Consent is one of the most important issues for patient safety
These consent principles are aimed at improving informed decision-making and reducing patient and service user harm.
They were developed with a cross-sector working group including the NMC, GPhC, GOC, GOsC, the Patient Safety Commissioner, the Patients Association, and the Council of Deans for Health, supported by other regulators including the GMC, GDC and GCC.
Why consent matters
Failures in consent are a leading cause of patient harm and litigation. NHS Resolution data shows claims for failures in informed consent have nearly doubled over the past decade. The NHS Long Term Plan emphasises empowering patients with choice and control—consent is central to achieving this.
The five consent principles
- Start with shared decision making
The process starts with unbiased conversations about all reasonable options available to patients and their potential risks and benefits, including the option to take no action. This discussion should include expected outcomes for varying options to support a shared understanding between patient and practitioner about the expectations and limitations of the available options. - Individualise the risks and benefits
Risks and benefits should be individualised to the (clinical and personal) circumstances of the individual patient and communicated in a way that supports understanding, including what risk (s) they would be prepared to take in order to achieve a desired outcome. Patients should be supported to consider the options in the context of their own lives and their preferences and values. When a patient is not able to consent or understand the risks and benefits, conversations about options should involve the family, friends of the patient or advocate. - Ensure it is a continuous process
Decision-making and consent should be seen as a continuous process which may be distributed between multiple professionals across time and location, through which a patient can fully understand the options available to them, is supported to deliberate on these options and then freely give their consent to proceed with their chosen course of action, unless the decision is to take no action. Some patients may be supported by their friends or family or have someone making decisions on their behalf. - Conclude with consent
Once a decision has been reached through shared decision-making, there should follow a conversation that confirms this decision, answers any outstanding questions and provides any additional information required (including any risks that the patient is likely to attach significance to not previously discussed). - Patients are equal partners
Patients are equal partners and active participants in the decision-making and consent process. Practitioners should encourage and support patients to ask questions and share their thoughts and opinions. Patients should not be pressured into making any decision and they should be free to change their mind at any stage. Consent is given by patients, not taken by practitioners.
These principles were developed by the HCPC and a cross-sector working group including the NMC, GPhC, GOC, GOsC, the Patient Safety Commissioner, the Patients Association, and the Council of Deans for Health and the work is also supported by other regulators including the GMC, GDC and GCC.
Christine Elliott, Chair of the HCPC, said:
Consent is the bedrock of patient safety, and it should never be seen as just a signature or a tick box exercise. By placing patients at the heart of decision-making, we build safer care, improve the quality of patients’ experience, and reduce the risk of harm.
"While we recognise in life-threatening situations informed consent cannot always be secured, there are too many examples where consent could have been obtained, but has not, and patients have been put at risk.
"We must continue to raise awareness of what informed consent means with patients, service users, and the public, and encourage continual conversations. That way everyone can be clear what to expect from their care and be able to make the right choices for them.
"The power of these principles lies in their having been co-produced with leading representatives of patients and in collaboration with other healthcare regulators, so we have a united approach on expected standards of conduct."
How to raise concerns
If you believe consent standards have not been met, contact your healthcare regulator or use the complaints process outlined on their website.
Further information
