Summary: Consent is the process of informing a patient about a procedure, and receiving permission to go ahead.
Who’s it for: All clinical staff
It’s expected that all clinicians understand consent, and the best practices around obtaining it.
This serves as a reminder, and any further guidance should come from your line manager, the resources at the bottom, or your defence organisation.
Principles & terms
Consent must be voluntary and informed, and the patient must have capacity for it to be valid.
- Voluntary consent: The decision to consent is made by an individual, rather than outside influences
- Informed consent: The patient must be given all information regarding what is involved, risks & benefits, alternatives, and consequences if declined
- Capacity: The patient must be capable of giving consent, based upon their ability to understand, retain, weigh-up, and communicate a decision. (See also: Mental Capacity Act)
- Gillick Competence: Considered for patients <16 if they wish to receive treatment without their guardian’s consent or knowledge. This takes into account maturity & mental capacity, their understanding, and ability to explain rationale behind decision making.
Gaining consent
Consent can be given either verbally or written. Each is as valid as the other.
- There are some specific occasions where written consent is necessary (such as in fertility treatment)
- If verbal consent is received, this should be detailed in a patient’s notes. This should include the risks/benefits discussed, and a discussion about alternatives & consequences. If the patient makes any specific requests, or are provided with any resources, this should also be noted.
- If consent is given in advance, it should be re-checked prior to any treatment.
- Sometimes implied consent is given, such as rolling up a sleeve for a blood test.
When consent is not needed
There are some circumstances where consent is not needed. More information can be found on NHS England - Consent to treatment
- The patient needs emergency treatment
- The patient requires treatment under the Mental Health Act
- There is a risk to public health