Chaperones

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Introduction

This policy is designed to protect both patients and staff from abuse or allegation of abuse and to assist patients to make an informed choice about their examinations and consultations. The first section is for clinicians and the section two is for staff who are trained to be a chaperone.

This policy should be read alongside the GMC guidance on intimate examinations and chaperones

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

• The clinician should give the patient a clear explanation of what the examination will involve.
• Always adopt a professional and considerate manner – be careful with humour as a way of relaxing a nervous situation as it can easily be misinterpreted.
• Always ensure that the patient is provided with adequate privacy to undress and dress.
• Ensure that a suitable sign is clearly on display in each consulting or treatment room offering the chaperone service if required.

This should remove the potential of 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. Patient 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.

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 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 determines that non-clinical staff will act in this capacity the patient must agree to the present of a non-clinician in the examination, and be at ease with this. The staff member will be trained by the LMC to be a Chaperone in the procedural aspects of personal examination, 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.

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

Your record will be noted with one of the following, as appropriate:

• Chaperone offered
• Provision of Chaperone refused
• Chaperone present
• Chaperone not available

Regular audit of the use of each read code by clinician will be undertaken, and it is expected that a high level of usage will be demonstrated.