An increasing number of outpatients are undergoing GI endoscopy. The pressure of this extra work has led to Endoscopy Units becoming increasingly vulnerable to inadequacies in their process of obtaining valid consent from every patient.
Obtaining valid consent is a process that underpins an important quality standard of our engagement with patients. It is a standard that is regularly assessed by the NHS Litigation Authority (NHSLA) as part of their regular quality standards assessments of hospital Trusts.
In 2001 the Department of Health (DoH) issued guidance on the process of obtaining consent and, as a result, model consent forms 1-4 were introduced. However, these changes produced practical problems for clinical services (including endoscopy) where high volumes of outpatients undergo low risk procedures.
In response to these problems and as an initiative to improve standards, the Endoscopy Committee of the BSG set up a Working Party to look at the possibility of obtaining remote or postal consent. Dr Hugh Shepherd at Winchester has piloted this process using procedure-specific booklets over a number of years. The postal consent booklets and their unique, procedure-specific accompanying consent forms were designed both to improve the consenting process and also to conform to DoH guidelines, retaining the “look and feel” of the model consent forms.
The booklets cover most common outpatient endoscopic procedures and are designed to be sent to patients well in advance of their appointment.
These booklets were finally approved by the Endoscopy Committee in June 2006. DoH model consent forms 1-4 should be used for all inpatients and for procedures not covered by the range of booklets.
The use of a remote consenting process should reduce the need for taking consent solely by the endoscopist. It should also discourage the signing of the consent form in the procedure room, a practice that does not conform with NHSLA guidance and is considered of such importance that is a standard that is soon to be incorporated into the GRS scoring assessment.
On the web site you will find the paired files of the various booklets and specific consent forms which can be downloaded for you to customise to a limited extent. A ‘frequently asked questions’ (FAQ) section has also been compiled to deal with the most common enquiries.
The working group and BSG Endoscopy Committee hope that you find this initiative of practical value in your unit. The booklets are currently only available in English, but if well received will be translated.