About the Consent Form – Patient Information Leaflet

Before a doctor or other health professional examines or treats you, they need your consent. Sometimes you can simply tell them whether you agree with their suggestions. However, sometimes a written record of your decision is helpful – for example if your treatment involves sedation or general anaesthesia. You’ll then be asked to sign a consent form. If you later change your mind, you’re entitled to withdraw consent – even after signing.

Health professionals must ensure you know enough to enable you to decide about treatment. They’ll write information on the consent form and offer you a copy to keep as well as discussing the choices of treatment with you. Although they may well recommend a particular option, you don’t have to accept that option. People’s attitudes vary on things like the amount of risk or pain they’re prepared to accept. That goes for the amount of information, too. The person who is treating you will encourage you to listen to all of the information about your treatment but if you’d rather not know about certain aspects, discuss your worries with them.

Always ask anything you want. As a reminder, you can write your questions in the space at the back of the leaflet. The person you ask should do his or her best to answer, but if they don’t know they should find someone else who is able to discuss your concerns. To support you and prompt questions, you might like to bring a friend or relative. Ask if you’d like someone independent to speak up for you.

If there’s any procedure you don’t want to happen, you should tell the people treating you. It’s also important for them to know about any illnesses or allergies which you may have or have suffered from in the past.

Amongst the health professionals treating you may be a “doctor in training” – medically qualified, but now doing more specialist training. They range from recently qualified doctors to doctors almost ready to be consultants. They will only carry out procedures for which they have been appropriately trained. Someone senior will supervise – either in person accompanying a less experienced doctor in training or available to advise someone more experienced.

If your treatment involves general or regional anaesthesia (where more than a small part of your body is being anaesthetised), you’ll be given general information about it in advance. You’ll also have an opportunity to talk with the anaesthetist when he or she assesses your state of health shortly before treatment. Hospitals sometimes have pre-assessment clinics which provide patients with the chance to discuss things a few weeks earlier.

As part of your treatment, blood and urine samples may be taken during a physical health check, in medication management or as part of long term conditions management eg. diabetes monitoring.

As part of your treatment some kind of photographic record may be made – for example X-rays, clinical photographs or sometimes a video. You will always be told if this is going to happen.

The photograph or recording will be kept with your notes and will be held in confidence as part of your medical record. This means that it will normally be seen only by those involved in providing you with care or those who need to check the quality of care you have received. The use of photographs and recordings is also extremely important for other NHS work, such as teaching or medical research. However, we will not use yours in a way that might allow you to be identified or recognised without your express permission.

Sometimes things don’t go as they should. Although the doctor involved should inform you and your family, often you are the first to notice something amiss. If you’re worried tell a health professional right away. Speak to your GP, or contact your clinic - the phone number should be on your appointment card, letter or consent form copy.

It’s your decision! It’s up to you to choose whether or not to consent to what’s being proposed. Ask as many questions as you like, and remember to tell the team about anything that concerns you or about any medication, allergies or past history which might affect your general health.

We have a Policy on Patient Consent to Examination or Treatment, which will be made available on request.

As well as giving you information health professionals must listen and do their best to answer your questions. Before your next appointment, you can write some down.

You may want to ask questions about the treatment itself, for example:
• What are the main treatment options?
• What are the benefits of each of the options?
• What are the risks, if any, of each option?
• What are the risks if I decide to do nothing for the time being?
• How can I expect to feel after the procedure?
• When am I likely to be able to get back to work?

You may also want to ask questions about how the treatment might affect your future state of health or style of life, for example:
• Will I need long-term care?
• Will my mobility be affected?
• Will I still be able to drive?
• Will it affect the kind of work I do?
• Will it affect my personal/sexual relationships?
• Will I be able to take part in my favourite sport/exercises?
• Will I be able to follow my usual diet?

Health care professionals should welcome your views and discuss any issues so they can work in partnership with you for the best outcome.

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If you want to make a comment, suggestion, compliment or complaint you can:
• talk to the people directly involved in your care
• ask a member of staff for a feedback form, or complete a form on the Trust website www.cntw.nhs.uk (click on the ‘Contact Us’ tab)
• telephone the Complaints Department 0191 245 6672
• email complaints@cntw.nhs.uk Please note that information sent to the Trust via email is sent at your own risk
• We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention.
You can provide feedback in the following ways:
- the quickest way for you to do this is to complete our short online survey at www.cntw.nhs.uk/poy
- complete a Points of You survey, available from staff.

• DoH (July 2009); Reference Guide to Consent for Examination or Treatment, 2nd Ed.
• CNTW(C)05 - Consent to Examination or Treatment Policy Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think
about this leaflet please get in touch.

This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre
Tel: 0191 246 7288

Published by the Patient Information Centre
2020 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
Ref, PIC/349/0218 February 2018 V4 (CNTW(C)05)
www.cntw.nhs.uk Tel: 0191 246 7288
Review date 2021