What is best practice when it comes to patient consent? - Hamilton Fraser


In 2015, the law regarding patient consent changed fundamentally following the case of Montgomery v Lanarkshire Health Board, where a woman gave birth naturally and complications followed that she had not been warned of, severely injuring the child for life. Had she known about them, she would have gone for a caesarean.

The days of ‘The doctor knows best’ are over

Not only has there been a surge in improvements in technology, diagnostic techniques and drug availability, the public are better informed about the range of treatments and there is a huge impact of public enquiries if something goes wrong.

It has now become vital that the practitioner informs the patient about all the risks involved in the procedure, based upon the materiality of the risk. A risk is ‘material’ if it is likely that a patient would ‘attach significance’ to it.

General Medical Council (GMC) guidelines for consent

Doctors and patients making decisions together

Cosmetic procedures are elective and the results are subject to scrutiny from the patient. There is a high risk of a claim if a patient is not warned about any adverse outcome. It is important not to make assumptions about the patient’s level of knowledge or which clinical factors the patient might consider significant.

Top 10 tips for patient consent

  1. Tailor consent forms to different treatments/tick box consent forms.
  2. Make sure the consent form is signed and dated by the patient.
  3. Include aftercare instructions on consent forms.
  4. Ask for a new consent form to be signed for treatments provided at different times (repeat or varied treatments).
  5. Clear clinical notes on dialogue. If a patient won’t engage in dialogue, record this.
  6. If leaflets are provided, keep copies in the records.
  7. Keep to a cooling-off period and record when the patient is happy to proceed once they have given consent.
  8. Identify psychologically vulnerable patients/patients with high expectations and consider carefully if you want to go ahead with the procedure.
  9. Consider informing the patient’s GP if necessary.
  10. Don’t depart from proposed treatment consented for without good reason.

It is also important to remember that consent may be withdrawn during the course of the procedure, e.g. if a patient asks for the procedure to stop due to pain or discomfort.

Continuing the treatment/procedure would then constitute assault/negligence.

If you are a Hamilton Fraser Cosmetic Insurance customer and have a claim raised against you, please contact our claims team on 0345 310 6370.

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