IMPORTANT: GLOBAL IT ISSUE AFFECTING PRESCRIPTIONS

You may have seen on the news there are global IT issues. Our surgery clinical patient system (Systm One) is unimpacted. The practice is able to issue prescriptions but Glade, Marlow Bottom and Lane End pharmacies are impacted and are unable to access and issue prescriptions from the central NHS Spine. If your nominated pharmacy

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Chaperones

Our Practice is committed to providing a safe, comfortable environment where patients and staff can be confident that best practice is being followed at all times; the safety of everyone is of paramount importance.

All medical consultations, examinations and investigations are potentially distressing. Patients can find examinations, investigations or photography involving the breasts, genitalia or rectum particularly intrusive (these examinations are collectively referred to as ‘intimate examinations’). Consultations involving dimmed lights, the need for patients to undress or intensive periods of being touched may also make a patient feel vulnerable.

Chaperoning is the process of having a third person present during such consultations to provide support, both emotional and sometimes physical, to the patient, to provide practical support to the Doctor as required, and also to protect the Doctor against allegations of improper behaviour during such consultations.

The Chaperone Policy can be found below.

Chaperone Policy

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.

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.

This should remove the potential for 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. Patients 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 doctors treating/examining patients of the opposite gender – there are many examples of alleged assault by female and male doctors on people of the same gender. Consideration should also be given to the possibility of a malicious accusation by a patient.

There may be occasions when a chaperone is needed for a home visit. The following procedure should still be followed.

Who Can Act as a Chaperone?

Informal Chaperone:

Many patients feel reassured by the presence of a familiar person and this request, in all cases, should be accepted. A situation where this may be not appropriate is where a child is asked to act as a chaperone for an adult undergoing an intimate examination or procedure. It is also inappropriate to expect an informal chaperone to take an active part in the examination, or to witness the procedure directly.

Formal Chaperone:

A formal chaperone is a clinical health professional such as a nurse or a specifically trained non-clinical staff member. This individual will have a specific role to play in terms of the consultation and this role will be made clear to both the patient and the person undertaking the chaperone role. This may include the undressing or assisting in the procedure being conducted. In these situations, staff should have had sufficient training to understand the role expected of them. Common sense dictates that in most cases, it is not appropriate for a non-clinical member of staff to comment on the appropriateness of the procedure or examination.

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.

Click here to link to the latest GMC guidelines for intimate examinations: www.gmcuk.org/guidance/ethical_guidance/21170.asp

Procedure

The clinician will contact Reception/RAC Triage 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, if the delay would not have an adverse effect on 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 if the delay would not have an adverse effect on the patient’s health.
  • 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 attend inside the curtain/screened-off area at the head of the examination couch and observe the procedure.
  • To prevent embarrassment, the chaperone should not enter conversation with the patient or GP unless requested to do so or make any mention of the consultation afterwards.
  • The chaperone will make a record in the patient’s notes after examination. The record will state that there were no problems or give details of any concerns or incidents that occurred. The chaperone must be aware of the procedure to follow if they wish to raise concerns.
  • The patient can refuse a chaperone, and if so, this must be recorded in the patient’s medical record.
  • Signage in each consulting room along with details on the web site and in reception offering a chaperone should a patient need one be clear.
  • Formal chaperones should be DBS checked.