Before a doctor or other health professional examines or treats you, they need your consent. Sometimes you can simply tell them whether you agree with their suggestions. However, sometimes a written record of your decision is helpful - for example if your treatment involves sedation or general anaesthesia. You'll then be asked to sign a consent form. If you later change your mind, you're entitled to withdraw consent - even after signing.
You can read the NHS Wandsworth consent policy here
What should I know before deciding?
Health professionals must ensure you know enough to enable you to decide about treatment. They'll write information on the consent form and offer you a copy to keep as well as discussing the choices of treatment with you. Although they may well recommend a particular option, you're free to choose another. People's attitudes vary on things like the amount of risk or pain they're prepared to accept. That goes for the amount of information, too. If you'd rather not know about certain aspects, discuss your worries with whoever is treating you.
Should I ask questions?
Ask as many questions as you like. The person you ask should do his or her best to answer, but if they don't know they should find someone else who is able to discuss your concerns. To support you and prompt questions, you might like to bring a friend or relative. Ask if you'd like someone independent to speak up for you.
Is there anything I should tell people?
If there's any procedure you don't want to happen, you should tell the people treating you. It's also important for them to know about any illnesses or allergies which you may have or have suffered from in the past.
Can I find out more about giving consent?
The Department of Health leaflet "Consent - what you have a right to expect" is a detailed guide on consent in versions for adults, children, parents, carers/ relatives and people with learning disabilities. Ask for one from your clinic or hospital, or read it on the Department of Health web site here
If someone does not have the capacity to consent for themselves, then they will be treated under the guidance laid out by the Mental Capacity Act 2005. This ensures that any treatment they receive is in their best interest and follows what they would have wanted to happen if they could consent for themselves. Further information on the Act can be found at the Office of the Public Guardian website
Who is treating me?
Amongst the health professionals treating you may be a "doctor in training" - medically qualified, but now doing more specialist training. They range from recently qualified doctors to doctors almost ready to be consultants. They will only carry out procedures for which they have been appropriately trained. A senior doctor will always supervise - either in person accompanying a less experienced doctor in training or available to advise someone more experienced.
What about anaesthesia?
If your treatment involves general or regional anaesthetic (where more than a small part of your body is being anaesthetised), you'll be given general information about it in advance. You'll also have an opportunity to talk with the anaesthetist when he or she assesses your state of health shortly before treatment. Hospitals sometimes have pre- assessment clinics which provide patients with the chance to discuss things a few weeks earlier.
Will samples be taken?
Some kinds of operation involve removing a part of the body (such as a gall bladder or a tooth). You would always be told about this in advance. Other operations may mean taking samples as part of your care. These samples may be of blood or small sections of tissue, for example from an unexplained lump. Such samples may be further checked by other health professionals to ensure the best possible standards. Again, you should be told in advance if samples are likely to be taken.
Sometimes samples taken during operations may also be used for teaching, research or public health monitoring in the future interests of all NHS patients. The NHS trust treating you will have a local system for checking whether you're willing for this to happen.
Photographs and videos
As part of your treatment some kind of photographic record may be made - for example X- rays, clinical photographs or sometimes a video. You will always be told if this is going to happen. The photograph or recording will be kept with your notes and will be held in confidence as part of your medical record. This means that it will normally be seen only by those involved in providing you with care or those who need to check the quality of care you have received. The use of photographs and recordings is also extremely important for other NHS work, such as teaching or medical research. However, we will not use yours in a way that might allow you to be identified or recognised without your express permission.
What if things don't go as expected?
Amongst the 25,000 operations taking place in the UK every day, sometimes things don't go as they should. Although the doctor involved should inform you and your family, often the patient is the first to notice something amiss. If you're worried - for example about the after- effects of an operation continuing much longer than you were told to expect - tell a health professional right away. Speak to your GP, or contact your clinic - the phone number should be on your appointment card, letter or consent form copy.
What are the key things to remember?
It's your decision! It's up to you to choose whether or not to consent to what's being proposed. Ask as many questions as you like, and remember to tell the team about anything that concerns you or about any medication, allergies or past history which might affect your general health.
Questions to ask health professionals
As well as giving you information health professionals must listen and do their best to answer your questions.
Questions may be about the treatment itself, for example:
- What are the main treatment options?
- What are the benefits of each of the options?
- What are the risks, if any, of each option?
- What are the success rates for different options - nationally, for this unit or for you (the surgeon)?
- Why do you think an operation (if suggested) is necessary?
- What are the risks if I decide to do nothing for the time being?
- How can I expect to feel after the procedure?
- When am I likely to be able to get back to work?
Questions may also be about how the treatment might affect your future state of health or style of life, for example:
- Will I need long- term care?
- Will my mobility be affected?
- Will I still be able to drive?
- Will it affect the kind of work I do?
- Will it affect my personal / sexual relationships?
- Will I still be able to take part in my favourite sport / exercises?
- Will I be able to follow my usual diet?
Health care professionals should welcome your views and discuss any issues so they can work in partnership with you for the best outcome.