INTRODUCTION
This policy is designed to protect both patients and staff from abuse or allegations of abuse and to assist patients to make an informed choice about their examinations and consultations.
GUIDELINES
Clinicians (male and female) should consider whether an intimate or personal examination of the patient (either male or female) is justified, and whether the nature of the consultation poses a risk of misunderstanding. Patients should be offered a chaperone for such examinations.
• The clinician should give the patient a clear explanation of what the examination will involve.
• 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.
• If a patient does not want a chaperone it is good practice to record ‘chaperone declined’ in the medical record.
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.
WHO CAN ACT AS A CHAPERONE?
A chaperone does not have to be medically qualified but will ideally:
• be sensitive, and respectful of the patient’s dignity and confidentiality
• be prepared to reassure the patient if they show signs of distress or discomfort
• be familiar with the procedures involved in a routine intimate examination
• be prepared to raise concerns about a doctor if misconduct occurs.
The role of a chaperone should be made clear to both the patient and the person who is undertaking the role.
The chaperone can decline the role if not comfortable and an alternative offered.
The chaperone should be told if assistance will be needed, such as assisting with undressing, helping on and off the examination bed.
INTIMATE EXAMINATIONS
It is particularly important to maintain a professional boundary when examining patients: intimate examinations can be embarrassing or distressing for patients. Whenever you examine a patient you should be sensitive to what they may perceive as intimate. This is likely to include examinations of breasts, genitalia and rectum, but could also include any examination where it is necessary to touch or even be close to the patient.
Wherever possible, you should offer the patient the security of having an impartial observer (a ‘chaperone’) present during an intimate examination. This applies whether or not you are the same gender as the patient.
The clinician should provide appropriate information and an explanation as to why an examination or procedure is required. They must be respectful, show compassion and give reassurance and must inform the patient that the procedure can be stopped at any time upon request.
Adequate privacy must be provided and all effort must be made to maintain the patient’s dignity.
RECORD KEEPING
You should record any discussion about chaperones and its outcome. If a chaperone is present, you should record that fact and make a note of their identity. If the patient does not want a chaperone, you should record that the offer was made and declined.