Decision making and consent: a public consultation on our draft guidance. Full questionnaire

Area of Consultation: Standards & Ethics

  • Start:Oct 24, 2018
  • End:Jan 23, 2019
  • Results planned
    for publication:
    Oct 24, 2019
  • Reference number:59
  • Status:CurrentCurrent

Consultation Summary:

We’re updating our guidance on decision making and consent

We’re consulting on our revised guidance for doctors on decision making and consent which explains the good practice principles for making decisions about care.

We’ve worked with a group of doctors, patients, and other health and care professionals to update our guidance, to make sure it’s still clear, relevant, consistent with the law across the UK and structured in a way that’s easy for doctors to refer to and use.

We’re now consulting on the revised guidance and welcome your feedback.

How do I take part?

We welcome responses from anyone with a view on the draft guidance. We’ve developed this questionnaire for medical and lay professionals who have a detailed working knowledge of the policy, practice and law around consent. You’ll need to read the guidance and register to complete it - click on the further information button below to access the guidance.

We’ve also developed short versions of this questionnaire for respondents who may not have time to review the guidance in detail:

You can view all the questionnaires (including in Welsh) and the draft guidance in a pdf format by clicking on the further information button below. 

You can access the questionnaires and the draft guidance on this consultation website or download the questionnaire by clicking on the 'further information button' below. You can send your completed response by:

  • email to gmcconsent@gmc-uk.org or
  • post to Consent consultation, Standards and Ethics Team, General Medical Council, Regents Place, 350 Euston Road, London NW1 3JN.

If you need these documents in another format or language, call us on 0161 923 6602 or email us at marketingcommunications@gmc-uk.org.

Background:

Good communication and decision making are at the heart of the doctor-patient relationship. But we know it can be challenging to get it right.

Our current Consent guidance (originally published in 2008) explains the good practice principles for making decisions about care, from the treatment of minor conditions to major interventions with significant risks or side effects.

Our guidance applies to all doctors registered with us, whatever their grade, specialty or UK location, so it is necessarily high level. It is important that it represents common ground between the profession, public and service providers, established through extensive consultation. It must also reflect how individual patients, carers and members of the public experience healthcare - particularly those with unequal access to care or with significant needs, such as patients with impaired capacity.

What’s in scope?

We explain the principles of consent and decision making in a few pieces of our explanatory guidance and we’ll make sure all references are consistent. But the focus of this review is our core guidance document Consent: patients and doctors making decisions together (2008).

Guidance on consent to share information is out of scope for this review as it’s addressed in Confidentiality: good practice in handling patient information (2017). These pieces of guidance are also out of scope:

While our 0–18 years and Consent to research guidance are not in scope for this review, you can share any feedback on these publications (see question 17, ‘overall comments’) and we will take this into account in any future reviews.

What have we done so far?

We’ve gathered evidence through our own and commissioned research as well as engagement, to understand what issues to address. We’ve redrafted our guidance to:

  • focus on how doctors can support patient decision making and involve patients in decisions about their care as far as possible
  • focus on the importance of doctors finding out what is meaningful for their patients and helping them explore the different options
  • include practical suggestions and examples to explain how the principles apply
  • make it more accessible by referring less to the law and more to the principles on which the law is based.

You can read more about the review on our website.

Putting the principles into practice

We develop learning materials to show how our guidance applies in practice. This includes our mental capacity decision support tool and interactive scenarios in Good medical practice in action. We welcome views on what other topics or issues we could cover in these materials and have asked for your suggestions.

Equality and diversity

We carry out an equality analysis as we develop our guidance to identify the steps we must take to comply with the three aims of the public sector equality duty under the Equality Act 2010. Your responses help us understand how our guidance might impact on doctors, patients and members of the public who share protected characteristics. We ask for diversity information from respondents to help us understand if any groups have raised specific issues about our guidance. This information helps us consider what steps we might need to take to reflect the issues raised.

Further Information

Purpose:

What are we asking for your views on?

There are 22 questions in total (17 on the guidance and the rest about the wider consultation process) and some questions asking about you. While you don’t have to answer all of them, your views are important, so please complete as many as you can.

We believe these issues in the guidance will be of most interest to you (though you can of course tell us about any aspect of this guidance update too):

  • about the guidance, scope and application (question 1)
  • summary of the main principles (question 2)  
  • how decisions are made (including the decision making framework  and responsibility and delegation) (questions 3­‑4)
  • guidance on supporting patient decision making (sharing information, maximising ability to make a decision, assessing and explaining benefits and harms, time and when patients don’t want to be involved) (questions 5‑9)
  • guidance on making a decision (expressions of consent, planning future care, making sure patient decision making is voluntary, assessing capacity, assessing the overall benefit of different options, the scope of treatment in emergencies and if you have legal authority to make a decision to protect the patient or other people) (questions 10-16)
  • overall comments on the guidance, including anything we haven’t specifically asked about (question 17)
  • putting the principles into practice (question 18)
  • equality and diversity consideration (question 19)
  • the consultation documentation and process (20‑22)
  • and finally, some information about you.

We aim to publish a final version of the guidance in 2019, but the date depends on the outcomes of this consultation.

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