A couple of circumstances occurred in my practice this week, which called our chaperone policy and procedure into play. Having chaperones and a policy was previously one of those QOF targets that we had to meet but there are times when you’ll be glad it’s there.
We know that some patients find examinations, investigations or procedures particularly difficult and may prefer to have a chaperone (or impartial observer) present in order to support them. Any consultations or procedures involving the need for patients to undress may make a patient feel vulnerable, particularly those procedures of an intimate or sensitive nature. In these circumstances a chaperone can act as a safeguard for both patient and clinician.
In some instances, a clinician might prefer a chaperone to be present during consultations in order to act as a safeguard against misunderstandings, formal complaints or, in extreme cases, legal action. Healthcare professionals should be aware that they are at an increased risk of their actions being misconstrued or misrepresented if they conduct sensitive examinations where a chaperone has been requested and this request has not been met.
When to offer a chaperone?
We wouldn’t offer a chaperone for every consultation but for those procedures where we know that the patient is likely to need someone else present e.g. for a cervical smear, the offer should be made at the time of appointment booking and offered again at the consultation. However, if the offer of a chaperone is made and refused, the patient’s record should clearly indicate the patient’s wishes.
If the patient has requested a chaperone and none is available, the appointment must be rebooked within a reasonable time with a chaperone provided. However, if the condition warrants immediate medical attention, the patient must be made aware before a decision for delay can be taken.
The role of the chaperone
A chaperone – who may be a nurse or a trained non-clinical staff member – is there to perform a specific role during consultations. They must be aware of the patient’s rights as well as making sure the patient is treated appropriately. The patient must be made aware of their rights and the role of the chaperone, including the need for the chaperone to be present inside the privacy curtain during intimate examinations. Make sure your chaperones have had an Enhanced Disclosure and Barring Service check, and that both staff and patients are informed about your practice policy on chaperones and how to raise any concerns.
Alison Lowerson – QCS Expert GP Practice Manager Contributor
