Chaperone Policy

CHAPERONE POLICY 

INTRODUCTION 

This policy is designed to protect both patients and staff from abuse or allegations of abuse and to assist patients to make an informed choice about their examinations and consultations. 

GUIDELINES 

Clinicians (male and female) should consider whether an intimate or personal examination of the patient (either male or female) is justified, or whether the nature of the consultation poses a risk of misunderstanding.   

Before conducting an intimate examination, you should: 

1. explain to the patient why an examination is necessary and give the patient an opportunity to ask questions 

2. explain what the examination will involve, in a way the patient can understand, so that the patient has a clear idea of what to expect, including any pain or discomfort 

3. get the patient’s permission before the examination and record that the patient has given it 

4. offer the patient a chaperone  

5. if dealing with a child or young person: 
   • you must assess their capacity to consent to the examination  
   • if they lack the capacity to consent, you should seek their parent’s consent⁴ 

6. give the patient privacy to undress and dress, and keep them covered as much as possible to maintain their dignity; do not help the patient to remove clothing unless they have asked you to, or you have checked with them that they want you to help. 

This should remove the potential for misunderstanding. However, there will still be times when either the clinician, or the patient, feels uncomfortable, and it would be appropriate to consider using a chaperone.   Patients who request a chaperone should never be examined without a chaperone being present. If necessary, where a chaperone is not available, the consultation / examination should be rearranged for a mutually convenient time when a chaperone can be present. If either you or the patient does not want the examination to go ahead without a chaperone present, or if either of you is uncomfortable with the choice of chaperone will require the examination to be re scheduled for a suitable chaperone to present, as long as the delay would not adversely affect the patient’s health. 

Complaints and claims have not been limited to male doctors with female patients – there are many examples of alleged homosexual assault by female and male doctors. Consideration should also be given to the possibility of a malicious accusation by a patient 

There may be rare occasions when a chaperone is needed for a home visit.  The following procedure should still be followed.  

WHO CAN ACT AS A CHAPERONE? 

A variety of people can act as a chaperone in the practice. Where possible, it is strongly recommended that chaperones should be clinical staff familiar with procedural aspects of personal examination. Where suitable clinical staff members are not available the examination should be deferred.  

Where the practice determine that non-clinical staff will act in this capacity the patient must agree to the presence of a non-clinician in the examination, and be at ease with this. The staff member should be trained in the procedural aspects of personal examinations, comfortable in acting in the role of chaperone, and be confident in the scope and extent of their role. They will have received instruction on where to stand and what to watch and instructions to that effect will be laid down in writing by the practice.    

CONFIDENTIALITY 

• The chaperone should only be present for the examination itself, and most discussion with the patient should take place while the chaperone is not present.   

• Patients should be reassured that all practice staff understand their responsibility not to divulge confidential information. 

Click here to link to the latest GMC guidelines for intimate examinations: http://www.gmc-uk.org/guidance/current/library/maintaining_boundaries.asp#10  

PROCEDURE 

• The clinician will contact Reception to request a chaperone. 

• The clinician will record in the notes that the chaperone is present, and identify the chaperone. 

• Where no chaperone is available the examination will not take place – the patient should not normally be permitted to dispense with the chaperone once a desire to have one present has been expressed. 

• The chaperone will enter the room discreetly and remain in the room until the clinician has finished the examination. 

• The chaperone will normally attend inside the curtain at the head of the examination couch and watch the procedure. 

• To prevent embarrassment, the chaperone should not enter into conversation with the patient or GP unless requested to do so, or make any mention of the consultation afterwards. 

• The clinician will make a record in the patient’s notes after examination of the chaperones presence and if applicable the chaperone will also document this in the patients record.   The record will state that there were no problems, or give details of any concerns or incidents that occurred. 

• The patient can refuse a chaperone, and if so this must be recorded in the patient’s medical record.