Chaperones

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Guidelines

Clinicians (male and female) should consider whether an intimate or personal examination of the patient (either male or female) is justified, or whether the nature of the consultation poses a risk of misunderstanding. 

The clinician should give the patient a clear explanation of what the examination will involve and the reason why it is necessary.

Always adopt a professional and considerate manner - be careful with humour as a way of relaxing a nervous situation as it can easily be misinterpreted.

Always ensure that the patient is provided with adequate privacy to undress and dress.

Ensure that a suitable sign is clearly on display in the waiting areas and each consulting or treatment room offering the chaperone service if required.

This should remove the potential for misunderstanding.   However, there will still be times when either the clinician, or the patient, feels uncomfortable, and it would be appropriate to consider using a chaperone. (This may occur even if the patient and the clinician are both of the same gender)

The offer of a chaperone should be recorded in the clinical notes.  If the patient declines the offer of a chaperone this must also be recorded in the clinical notes  

Patients who request a chaperone should never be examined without a chaperone being present. If necessary, where a chaperone is not available, the consultation / examination should be rearranged for a mutually convenient time when a chaperone can be present.  Equally, if the GP wants a chaperone to be present and the patient doesn’t the GP should try and encourage the patient to agree to a chaperone being present or make arrangements for the patient to see a different doctor.  Where this is not possible the final arrangements should be clearly recorded in the notes

Complaints and claims have not been limited to male doctors with female patients - there are many examples of alleged homosexual assault by female and male doctors. Consideration should also be given to the possibility of a malicious accusation by a patient

Who Can Act As A Chaperone?

A variety of people can act as a chaperone in the practice. Where possible, it is strongly recommended that chaperones should be clinical staff familiar with procedural aspects of personal examination. Where suitable clinical staff members are not available the examination should be deferred.

Where the practice determines that non-clinical staff will act in this capacity the patient must agree to the presence of a non-clinician in the examination, and be at ease with this. The staff member should be trained in the procedural aspects of personal examinations, comfortable in acting in the role of chaperone, and be confident in the scope and extent of their role. They will have received instruction on where to stand and what to watch and instructions to that effect will be laid down in writing by the practice.