1.2 Consent

Working in a person-centred way requires that everything you do for a patient is done with their consent. If you are going to take their temperature or another straightforward observation, usually a nod or verbal consent is enough to tell you that they are happy for you to carry out the action.

In the next audio clip you will hear Gail talking about how important it is to always get the patient’s consent before carrying out any actions with them, using real examples as to whether this may be explicit/informed or informal consent.

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Transcript: Obtaining patient consent

Gail:

You must always get consent from a patient and this can be in um different ways.

If a patient is having an operation or an intervention, normally they would have to sign a Formal Consent Form, and a Formal Consent Form can come in lots of guises – it could be that the patient consents for themselves; it can be that the patient has an advocate that will sign for them.

If it’s a patient that is under an age or doesn’t understand, then a parent can sign for that patient, so there are lots of different Consent Forms and you have to make sure that you use the appropriate Consent Form - that is really important!

Consent on a formal form is usually taken by the doctor that is going to do the procedure or the operation, and when the consent’s done, you will talk to the patient and tell them what the risks, complications, side effects could be, what they are going to do um and what may happen afterwards so this is what they call an Informed Consent.

So the patient then knows everything about that procedure or that operation, and he then can sign that consent if he agrees with it. So that is Informed Consent.

The other consent that there is, is a Verbal Consent. I would use this as a healthcare [assistant] um, all the time.

Every time you go to a patient to do anything with them you must gain an Informal Consent from them. This can be ‘Mrs Jones I’m just coming to do your blood pressure, is that alright?’ and the patient would say yes or no. If the patient says no, then we don’t do that blood pressure!

We would then maybe go and speak to a member of staff to pass that on and maybe go in from a different angle and actually explain why we need to do the blood pressure.

So everything that you do for a patient, you must gain consent. If you are actually saying to them ‘shall we put your nightie on’, that they say ‘yes’, that is a consent. You must gain consent!

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Obtaining patient consent

1. Explicit (or informed) consent means that the person giving consent knows exactly what they are agreeing to. For example, a patient going for surgery needs to give written consent and, if patient information is to be shared, they need to understand what will happen as a result of this.
2. Implied consent: This is when someone has not explicitly said that their personal information may be shared but their behaviour suggests that they are aware that it will be passed on and they are happy with this. For example, because a patient agreed to go to the diabetes clinic, his GP reasonably assumed he also agreed to his information being passed on to the clinic (The Open University, 2015, p. 60).
3. Mental capacity and consent: There may be times when your patient lacks the mental capacity to give consent or make a decision, maybe due to physical illness or a learning disability or dementia, or they cannot communicate what they want. In such instances a family member might be asked to give consent on their behalf (The Open University, 2015, p. 60).