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.
Clinicians should consider whether an intimate or personal examination of the patient is justified, or whether the nature of the consultation poses a risk of misunderstanding.
When an intimate examination is to be undertaken, the following points should be considered:
- Explain to the patient that an intimate examination is necessary and give the patient an opportunity to ask questions.
- 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.
- Obtain the patient’s permission before the examination and record that the patient has given it.
- Whenever possible, offer a chaperone.
- Ensure that the patient is provided with adequate privacy to undress and dress.
- Keep discussion relevant and avoid unnecessary personal comments.
- Stop the examination if the patient asks you to.
- Ensure that a suitable sign is clearly on display in each consulting or treatment room offering the chaperone service if required.
The patient should be given a choice as to whether the healthcare assistant or practice nurse or a person of their own choice chaperones them; however relatives/friends of the patient are not impartial observers and so would not usually be a suitable chaperone, but you should comply with a reasonable request to have such a person present as well as a chaperone.
The use of untrained administration staff is not acceptable. If necessary another appointment can be made for the examination, in which case this decision should be recorded.
The patient can refuse a chaperone and if so this must be recorded in the patient’s notes. In this situation, or if an appropriate chaperone is not available, the clinician must consider whether it is appropriate to proceed with the examination without a chaperone. It may be more appropriate to rebook a later appointment, a joint appointment or an appointment with another health care professional, in which case the decision should be recorded.
There may be rare occasions when a chaperone is needed for a home visit.
- Clinician will contact the nursing team to request a chaperone.
- Where no chaperone is available, a clinician may offer to delay the examination to a date when one will be available, as long as a delay would not adversely affect the patient’s health.
- If a clinician wishes to conduct an examination with a chaperone present but the patient does not agree to this, the clinician must clearly explain why they want a chaperone to be present. The clinician may choose to consider referring the patient to a colleague who would be willing to examine them without a chaperone, as long as the delay would not adversely affect the patient’s health
- Clinician to record in medical records that chaperone is present and identify the chaperone.
- The chaperone must be sensitive and respect the patient’s dignity and confidentiality.
- The chaperone should reassure the patient if they show signs of distress or discomfort.
- The chaperone must stay for the whole examination and be able to see what the clinician is doing, if practical.
- The chaperone must be prepared to raise concerns if they are concerned about the clinician’s behaviour.
- The chaperone will make a record in the patient’s notes after examination. The record will state that there were no problems, or give the details of any concerns or incidents that occurred.