HEALTHCARE PRACTICE


Chaperone essential


Not all healthcare organisations have established chaperone policies despite the risks both to doctors and patients


I


NTIMATE physical examinations – those of the breast, genitals and rectum – are a routine part of clinical assessment and


diagnosis for many clinicians but can be embarrassing and uncomfortable for patients. It is necessary to offer a chaperone for patient reassurance and also protection and medico-legal cover for both the patient and the doctor. Awareness of the need to offer a chaperone was emphasised by the case of Dr Clifford


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Ayling. In 2000 Ayling was convicted of 13 counts of indecent assault on female patients in his care. Following a public inquiry in 2004 into the misconduct of this criminal doctor, there was an increased call for the greater use of chaperones by several professional bodies, including the GMC and various medical defence organisations. Recommendations from the inquiry


regarding the use of chaperones were made in a subsequent report and aimed at trusts, encouraging them to develop chaperone policies and also instructing proper chaperone use among individual doctors. Allegations similar to those made against Ayling have been continually reported to the GMC. An FOI request made to the regulator in 2009 revealed that 35 complaints were attributed to inadequate chaperone use from March 2006 to August 2009, and MDDUS deals with


numerous complaints and claims each year.


Protecting patients and doctors Despite this, many doctors are still not regularly using chaperones for examinations and a study by Metcalfe in 20101


almost half of acute NHS trusts in England had yet to initiate a chaperone policy. When chaperones were used, the vast majority of doctors did not record their use2


. Together


these put patients at risk of assault and doctors liable to medico-legal proceedings. Te number of trusts with a chaperone


policy has increased since the publication of the Ayling inquiry but by 2010 many trusts still did not have a policy nor did they intend to put one in place. Tere may be several reasons for the lack of implementation such as: increasing financial difficulties, lack of awareness or interest in applying the Ayling


SUMMONS showed that


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