Chaperone Policy

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Our chaperone policy is based on the practice’s commitment to equity and diversity.

A chaperone may be required in the following situations:

• Intimate examinations: These are examinations of rectal, genital or breast area.
• For patients with certain cultural or religious beliefs: Any examination requiring shedding of clothing. Some patients may be uncomfortable with this and our clinicians need to approach the subject with particular sensitivity.
• Patients with disabilities: A patient with a severe mental or physical disability is unlikely to attend surgery unaccompanied. clinicians should endeavour to communicate with the patient with the assistance of the relative or carer accompanying them. Particular care should be taken to ensure the patient is not made to feel that their wishes are being ignored.
• Examinations by a member of the opposite sex: Some patients may be uncomfortable with this for religious or other reasons.
• Examinations on patients with poor English: It would be unwise to proceed with any examination unless the clinician is satisfied that the patient understands and can give informed consent. If an interpreter is present they may be able to double as a chaperone. If an urgent clinical need for an examination is evident, every effort should be made to communicate with the patient by whatever means are available before proceedingwith the examination.
• Examinations on children: Children are expected to be accompanied by a parent or adult relative to whom the need for the examination will be explained and consent obtained. They will be expected to remain with the child during the examination, so a further chaperone will not normally be necessary. The clinician will obviously seek to reassure the child and explain the examination if appropriate to the child.
• Teenagers aged 13 and upwards: Teenagers can consent to examinations provided the clinician is sure that they have sufficient competence to understand the nature and purpose ofthe examination. Still, in this situation the use of a chaperone may be advised.

Under these situations the clinician will:

• Explain why the examination is needed and what it will involve
• Obtain verbal express permission before proceeding
• Give the patient privacy to dress and undress
• Allow the patient to postpone or decline to be examined
• If appropriate offer a chaperone and document the fact that the patient has been offered a chaperone and that permission has been given or declined   

The clinician is also entitled to request a chaperone be present if they feel the situation warrants it.

Should the patient refuse, the clinician can inform the patient that they are unable to perform the examination unless a third person is present. 

Who should act as a chaperone?

The practice will endeavour to find the most appropriate staff member to perform the role of the chaperone. Sometimes the patient’s friend or relative may be appropriate but if the patient being examined has a history of unpredictable behaviour it may be better to have a member of the practice team present as well.

Examinations on home visits

Clinicians are at an at an increased risk of their actions being misconstrued or misrepresented if they conduct intimate examinations at patients' homes and it would be better to encourage these to be done at the surgery where appropriate arrangements can be made. A family member or friend could, however act as a chaperone if available.

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
• The chaperone will enter the room discreetly and remain in the room until the clinician has finished the examination
• The chaperone will normally attend inside the curtain at the head of the examination couch
• To prevent embarrassment, the chaperone should not enter into conversation with the patient or clinician unless requested to do so, or make any mention of the consultation afterwards
• The chaperone will give details of any concerns or incidents that occurred to the Practice Manager or their deputy immediately after the consultation
• The patient can refuse a chaperone, and if so this must be recorded in the patient’s medical record