chaperones

It is policy that any member of the organisation team can act as a chaperone only if they have undertaken appropriate chaperone training. The GMC advises that a relative or friend of the patient is not considered to be an impartial observer and therefore would not be considered a suitable chaperone.

2.3 General Guidance

All clinicians consider using a chaperone for some or all of the consultation and not solely for the purpose of intimate examinations or procedures. This applies whether the clinician is of the same gender as the patient or not.

Before conducting any intimate examination, the clinician will follow this checklist:

• 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

During the examination, the clinician will

• Ensure the patient’s privacy during the examination when they are dressing and undressing, for example by using screens and gowns/sheets
• Position the chaperone where they can see the patient and how the examination is being conducted
• Explain what they are going to do before they do it and seek consent again (if the examination is going to differ from what the patient was previously advised)
• Avoid personal remarks
• Invite the patient to advise if the examination becomes uncomfortable.
• Watch the patient for any signs of pain or discomfort and check the patient is happy for the examination to continue

Ensure that the patient fully understands the why, what and how of the examination process should mitigate the potential for confusion.

2.4 Expectations Of A Chaperone

All staff who undertake a formal chaperone role will have been fully trained, so they develop the competencies required.

At Forrest Medical Centre, chaperone training includes

• What is meant by the term chaperone
• What an intimate examination is
• Why chaperones need to be present
• The rights of the patient
• The role and responsibilities of the chaperone. Chaperones must place themselves inside the screened off area rather than outside of the curtains/screen
• The policy and mechanism for raising concerns

Training is provided in house by a practice nurse and online training modules.

Additionally, at Forrest Medical Centre chaperones will adhere to the GMC guidance which states chaperones should

• Be sensitive and respect the patient’s dignity and confidentiality
• Reassure the patient if they show signs of distress or discomfort
• Be familiar with the procedures involved in a routine intimate examination
• Stay for the whole examination and be able to see what the doctor is doing, if practical
• Be prepared to raise concerns if they are concerned about the doctor’s behaviour or actions

For most patients and procedures, respect, explanation, consent and privacy are all that is needed. These take precedence over the need for a chaperone. A chaperone does not remove the need for adequate explanation and courtesy. Neither can a chaperone provide full assurance that the procedure or examination is conducted appropriately.

2.5 Disclosure And Barring Service (DBS) Check

Clinical and Non-Clinical staff who undertake a chaperone role at Forrest Medical Centre will already have a DBS check.

2.6 When A Chaperone Is Unavailable

If the patient has requested a chaperone and no one is available, the patient will be able to reschedule within a reasonable timeframe. If the seriousness of the condition means a delay is inappropriate, this should be explained to the patient and recorded in their notes. A decision to continue or not should be reached jointly. Special consideration will be given to examinations performed during home visits.

2.7 Practice Procedure

• We record in the patients healthcare record that a chaperone is present and identify them
• The chaperone will be introduced to the patient
• The chaperone will maintain a position so that they are able to witness the procedure/examination (usually at the head end)
• The chaperone will always adhere to their role
• Post procedure or examination, the chaperone will ensure they annotate in the patient’s healthcare record that they were present during the examination and there were no issues observed
• The clinician will annotate in the patients healthcare record the full details of the procedure as per current medical records policy

3 Summary

The relationship between the clinician and patient is based on trust and chaperones are a safeguard for both parties at Forrest Medical Centre.

The role of a chaperone is vital in maintaining a good standard of practice during consultations and examinations. Regular training for staff and raising patient awareness will ensure that this policy is maintained.