1. Purpose
Sexual health care involves intimate examinations. Done well, with consent, dignity and the offer of a chaperone, they are safe and respectful and protect both the patient and the clinician. This policy sets out how the Service carries out intimate examinations and offers chaperones.
The Service must verify this policy against current GMC guidance on intimate examinations and chaperones before adoption.
2. Sources to verify before adoption
- GMC, guidance on intimate examinations and chaperones: https://www.gmc-uk.org/
- Royal College of Nursing, chaperoning guidance: https://www.rcn.org.uk/
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 10 (dignity and respect) and Regulation 12 (safe care and treatment): https://www.legislation.gov.uk/uksi/2014/2936/regulation/10
3. Scope
This policy applies to:
- every intimate examination the Service carries out
- the offer and use of chaperones
- the clinicians who examine and the staff who act as chaperones
4. Explaining and consenting before the examination
Before any intimate examination the clinician:
- explains why the examination is needed, what it involves and what the patient will feel
- gains the patient's consent and records it
- stops if the patient asks to stop, at any point
The examination is limited to what is clinically necessary.
5. Offering a chaperone
- a chaperone is offered for every intimate examination, regardless of the genders of the patient and clinician
- the offer, and whether the patient accepts or declines, is recorded, along with the name of the chaperone where one is present
- a chaperone is an impartial person, trained for the role, whose job is to support and reassure the patient and to observe the examination; a family member or friend is not a substitute for a trained chaperone, though the patient may also wish them present
- where the patient declines a chaperone but the clinician feels one is needed, the clinician explains why and may decline to proceed without one, offering to rearrange
6. Dignity and privacy
- the patient undresses and dresses in private, and is kept covered as much as possible, exposing only the area being examined
- the examination takes place in a private space free from interruption
- the patient's cultural, religious and personal preferences are respected, including a request for a clinician or chaperone of a particular gender where that can be met
7. Protecting patient and clinician
The offer of a chaperone, the explanation and consent, and a respectful technique protect the patient from harm and the clinician from misunderstanding. Where a concern about conduct arises, on either side, it is recorded and raised through the Service's safeguarding and incident routes.
8. Recording
For every intimate examination the Service records: the consent, the chaperone offer and the patient's choice, the chaperone's name where present, and the examination findings. The record shows the patient's dignity and choice were respected.
9. Training
Clinicians are trained in carrying out intimate examinations respectfully, and chaperones are trained for the role, both refreshed on a stated cadence. The Service records who is trained and the next refresher date.
10. Audit cadence
The Service checks, on a stated cadence, that:
- intimate examinations were explained and consented, and the consent recorded
- a chaperone was offered every time, with the offer, the patient's choice and the chaperone's name recorded
- dignity and privacy, and patients' gender and cultural preferences, were respected
- chaperones are trained and conduct concerns were raised and acted on
The Registered Manager and the clinical lead review the results and record the improvement actions that follow.