Changes in surgical consent practices for common otolaryngology procedures: impact of Modernising Medical Careers

2010 ◽  
Vol 124 (8) ◽  
pp. 899-904 ◽  
Author(s):  
P Puwanarajah ◽  
S E McDonald
Keyword(s):  
National Health Service ◽  
Telephone Survey ◽  
Elective Surgery ◽  
General Medical Council ◽  
Medical Council ◽  
Consent Forms ◽  
Department Of Health ◽  
Medical Careers ◽  
Patient Consent ◽  
Selection Of

AbstractObjectives:To assess elective surgery consent practices amongst senior house officers from a selection of UK ENT departments, and to compare results with similar surveys in 2002 and 2005.Methods:A telephone survey of senior house officers in 40 UK ENT departments was conducted to assess departmental consent policies and knowledge of complications of common ENT operations.Results:A total of 77.5 per cent of responding senior house officers were responsible for consenting, reduced from 92.5 per cent in 2002 (p = 0.06). There had been a significant improvement in the use of patient information sheets, from 25 per cent of departments in 2002 to 65 per cent in 2008 (p = 0.0002). There had been no improvement in training or in the use of standard National Health Service consent forms, and the senior house officers' knowledge of specific complications remained poor. Of the senior house officers surveyed, 37.5 per cent were foundation trainees.Conclusions:There has been some improvement in information delivery to patients during the consent process, in accordance with General Medical Council, Department of Health and Modernising Medical Careers guidelines. However, most senior house officers are still required to obtain patient consent without appropriate training.

Changing practices in the consent process for nose and throat procedures: a three-year study

2008 ◽  
Vol 122 (10) ◽  
pp. 1105-1108 ◽  
Author(s):  
S E McDonald ◽  
N K Chadha ◽  
R S Mills
Keyword(s):  
Informed Consent ◽  
Elective Surgery ◽  
General Medical Council ◽  
Medical Council ◽  
Information Leaflets ◽  
Department Of Health ◽  
Similar Survey ◽  
Health Model ◽  
Changing Practices ◽  
Small Change

AbstractObjectives:To assess elective surgery consent practices amongst senior house officers from a selection of UK ENT departments, and to compare results with those obtained in a similar survey in 2002.Methods:A telephone survey of senior house officers in 40 UK ENT departments was carried out to assess departmental consent policies and knowledge of complications of common ENT operations.Results:Over 80 per cent of the senior house officers surveyed remained responsible for obtaining consent for routine surgery. Since 2002, there had been a significant increase in the proportion of departments which: used the Department of Health model consent form; provided patient information leaflets; and had an established informed consent protocol. Senior house officers' knowledge of specific complications remained poor.Conclusion:There has been a small change in the practice of obtaining informed consent, in accordance with General Medical Council guidelines. Many senior house officers continue to perform this duty, however, and the majority are poorly trained.

scholarly journals Modernising medical careers, the Foundation Programme and psychiatry

2005 ◽  
Vol 29 (6) ◽  
pp. 204-206 ◽  
Author(s):  
Nick Brown ◽  
Dinesh Bhugra
Keyword(s):  
Postgraduate Education ◽  
General Medical Council ◽  
Health Department ◽  
Training Programme ◽  
Medical Council ◽  
Unfinished Business ◽  
Implementation Team ◽  
Department Of Health ◽  
Medical Careers ◽  
Foundation Programme

The stated aim of the new Foundation Programme is to equip all doctors with a range of generic competencies before they embark on a specialist training programme, following the advice in Modernising Medical Careers (Department of Health, 2003, 2004), which built upon Unfinished Business, Proposals for the Reform of the Senior House Officer Grade (Department of Health, 2002). The educational aims of this 2-year programme are to develop generic skills, competencies and attitudes to ensure professional conduct that will reflect ‘good medical practice’ as defined by the General Medical Council (1998). Any education for the Foundation Programme must concentrate on these areas. A Curriculum for the Foundation Years in Postgraduate Education and Training is being produced by the Academy of Medical Royal Colleges in co-operation with the Modernising Medical Careers Implementation Team at the Department of Health (Department of Health, 2005).

Confidentiality and Release of Medical Information

2018 ◽  
pp. 25-37
Author(s):  
Rebekah Ley ◽  
Natalie Hayes
Keyword(s):  
Medical Information ◽  
Common Law ◽  
General Medical Council ◽  
Tort Law ◽  
European Convention ◽  
Regulatory Body ◽  
Medical Council ◽  
Patient Consent ◽  
Practice Of Medicine ◽  
Professional Guidance

The duty of confidentiality that a doctor owes to a patient is probably as old as the practice of medicine and is essential for trust between doctors and their patients. However, it is not an absolute duty and there are instances when a doctor is entitled, and in certain circumstances obliged, to disclose confidential information without patient consent to do so. This chapter is concerned with doctor–patient confidentiality and when medical information can reasonably be released. Confidentiality is covered by a mixture of UK statute, common law, tort law, and the European Convention on Human Rights. It is also a core component of the professional guidance given to doctors by the profession’s regulatory body, the General Medical Council, to which all doctors registered with it are expected to adhere.

scholarly journals An audit cycle of consent form completion: A useful tool to improve junior doctor training

2016 ◽  
Vol 49 (01) ◽  
pp. 72-75 ◽  
Author(s):  
Catherine Leng ◽  
Kavita Sharma
Keyword(s):  
Junior Doctor ◽  
General Medical Council ◽  
Consent Form ◽  
Junior Doctors ◽  
Medical Council ◽  
Emergency Setting ◽  
Consent Forms ◽  
Surgical Practice ◽  
Audit Cycle ◽  
Practice Methods

ABSTRACT Background: Consent for surgical procedures is an essential part of the patient's pathway. Junior doctors are often expected to do this, especially in the emergency setting. As a result, the aim of our audit was to assess our practice in consenting and institute changes within our department to maintain best medical practice. Methods: An audit of consent form completion was conducted in March 2013. Standards were taken from Good Surgical Practice (2008) and General Medical Council guidelines. Inclusion of consent teaching at a formal consultant delivered orientation programme was then instituted. A re-audit was completed to reassess compliance. Results: Thirty-seven consent forms were analysed. The re-audit demonstrated an improvement in documentation of benefits (91–100%) and additional procedures (0–7.5%). Additional areas for improvement such as offering a copy of the consent form to the patient and confirmation of consent if a delay occurred between consenting and the procedure were identified. Conclusion: The re-audit demonstrated an improvement in the consent process. It also identified new areas of emphasis that were addressed in formal teaching sessions. The audit cycle can be a useful tool in monitoring, assessing and improving clinical practice to ensure the provision of best patient care.

Updated GMC guidance on decision-making and consent: implications for urologists

2020 ◽  
pp. 205141582094553
Author(s):  
Siobhan Duffy ◽  
Catriona Barlow ◽  
Mark Underwood ◽  
Elizabeth Day
Keyword(s):  
Decision Making ◽  
General Medical Council ◽  
Medical Council ◽  
Level Of Evidence ◽  
Consent Forms ◽  
One Stop

We summarise the updated General Medical Council guidance on consent and decision-making. We explore the emphasis on enabling supported decision-making and the implications this has in day to day urological practice. In particular, we address some of the issues encountered in one-stop clinics, on pooled elective lists and with pre-written consent forms. The new guidance will emphasise the importance of sharing information relevant to your patient in light of the Montgomery ruling. Every decision is unique. We must appreciate the importance of the process of decision-making and understand our role as the clinician. Here we suggest some practical considerations to address the updated General Medical Council guidance. Level of evidence: Not applicable.

scholarly journals 108 Neck of Femur Fractures: Streamlined Approach to Improve Consenting Practices

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
O Brown ◽  
A Gaukroger ◽  
M Raza ◽  
R Sturley ◽  
M Arnander
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
General Medical Council ◽  
Mean Value ◽  
Medical Council ◽  
The Novel ◽  
Neck Of Femur ◽  
Consent Forms ◽  
Femur Fractures ◽  
Operative Fixation

Abstract Aim Neck of femur fractures (NOFs) are synonymous with frailty, and successful outcomes are achieved with operative fixation. The United Kingdom’s General Medical Council guidance governing consent highlights the importance of thorough pre-operative discussion of risk with the patient. We aimed to audit consenting practices in NOF patients within our unit against the British Orthopaedic Association’s (BOA) criteria, with the addition of delirium as a risk factor. Method In cycle one all operatively managed NOFs over a two-month period in October-November 2019 were retrospectively reviewed. Consent forms 1 (CF1) and 4 (CF4) were assessed against BOA-endorsed criteria. Our intervention included a standardised sticker detailing 14 important risks was introduced and a departmental seminar on delirium. A second cycle was undertaken from August-October 2020 to close the audit loop Results No consent form documented all BOA-approved risk factors in cycle one (N = 35). Of cycle two’s 35 patients, 70.8% CF1 were completed using the novel sticker. All of these had 100% BOA-approved risk documentation. Consent forms without the sticker in cycle two documented 9/14 risks (mean value). No CF4 had any risks documented in either cycle. Delirium was documented in 51% in total and in 75% patients with CF1. Delirium documentation improved from 2.9% in cycle one to 51.4% in cycle two. Conclusions Clear lapses in operative consenting processes were identified, especially regarding delirium and CF4 documentation. The introduction of a novel consent sticker drastically improved compliance with BOA guidance for CF1. Recognition and departmental education regarding delirium significantly reduced incidence between cycles.

scholarly journals An audit of consent for allograft use in elective orthopaedic surgery

2016 ◽  
Vol 98 (04) ◽  
pp. 254-257 ◽  
Author(s):  
CJ Mullan ◽  
R Pagoti ◽  
H Davison ◽  
MG McAlinden
Keyword(s):  
Informed Consent ◽  
Disease Transmission ◽  
Orthopaedic Surgery ◽  
High Volume ◽  
General Medical Council ◽  
Adverse Outcomes ◽  
Audit And Feedback ◽  
Medical Council ◽  
Patient Consent ◽  
Arthroplasty Surgery

Introduction Patients receiving musculoskeletal allografts may be at risk of postoperative infection. The General Medical Council guidelines on consent highlight the importance of providing patients with the information they want or need on any proposed investigation or treatment, including any potential adverse outcomes. With the increased cost of defending medicolegal claims, it is paramount that adequate, clear informed patient consent be documented. Methods We retrospectively examined the patterns of informed consent for allograft bone use during elective orthopaedic procedures in a large unit with an onsite bone bank. The initial audit included patients operated over the course of 1 year. Following a feedback session, a re-audit was performed to identify improvements in practice. Results The case mix of both studies was very similar. Revision hip arthroplasty surgery constituted the major subgroup requiring allograft (48%), followed by foot and ankle surgery (16.3%) and revision knee arthroplasty surgery (11.4%) .On the initial audit, 17/45 cases (38%) had either adequate preoperative documentation of the outpatient discussion or an appropriately completed consent form on the planned use of allograft. On the re-audit, 44/78 cases (56%) had adequate pre-operative documentation. There was little correlation between how frequently a surgeon used allograft and the adequacy of consent (Correlation coefficient -0.12). Conclusions Although the risk of disease transmission with allograft may be variable, informed consent for allograft should be a routine part of preoperative discussions in elective orthopaedic surgery. Regular audit and feedback sessions may further improve consent documentation, alongside the targeting of high volume/low compliance surgeons.

Informed consent in orthopaedics

2018 ◽  
Vol 100-B (9) ◽  
pp. 1253-1259 ◽  
Author(s):  
S. Seewoonarain ◽  
A. A. Johnson ◽  
M. Barrett
Keyword(s):  
United Kingdom ◽  
Informed Consent ◽  
Reading Ability ◽  
General Medical Council ◽  
Medical Council ◽  
Written Information ◽  
The United Kingdom ◽  
Patient Consent ◽  
Improve Compliance ◽  
The Mean

Aims Informed patient consent is a legal prerequisite endorsed by multiple regulatory institutions including the Royal College of Surgeons and the General Medical Council. It is also recommended that the provision of written information is available and may take the form of a Patient Information Leaflet (PIL) with multiple PILs available from leading orthopaedic institutions. PILs may empower the patient, improve compliance, and improve the patient experience. The national reading age in the United Kingdom is less than 12 years and therefore PILs should be written at a readability level not exceeding 12 years old. We aim to assess the readability of PILs currently provided by United Kingdom orthopaedic institutions. Patients and Methods The readability of PILs on 58 common conditions provided by seven leading orthopaedic associations in January 2017, including the British Orthopaedic Association, British Hip Society, and the British Association of Spinal Surgeons, was assessed. All text in each PIL was analyzed using readability scores including the Flesch–Kincaid Grade Level (FKGL) and the Simple Measure of Gobbledygook (SMOG) test. Results The mean FKGL was 10.4 (6.7 to 17.0), indicating a mean reading age of 15 years. The mean SMOG score was 12.8 (9.7 to 17.9) indicating a mean reading age of 17 years. Conclusion Orthopaedic-related PILs do not comply with the recommended reading age, with some requiring graduate-level reading ability. Patients do not have access to appropriate orthopaedic-related PILs. Current publicly available PILs require further review to promote patient education and informed consent. Cite this article: Bone Joint J 2018;100-B:1253–9.

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