Calls for medical consent checklist after series of ‘devastating’ failings

● Patient left traumatised after surgeons kept operating

Scotland’s public services watchdog is calling for a medical consent checklist to be used by health professionals after a number of “devastating” patient failures during operations were highlighted in a report.

Evidence from the Informed Consent – Learning From Mistakes study carried out by the Scottish Public Services Ombudsman (SPSO) included a complaint that a female patient was left “traumatised” after a colonscopy operation was carried out by surgeons despite numerous requests by the woman and nurses present to stop the procedure. In this case, the patient was also asked to sign a consent form on the way into the operating theatre.

Other complaints included a patient known only as Miss C who had a cyst on her ovaries and ended up agreeing on the day of surgery to a more complex procedure that involved the removal of both her ovaries. Miss C later complained that her consent had not been properly obtained for the procedure.

Key findings from the report included a lack of time for

0 There are calls for better consent arrangements after what a watchdog’s report called a series of ‘devastating’ failures consent conversations to take place and concerns that patients did not fully understand the treatment they were consenting to and the implications of giving their consent. There was also inadequate record-keeping which meant there was no evidence of what was discussed.

The SPSO report calls for the health organisations, scrutiny bodies and policymakers to use a practical tool in the form of a consent checklist to evaluate whether a process is robust enough to avoid the common failings they are seeing.

Jim Martin, the Ombudsman, said: “We consider it timely to contribute our unique perspective to this discussion. The complaints we see provide a useful insight into the kinds of failings that can occur in consent processes, and the impact this has on ordinary people.

“Webelieveaswellasputting things right for individual patients and their families, complaints can and should drive improvements. This report forms part of the vital work we do to help public bodies learn and improve, prevent repeat failings and reduce future complaints.”

A Scottish Government spokeswoman said: “We welcome the publication of this report as a contribution to the wider discussion on how consent and shared decision making processes can be improved in Scotland. The NHS does a fantastic job in the overwhelming majority of cases. However there will be occasions when people’s experiences of the NHS do not meet their expectations. When that happens boards must listen, learn, and act, so services can be improved for all.

“The Chief Medical Officer has confirmed the consent process will be reviewed by the Scottish Government, General Medical Council and the Academy of Medical Royal Colleges.”