Chaperone Policy
Introduction
Vine Medical Group is committed to providing a safe, comfortable environment where patients and staff can be confident that best practice is being followed at all times and the safety of everyone is of paramount importance.
In clinical medicine, a chaperone is a person who serves as a witness for both a patient and a medical practitioner, as a safeguard for both parties during a medical examination or procedure and is a witness to continuing consent of the procedure. Family members or a friend may be present, but they cannot act as a formal chaperone.
There are two main considerations involved in having a chaperone to assist during intimate examinations: namely for the comfort of the patient and the protection of the doctor or nurse from allegations of impropriety.
Intimate examinations or procedures can be embarrassing or distressing for patients. Obvious examples of an intimate examination include examinations of the breasts, genitalia and the rectum, but it may extend to any examination where it is necessary to touch or be close to the patient, for example conducting eye examinations in dimmed lighting, taking the blood pressure or palpating the apex beat (which refers to the sensation felt at the Point of Maximal Impulse, i.e. the area on the chest where the heart’s position is most prominent). Staff must be aware that patients may consider any examination as an intimate examination where it is necessary to touch or be close to the patient.
All patients are entitled to have a chaperone present for any consultation, examination or procedure.
Chaperone Responsibilities
The primary role of the chaperone is to assist the clinician undertaking the procedure in supporting the patient and to act as the patient’s advocate, being sensitive to their needs and respecting and maintaining their privacy and dignity.
Their responsibilities include, but are not limited to:
- Being sensitive to the patient’s needs, respecting and maintaining their privacy and dignity
- Providing emotional comfort and reassurance
- Being alert to signs of patient distress – both verbal and non-verbal
- Being courteous and professional at all times
- Acting as the patient’s advocate when required
- Encouraging patients to ask questions and seek clarification and helping them to understand what is being communicated to them
- Being familiar with the procedures involved in a routine intimate examination
- Staying for the whole examination and being able to see what the healthcare practitioner is doing
- Being prepared to raise concerns if they are concerned about the clinician’s behaviour or actions
- Recording when they have acted as chaperone in clinical records
Who Can Act as a Chaperone
Chaperones are clinical or non-clinical members of staff who have been trained in the competencies required.
Where the Practice determines that non-clinical staff will act in this capacity, the staff member will:
- Have undergone appropriate risk assessments and checks
- Be trained in the procedural aspects of personal examinations
- Be comfortable acting in the role of formal chaperone
- Be confident in the scope and extent of their role
- Understand how to raise concerns
As per GMC guidance, relatives or friends of the patient are not considered to be impartial observers and would not usually be a suitable chaperone. However, staff should comply with a reasonable request to have such a person present in addition to the formal chaperone.
Offer of Chaperone
The availability of chaperones for any examination is shared with patients via the Practice website and through posters displayed in waiting rooms and clinical rooms.
In all cases of intimate examinations, a chaperone should be offered and consent taken. The General Medical Council (2024) definition of an intimate examination is used as a guiding principle: “Examinations of the breast, genitalia and rectum but could also include any examination where it is necessary to touch, examine intimate parts of the patient’s body digitally, or even be close to the patient.” The patient retains the right to decline.
Staff must demonstrate cultural sensitivity and respect each patient’s values regarding privacy, dignity and intimacy. Staff should consider the patient’s preferences in relation to choice of chaperone, including considerations relating to sex, religious beliefs or other personal circumstances.
Staff should also identify where patients may have additional needs, such as learning disabilities, and make reasonable adjustments to ensure they understand the offer and feel supported. This may include using accessible information, involving carers or advocates, or allowing extra time for discussion.
Requesting a Chaperone
Wherever possible, patients are asked to request a formal chaperone at the time of booking the appointment so that arrangements can be made and the appointment is not delayed. Where this is not possible, the Practice will endeavour to provide a chaperone at the time of the request.
If a chaperone is not immediately available, whether due to patient preference or resource limitations, patients must be offered the option to reschedule the appointment within a reasonable timeframe, taking into account the urgency of their clinical needs.
If postponing the examination would pose a risk due to the severity of the condition, this must be explained to the patient and recorded in their clinical notes. The decision to proceed or defer should be made collaboratively between the patient and the clinician.
If a clinician wishes to conduct an examination with a chaperone present but the patient does not agree, the clinician will explain clearly why they want a chaperone to be present. The clinician may consider referring the patient to a colleague who would be willing to examine them without a chaperone, provided the delay would not adversely affect the patient’s health.
Records Management
Clinicians should record the offer and use of chaperones on the patient’s clinical record, including:
- Date and time of examination or procedure
- Examination or procedure undertaken
- Indication for the examination
- Consent to the procedure and presence of a chaperone, including details of the discussion and the name and title of the chaperone offered
- Name and role of the chaperone and any additional persons present
- If no chaperone was present, an explanation of why this was declined
Chaperones should record in the patient’s clinical record:
- Their presence, including their name, date, time and nature of the examination or procedure, and confirmation that no issues were observed
Raising Concerns
In line with the Practice value, “We are not afraid to speak up”, all staff members, including chaperones, should raise any concerns with the Senior Management Team or the internal Freedom to Speak Up Guardian.
The Whistleblowing Policy details how staff members can raise concerns and seek advice both internally and externally.
Chaperones can support patients or their families or carers to raise concerns by signposting them to the Complaints Policy on the Practice website.
Further Resources
