Chaperones - FAQs

Correct as of February 2010

Can receptionists be chaperones? What training is required? Where should a chaperone stand? There is a certain ambiguity surrounding chaperones and what exactly their purpose is. Below are common questions that MPS has received about chaperones.

1. What if a chaperone is not available?

There may be occasions when a chaperone is unavailable (for example, on a home visit or in the out-of-hours setting). In such circumstances, the doctor should first consider whether or not on a clinical basis the examination is urgent.

If the examination is not urgent, then it might be possible to simply rearrange the appointment for a time when a chaperone will be available.

If the examination is clinically indicated on an urgent basis, but the doctor has enough information from the history to indicate that the patient would require an admission to hospital in any event, then it may be appropriate to admit them.

If the examination is urgent, but hospital admission is not indicated on the history alone, there may be occasions when a doctor goes ahead in the absence of a chaperone. In such circumstances, the patient’s consent should be obtained and recorded. In addition, the fact that the patient was examined in the absence of a chaperone should be recorded, together with the rationale for the same.

2. Should chaperones be trained?

Chaperones need to be trained so that they understand what a legitimate clinical examination entails

Practices should no longer use untrained practice staff to fulfil the role of a chaperone. Chaperones need to be trained so that they understand what a legitimate clinical examination entails and at what stage it becomes inappropriate. Your PCT may be able to help in terms of identifying locally available training courses for chaperones.

Although a chaperone does not have to be medically qualified they must be:

• Sensitive to the patient’s confidentiality.
• Prepared to reassure the patient.
• Familiar with the procedures involved in an intimate examination.
• Prepared to raise concerns about a doctor if misconduct occurs.

3. What if a patient declines a chaperone?

Even if a patient declines the offer of a chaperone, the doctor/nurse may feel that it would be wise to have a chaperone present for their own protection

Even if a patient declines the offer of a chaperone, the doctor/nurse may feel that in certain circumstances (for example, an intimate examination on a young adult of the opposite gender), it would be wise to have a chaperone present for their own protection.

The doctor should explain that they would prefer to have a chaperone, explain that the role of the chaperone is in part to assist with the procedure and provide reassurance. It is important to explore the reasons why the patient does not wish to have a chaperone and to address any concerns they may have.

If the patient still declines, the doctor will need to decide whether or not they are happy to proceed in the absence of a chaperone. This will be a decision based on both clinical need and the requirement for protection against any potential allegations of improper conduct.

Another option to consider is whether or not it would be appropriate to ask a colleague to undertake the examination (although the chaperone issue may still prevail).

The doctor should always document that a chaperone was offered and declined, together with the rationale for proceeding in the absence of a chaperone. If a chaperone is present then it is important to record their identity.

4. Do same-gender examinations require a chaperone?

In the context of allegations of improper conduct, the most common scenario is that a female patient makes allegations against a male doctor. In MPS’s experience, it is unusual for doctors to be the subject of allegations of improper conduct from patients of the same gender.

However, there have been such cases, and MPS advises that a chaperone be offered for any intimate examination regardless of the patient’s gender. The GMC guidance Maintaining Boundaries reinforces this advice, by stating that a chaperone should be offered “whether or not you are the same gender as the patient” (paragraph 10).

Further information:

• MPS factsheet - Chaperones.