Chaperones – What to expect
The Practice is committed to providing a safe comfortable environment where patients and staff can be confident that best practice is being followed at all times and the safety of everyone is of paramount importance.
What is a Formal Chaperone?
There is no common definition of a chaperone and their role varies considerably depending on the needs of the patient, the healthcare professional and the examination being carried out.
Their role can be considered in any of the following areas:
- Emotional comfort and reassurance to patients
- Assist in examination (e.g. during IUCD insertion)
- Assist in undressing
- Act as interpreter
- Protection to the healthcare professional against allegations / attack
In clinical medicine, a formal chaperone is a person who serves as a witness for both a patient and a medical practitioner as a safeguard for both parties during a medical examination or procedure and is a witness to continuing consent of the procedure. Family members or friend may be present but they cannot act as a formal chaperone.
Why do we need Chaperones?
There are two considerations involved in having a chaperone to assist during intimate examinations; namely for the comfort of the patient and the protection of the doctor/nurse from allegations of impropriety. Chaperones may also be suggested if patients need extra assistance simply in relation to their mobility or simply as emotional support.
What is an intimate examination?
Obvious examples of an intimate examination include examinations of the breasts, genitalia and the rectum but it also extends to any examination where it is necessary to touch or be close to the patient for example conducting eye examinations in dimmed lighting, taking the blood pressure or palpating the apex beat.
The rights of the Patient:
All patients are entitled to have a chaperone present for any consultation, examination or procedure where they feel one is required. Patients have the right to decline the offer of a chaperone. However the clinician may feel that it would be wise to have a chaperone present for their mutual protection for example, an intimate examination on a young adult of the opposite gender.
If the patient still declines the doctor will need to decide whether or not they are happy to proceed in the absence of a chaperone. This will be a decision based on both clinical need and the requirement for protection against any potential allegations of improper conduct.
Appropriately Trained Chaperones:
An appropriately trained Chaperone is defined as a member or Practice staff who has completed the Practice Training Programme and has been assessed as competent by a member of the Practice clinical team. The practice has two levels of Appropriately Trained Chaperone:
Level One: Intimate examination, excluding breasts, genitalia and rectum: The chaperone can be a trained member of administration staff or any clinician (nurse or GP).
Level Two: Intimate examination of the breasts, genitalia and rectum: Only another clinician will be a chaperone in these circumstances.
Consultations involving intimate examinations:
If an intimate examination is required, the clinician will:
- Establish there is a need for an intimate examination and discuss this with the patient.
- Give the patient the opportunity to ask questions.
- Obtain and record the patient’s consent.
- Offer a chaperone to all patients for intimate examinations (or examinations which may be construed as such). If the patient does not want a chaperone it will be recorded in the notes.
The Patient can expect the chaperone to be:
- Available if requested.
- Pleasant/approachable/professional in manner, able to put them at ease.
- Competent and safe.
- Clean and presentable.
Where will the chaperone stand?
The positioning of the chaperone will depend on several factors for example the nature of the examination and whether or not the chaperone has to help the clinician with the procedure. The clinician will explain to you what the chaperone will be doing and where they shall be in the room.
Should you have a concern about a chaperone.
Patients should raise any concerns/make any complaint via the practice’s usual comments/complaints procedure.
When a chaperone is not available:
There may be occasions when a chaperone is unavailable (for example on a home visit or when no trained chaperone of the appropriate sex is in the building). In such circumstances the doctor will assess the circumstances and decide if it is appropriate to go ahead without one.