Surgical consenting

1. Local Practice in
Surgical Consent
P FLETCHER, V NICHITA, R ANTAKIA, A HARDY
SURGICAL DIRECTORATE
PETERBOROUGH CITY HOSPITAL

2. Introduction
 Consent means agreement/permission
 Informed consent is the process in which a healthcare provider educates a
patient about the risks, benefits & alternatives of a given procedure /
intervention
 Both an ethical and legal obligation of medical practitioners and originates from
the patient’s right to direct what happens to their body
 Informed consent requires that the patient can understand, retain and recall
information provided to make a decision about undergoing a certain procedure

3. General principles
 Two types: Implied/verbal and Expressed/in writing
 Obtained prior to a procedure
 Obtained by a qualified clinician (understands fully what the surgery entails)
 Not under coercion
 No alteration should be made
 In emergency, clinicians may undertake any procedure to save life
 In elective situation, ample time is needed (providing leaflets as available)

4. Methodology
 Retrospective consecutive 4 weeks of both elective and emergency general
surgery procedures
 Prospective consecutive 4 weeks of both elective & emergency cases
 Patient’s survey / questionnaire

5. Results summary
 Cycle one (retrospective)
 A total of 108 consecutive patients were included
 Sixteen patients (14.8%) were consented on the same day as their
surgery
 Cycle two (prospective)
 A total of 105 consecutive patients were included
 Two patients (1.9%) were consented on the same day as their
surgery

6. Recommendations
 To provide more information leaflets with diagrams when available (98% on
patients’ survey questionnaire)
 In elective cases, 92% of patients preferred to be consented ≥ 1 week ahead
of their planned procedures

7. References
 RCS of England guidelines
https://www.rcseng.ac.uk/standards-and-research/standards-and-guidance/good-
practice-guides/consent/
 GMC guidelines
https://www.gmc-uk.org/professional-standards/professional-standards-for-
doctors/decision-making-and-consent
 NICE guidelines
https://www.nice.org.uk/guidance/ipg56/documents/consent-procedures-for-
which-the-benefits-and-risks-are-uncertain2
 BMA recommendation
https://www.bma.org.uk/advice-and-support/ethics/seeking-consent/seeking-
patient-consent-toolkit