1 Introduction

This policy sets out guidance for the use of chaperones that should be in place for consultations, examinations and investigations. City Osteopathy & Physiotherapy 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.

Chaperoning should not be undertaken by any other than chaperone-trained staff: the use of untrained administrative staff is not acceptable, however the patient must have the right to decline any chaperone offered if they so wish.

2 Scope

2.1 Who it applies to

This policy applies to all healthcare professionals working within City Osteopathy & Physiotherapy. It also covers any non-medical personnel who may be involved in providing care. 

In this guidance all staff groups covered will be referred to as the “healthcare professional”. The use of the feminine gender equally implies the male and similarly the use of the male gender equally implies the female.

The policy applies and must be acted upon, but not limited to the following circumstances:

• A patient under the age of 18
• A female patient booked in with a male healthcare professional who may be giving cause for concern.
• A female patient who is booked in for treatment that may require the removal of garments in order to be correctly treated.
• A vulnerable patient or one who may have learning difficulties or mental health issues.
• Any patient either front of house or a healthcare professional deems a potential risk

2.2 Why and how it applies to them

All clinical staff may at some point be asked to act as a chaperone at City Osteopathy & Physiotherapy. Therefore, it is essential that clinical personnel are fully aware of their individual responsibilities when performing chaperone duties.

3 Definition of ‘Chaperone’

A chaperone can be defined as ‘an independent person, appropriately trained, whose role is to independently observe the examination/procedure undertaken by the health professional to assist the appropriate provider-patient relationship’.

4 Policy

4.1 General Guidance

It may be appropriate to offer a chaperone for a number of reasons. All healthcare professionals should consider using a chaperone for some or all of the consultation and not solely for the purpose of intimate examinations or procedures. This applies whether the healthcare professional is of the same gender as the patient or not.

Before conducting any intimate examination, the healthcare professional should:

• Explain to the patient why an examination is necessary and give the patient an opportunity to ask questions
• Explain what the examination will involve, in a way the patient can understand, so that the patient has a clear idea of what to expect, including any pain or discomfort
• Get the patient’s consent before the examination and record that the patient has given it
• Offer the patient a chaperone
• Give the patient privacy to undress and dress, and keep them covered as much as possible to maintain their dignity; do not help the patient to remove clothing unless they have asked you to do so, or you have checked with them that they want you to help

4.2 Role of the Chaperone 

There is no common definition of a chaperone and their role varies considerably depending on the needs of the patient, the healthcare professional and the examination of procedure being carried out. 

Broadly speaking, their role can be considered in any of the following areas:

• Providing emotional comfort and reassurance to patients
• To assist with the undressing of patients
• To act as an interpreter
• To provide protection to healthcare professionals against unfounded allegations of improper behaviour
• An experienced chaperone will identify unusual or unacceptable behaviour on the part of the healthcare professional. 

A chaperone is present as a safeguard for all parties (patients and practitioners) and is a witness to continuing consent of the procedure; however a chaperone cannot be a guarantee of protection for either the examiner or examinee.

4.3 Competencies and training

Chaperones should undergo training which enables them to understand:

• What is meant by the term ‘chaperone’
• A knowledge of the range of examinations or procedures they may be expected to witness
• Why they need to be present, including positioning
• Their role and responsibilities as a chaperone
• How to raise concerns in conjunction with practice policy
• The rights of the patient
• The requirement to annotate their presence on the individual’s healthcare record post consultation

Training will be undertaken by all staff who may be required to act as a chaperone at City Osteopathy & Physiotherapy.

4.4 Communication and Record Keeping

All patients should be routinely offered a chaperone during any intimate examination. This does not mean that every consultation needs to be interrupted in order to ask if the patient wants a third party present.

If the patient is offered and does not want a chaperone, it is important to record that the offer was made and declined. Patients may decline the offer of a chaperone for a number of reasons (including but not limited to): 

• because they trust the healthcare professional
• think it is unnecessary or 
• prefer privacy.