When the medical team are planning to offer you certain treatments, the staff caring for you may need to ask your permission to perform a particular treatment or investigation. This is known as giving your consent.
Consent is part of what we call shared decision making. Our staff will know a lot about the conditions that they treat regularly and the treatments on offer. They will want to get to know you as much as they can and pass on as much information as they can to help in decision making. Only you can decide how much information you need and you will make the final choice about treatment because you will always be the best judge of what is best for you personally.
It’s always up to you whether you consent to any treatment or investigation that is being proposed.
This information explains consent a little more to help you know what to expect. If there is anything you don’t understand, please ask. We will answer your questions or give you more information.
What to expect
Before any health professional examines or treats you, they need your agreement. We will:
- Explain any proposed treatment to you in a way you can understand
- Involve you in all the decisions about your care or treatment. If you do not want to know about certain aspects of your treatment, please talk to us about this.
For most simple medical tasks, you only need to say that you agree for us to go ahead. For more involved procedures, we will ask you to sign a consent form confirming your agreement. This would include:
- treatment that might carry a risk or risks that need fuller discussion
- treatment which is complicated and needs a full explanation ahead of time
- treatment that needs sedation or an anaesthetic and decisions agreeing ahead of time as you may be asleep or unable to decide properly at the time about your care
We will usually do this at the time your treatment plan is started when you visit the outpatient clinic and decide to go on the operating list. You will be given a copy of the consent form.
On the day of your admission to hospital, you will be asked to confirm that you wish to go ahead and your team will not continue unless they are sure about your agreement.
Asking for your consent
When we ask you to agree to any treatment or investigation, you should expect the staff caring for you to explain:
- the possible outcomes if you decide not to have it
- the other available options you might want to consider and their chances of helping
- the type and extent of the treatment being proposed – how it is done and as much as possible previous experience of others to give you a feel for what it might be like
- the chances of success of the preferred option
- the advantages and disadvantages of the treatment
- any risks and side effects that you might want or need to know about
- how consent works and your right to change your mind and withdraw consent at any time.
We might need to take your blood or small sections of tissue as part of your treatment. You should be told in advance if samples are likely to be taken. These samples might also be used for teaching and research, although we will not use them in a way that can identify you unless we have your permission.
We sometimes use images, including x-rays, scans, photographs and videos, for teaching and research. Unless we have your permission, these will not be published or used in a way that can identify you. If you have any concerns about this, please talk to the staff caring for you.
What should you expect from the clinical team around consent?
- You should have as much information you want or need to make your decision.
- You should have enough time to think about the information before committing to a decision.
- At the time of the procedure, your team should confirm with you that you have everything you need and are happy with your decision.
What should I do if I am worried about consent?
At the ROH, the lead for Consent is the Executive Medical Director. If you feel concerned at any stage about consent, please talk in the first instance to the clinician and the team looking after you. If you are still worried please contact the Executive Medical Director 0121 685 4000 extension 55166 or contact PALS on 0121 685 4128.
What if I need more information?
- Ask questions at any time you wish to.
- If you’re not sure about what you are being told, please call us so we can discuss the proposed treatment or investigation with you in more detail. It is not unusual to need to discuss medical treatments more than once.
- It is often a good idea to ask a relative or friend, or your nurse, to be with you when your treatment is being explained. This will help you if you are discussing the treatment later.
- You might find it helpful to write down any questions you want to ask. It is important that we know about your concerns so that we can answer any questions.
- We can arrange for you to speak with someone in the language you need, or in sign language. For more information, please call the Appointments team if you are attending an outpatients appointment. If you require this for your admission, please contact your consultant’s secretary on the number included on your admission letter.
Making your decision or changing your mind
For more involved procedures, where written consent is taken, we will usually plan for you to have time to think things over and to talk to friends, family carers or advisers. Please tell us if you want more time to think about what is being proposed. Although we may have recommended a particular treatment or investigation, the choice of which treatment option to take is yours alone. You will not be criticised or judged for the choices you make; we all have different views and values about how to approach our medical care. Similarly you do not have to agree to everything that is being proposed – you can “qualify” your agreement by saying any options you do not want to happen.
However, we cannot arrange a treatment to you if:
- It is not available
- We feel it is not suitable for your care
What if I change my mind?
You can change your mind at any time, even if you have signed a consent form. Make sure you tell your doctor or the nurse in charge immediately so this can be recorded in your medical notes and everyone is aware of your decision.
You do not have to give a reason for refusing treatment, but it is helpful to tell the staff about your concerns so they can give you the best advice. If you are unsure about agreeing to a particular treatment, you might consider asking for another opinion from a different doctor, nurse or other health professional. If you do, we will do our best to help you.
Who can give consent and advance directives?
If you are an adult patient (18 years old and over), only you can give consent for your treatment. Your relatives or next of kin cannot do this on your behalf.
If you are a young person (16 or 17 years old) you are also able to consent to your own treatment although in this case someone with parental responsibility can also give consent.
People who are not able to make decisions for themselves can still receive the best of care. The team will take advice and plan care in the best interests of the person, unless the decision can wait until the person regains the ability to decide for themselves. In this case the opinions of family or those close to the person may be taken into consideration alongside all other information. The final decision is made by the team and we must always act in your best interests.
There are other, very specific, circumstances when senior medical staff might need to make decisions on behalf of an adult, for example if someone is detained under the Mental Health Act.
There are some additional issues about consent in the case of children under 16 years of age. We will explain these to you if they apply.
More information about consent can be found on the Department of Health and Social Care website: www.gov.uk/government/publications/reference-guide-to-consent-forexamination-or-treatment-second-edition
What if I have made an advance directive?
If you have made an advance directive – sometimes known as a living will – before losing the ability to decide for yourself or to communicate effectively, you or your relatives should make the staff aware of this as soon as possible. Details will then be placed in your medical notes, which will allow us to respect your wishes.
Consent and confidentiality
Any information we hold about you will be treated confidentially. This information will be used to give you the best possible care. It will also be used to help us run and monitor the quality of our services.
We might use some of the information about you for research, but only after we have removed any details which would make it possible to identify you. No information about you will be used in any way that can identify you unless we have asked for your permission.
PALS and complaints
If you require any further information or require support, please contact our PALS team on 0121 685 4128 or email