Consent is the voluntary agreement given by a person to allow something to happen to them, and/or to be done to them, and/or to allow their participation in something. It is a fundamental right that every adult with capacity has the absolute right to determine what happens to their own body. This right is protected in law and is reflected in the Health and Care Professions Council (HCPC) standards and the CSP Code of Conduct. We are regulated by HCPC and members of Chartered Society of Physiotherapy.
The patient’s consent is essential for any assessment and/or intervention that involves touching the patient, asking them to remove items of clothing, or using any instrument or modality that involves breaking the skin (in physiotherapy for example, acupuncture or injection therapy).
This means that the consent that has been given is right and proper and meets three tests:
The patient must have the capacity to give their consent,
The consent must be given voluntarily,
The patient must have been given all the information they ask for in order to make their decision.
Consent should be obtained prior to assessment and/or treatment where the patient has capacity to do so. Provision in law is made to allow emergency treatment without consent due to necessity to save life. It is important to recognize that where ongoing treatment is required, the ‘informed consent’ of the patient is an ongoing event and not a one-off occurrence, and the presence of on-going consent to treatment should be reaffirmed. Consent should be reaffirmed if there are significant changes to the treatment plan, or the patient’s condition or the patient reports new information to you.
Consent may be valid in law if it is either explicit (written or oral) or implied (a behaviour of the patient that implies they agree to something happening to them e.g. rolling up a sleeve for a blood pressure check). Our good practice is to gain the explicit consent of the patient in all cases where possible and this might be in one of two forms: oral or written.
Oral consent (often also called verbal consent) is where you give your consent by speaking to our physiotherapist to tell her your decision. In most cases, oral consent will be acceptable provided an adequate record of the oral consent is documented.
Written consent is only required by law for treatment under sections of the Mental Health Act, Human Fertilisation and Embryology Act and Human Tissue Act. However, we will ask you for written consent in the following cases:
Where treatment is complex or involves significant risk
For treatment involving general or regional anaesthesia
Where clinical care is not the prime aim of the intervention
Where treatment could result in significant adverse consequences to patient's employment, social or personal life even when performed properly.
In the context of physiotherapy, our good practice is to obtain written consent for any intervention that is invasive. This might include, but is not limited to:
injection therapy in neurological and/or MSK practice
acupuncture
dry-needling
performing nerve conduction studies
per rectum or per vaginam examination (i.e. in pelvic floor physiotherapy)
We might use digital forms (i.e. ask you to fill a web form) to gain your explicit written consent in order to reduce paper usage. In such case you will receive digitally signed confirmation of the consent.