Where a chaperone is not routinely provided patients must be aware that they are able to ask for one without feeling difficult.
What is a Chaperone?
A chaperone is an adult who is present during an intimate examination of a patient. A chaperone is there to protect both the patient and the doctor or midwife from allegations of inappropriate behaviour.
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. 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 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. Training is ongoing with attendance of update courses.
In some cultures, examinations by men (on women) may be unacceptable. Some patients may be unwilling to undress, or raise concerns related to culture. These concerns should be respected and recorded, and in a similar way, if there is a language difficulty, it may be best to defer an examination until an interpreter is available.
Where mental health patients are concerned, or those who may have difficulty in understanding the implications of an examination, it may be inappropriate to proceed until more secure arrangements can be made. Where a GP wishes to examine a patient in their own home where another family member may not be present, it may be more important that a chaperone is present, and you need to be aware of your responsibilities in these circumstances.