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We have recently seen a significant increase in the number of cases where doctors have been referred to the GMC and/or allegation(s) have been made to the Police in relation to sexual assault.
Due to the surge of such complaints, we encourage all our members to review and carefully consider the below advice and guidance on the use of chaperones when carrying out an intimate examination on a patient.
The GMC’s Good Medical Practice guidelines set out the principles, values, and the standards of care that professionals should adhere to. We appreciate that there may be occasions where there may be a deviation from the guidelines, however, we strongly recommend that you follow the below advice.
There will be times when you will need to carry out intimate examinations on patients. These are likely to include but not limited to examinations of breasts, genitalia, and rectum. Prior to conducting an intimate examination on a patient, you should firstly explain to the patient why an examination is necessary and give the patient an opportunity to ask you any questions that they may have in respect of the need for you to undertake an intimate examination. Please also consider whether there are any communication barriers and if so, request an interpreter or delay the examination if possible until the patient can understand with the use of an interpreter.
It can be easy for professionals to want to ensure they conduct a full examination but please remember that the patient may start to feel uncomfortable so, explain to the patient that they can request for the examination to stop at any time.
Before any examination you must obtain the patient’s consent, and this should be recorded and documented if this ever needs to be referred to in the future in the patient’s medical records.
Most of all, it is imperative that you offer the patient a chaperone and clearly explain why a chaperone is being offered, and what the chaperone’s role would be during the examination.
A chaperone will most likely be a health professional and you must be satisfied that the chaperone is familiar with the procedures involved in the examination and can stay for the duration of the examination. The chaperone should not leave the room in any circumstances while you are examining the patient. A relative or friend of a chaperone will not be trained or qualified so would not be an appropriate chaperone.
Please never assume that a patient does not wish to have a chaperone. You must always ask the patient before any intimate examination whether they would like a chaperone or not. If the patient refuses to have a chaperone, this must be clearly documented and recorded that a chaperone was offered but the patient declined, and any reasons why. If a patient requests a chaperone but there is no trained chaperone available, you can offer to delay the examination, when one will be available, but this should not affect the patient’s health.
If the patient would like to proceed in the absence of a chaperone but you do not feel comfortable, you can refer the patient to a colleague who may be willing to examine the patient without a chaperone. However, if this is not possible and you do not feel comfortable with carrying out an intimate examination, you can insist on a chaperone being present. Please note that you do not need the consent of a patient if you would like a chaperone present. If you arrange for a chaperone to be present at your request, the chaperone should be recorded in the medical records.
If you have any questions about the intimate examinations and chaperones, and wish to discuss this further, please feel free to contact MDS for assistance.
