A concern has been raised about an examination

A patient has said they did not know what would happen, were not offered a chaperone, or felt exposed. These are among the most common complaints in hands-on practice.

You are under fitness to practice investigation

A case is open with the GMC, GDC, NMC, GPhC, HCPC, GOC, GCC, GOsC or Social Work England, and you need documented CPD and written reflection to put behind your response.

The record does not show what happened

The consent conversation took place but was not written down, or the chaperone offer was not recorded. What follows is an argument about memory rather than evidence.

You want to get ahead of it

You carry out intimate examinations, work with children or vulnerable adults, or run a service where chaperone practice is inconsistent, and you want it right before anyone asks.

“Nobody explained what would happen”

The most common consent complaint: the examination itself was appropriate, but the patient did not know in advance what it would involve.

No chaperone offered

An intimate examination carried out without the offer being made, or the offer made so briefly that the patient did not register it.

The record is silent

No entry showing what was explained, what was agreed, or that a chaperone was offered — leaving your account against the patient’s with nothing to corroborate either.

Dignity and exposure

Undressing without explanation, no gown offered, curtains or doors, and who else was present or could hear.

Capacity and vulnerable patients

Children, adults who may lack capacity, and situations where a parent, carer or valid authority should have been involved in the decision.

Confidentiality and privacy of information

Conversations overheard, records left visible, and information shared with family without the patient’s agreement.

Introduction to privacy, consent and chaperones

Patient dignity and privacy and why they matter, the fundamentals of informed consent, and the role a chaperone actually plays.

Standards and expectations

The ethical standards behind consent and privacy, the regulatory guidance on chaperone use, and the imperative of maintaining patient dignity.

Maintaining privacy and dignity in practice

Techniques for respecting physical privacy, how privacy differs across healthcare settings, and balancing transparency with a patient's right to privacy.

Informed consent and patient autonomy

The principles of informed consent, and how to document a consent conversation so that it holds up later.

Effective use of chaperones

When to offer a chaperone, the role they play in supporting the patient, and the documentation and communication that should accompany their presence.

Worked scenarios

Three lessons of practical examples — privacy and dignity situations, consent challenges and how they were resolved, and chaperone use in practice.

Reflective practice

Reflecting on your own practice in privacy, consent and chaperone use, building a plan for improvement, and adapting as guidance changes.

Conclusion and assessment

A summary of the core concepts, followed by a post-course assessment. Your certificate is issued on completion.

Voluntary

Given freely, without pressure or undue influence from you, from colleagues, or from family. A patient who agrees because they feel they cannot say no has not consented.

Informed

They have the information they reasonably need — what is proposed, the risks and benefits, the alternatives including doing nothing — in a form they can actually use, with reasonable steps taken to check they understood.

Capacity

They can understand, remember and weigh the information for this particular decision. Capacity is decision-specific and can change, so it is assessed at the time rather than assumed.

And it is continuous

Consent given at the start of a plan of care does not cover everything that follows. If the examination goes further, the plan changes, or someone else will provide the care, it needs revisiting and recording again.

Offer before, not during

Wherever the assessment or care might reasonably be considered intimate, where the patient is a child or a vulnerable adult, and whenever the patient requests one — raised before the examination begins.

Explain undressing, and offer a gown

Where there is a clinical need for clothing to be removed, explain the reason, obtain consent, respect the patient’s privacy to undress, and offer a gown. If clothing has to be adjusted mid-examination, ask again.

An impartial observer, not a companion

A chaperone supports the patient, observes the interaction and helps maintain boundaries — ideally a trained member of the healthcare team. A relative accompanying the patient is not the same thing.

Record the offer either way

That you offered, and whether one was used or declined. A declined offer that was never written down is indistinguishable, later, from an offer never made.

Valid consent

Permission given by a patient, or someone with valid authority to decide for them, that is voluntarily given, informed as far as can reasonably be expected, and made by someone with the capacity to make that decision. All three limbs are required; being informed alone is not sufficient.

Capacity

The ability of a patient to understand, remember and consider the information provided to them so as to make a particular decision. Capacity is decision-specific and can change over time.

Chaperone

A person present during a professional encounter who acts as an impartial observer, supports the patient, and helps maintain professional boundaries. Their presence also protects the professional against misunderstanding or false allegation.

Intimate examination

Examination of breasts, genitalia or rectum is always intimate, and the term also covers any procedure requiring you to touch or examine intimate parts of the body, or to be physically very close to the patient. Some patients have concerns about undressing but feel unable to say so.

Patient dignity

Recognising and treating the patient as a person rather than a case: respecting privacy while undressing and being examined, their right to choose who is present, and their comfort throughout.

Remediation

The concrete steps taken so the same thing does not happen again — training, changes to how you consent, chaperone or record — together with evidence that they happened and have been sustained.

Boundaries in both directions, and the power imbalance that makes consent a professional responsibility rather than a patient's.

When disclosure is lawful, how breaches usually happen, and how to remediate one.

Records, corrections and contemporaneous entries — what makes a consent conversation provable.

The element assessed in almost every case, whatever the allegation, and the one most often described as lacking.

How to write reflection that reads as understanding rather than regret, in your own words.

Turning insight into concrete, evidenced change that a panel can see actually happened.

What fitness to practice means, how the process works, and what is being assessed at each stage.

Restoring confidence after a concern — with patients, with colleagues and with the regulator.