Chaperones

The Aylesbury Partnership 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.

This Chaperone Policy adheres to guidance and policy of the Medical Protection Society and General Medical Council.

The Chaperone Policy is clearly advertised through patient information leaflets and can be read at the Practice upon request. A Poster is also displayed in the Practice Waiting Area.

Why use chaperones?

  • Their presence adds a layer of protection for a doctor. It is very rare for a doctor to receive an allegation of assault if they have a chaperone present.
  • To acknowledge a patient’s vulnerability.
  • Provides emotional comfort and reassurance.
  • Assists in the examination.
  • Assists with undressing patients.
  • May enable them to act as an interpreter.

What is an intimate examination?

Obvious examples 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, palpating the apex beat. Consult GMC and NMC advice on intimate examinations (see further information).

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 the practice determines 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.

A relative or friend of the patient would not be a suitable chaperone, however you should comply with a reasonable request to have a friend or relative present as well as (but not instead of) a chaperone

Checklist

  • Establish there is a need for an intimate examination and discuss this with the patient.
  • Explain why an examination is necessary, and what it entails, so that the patient has a clear understanding of what to expect – including whether the examination is likely to be uncomfortable or painful.
  • Offer a chaperone to all patients for intimate examinations (or examinations that may be construed as such). If the patient does not want a chaperone, record this in the notes. This should include patients of the same gender as yourself.
  • If the patient continues to refuse, their clinical needs must take precedence.
  • You may consider referring the patient to a colleague who would be willing to examine them without a chaperone, but only if the delay will not adversely affect their health.
  • Be aware and respect cultural differences. Religious beliefs may also have a bearing on the patient’s decision over whether to have a chaperone present.
  • Give the patient privacy to undress and dress. Use paper drapes where possible to maintain dignity.
  • Explain what you are doing at each stage of the examination, the outcome when it is complete and what you propose to do next. Keep the discussion relevant and avoid personal comments.
  • Record the identity of the chaperone in the patient’s notes
  • Record any other relevant issues or concerns
  • In addition, keep the presence of the chaperone to the minimum necessary period. There is no need for them to be present for any subsequent discussion of the patient’s condition or treatment.

Where should the chaperone stand?

Exactly where the chaperone stands is not of major importance, as long as they are able to properly observe the procedure so as to be a reliable witness about what happened.

Key points to remember

  • Inform your patients of the practice’s or organisation’s chaperone policy.
  • Record the use, offer and declining of a chaperone in the patient’s notes.
  • Ensure training for all chaperones.
  • GPs do not have to undertake an examination if a chaperone is declined, providing a delay will not adversely affect the patient’s health.
  • Be sensitive to a patient’s ethnic/religious and cultural background. The patient may have a cultural dislike to being touched by a man or undressing.
  • Do not proceed with an examination if you feel the patient has not understood due to a language barrier.