College drops plan for third-party written consent

RACGP drops proposal to require doctors to obtain written consent from patients for a third-party presence

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The RACGP has dropped a proposal to require doctors to obtain written consent from patients for a third party, such as a friend brought along by the patient, to attend a consultation.

But the patient’s consent must be recorded if any third party – such as a practice nurse – is introduced by the practice, according to the second draft of revised college standards.

“If the practice nurse was involved in the consultation at the request of the GP, ie, as a chaperone, then that should be noted in the medical record and the name of the practice nurse,” Dr Mike Civil, head of the RACGP standards committee, told The Medical Republic.

“If a practice nurse is assisting a GP during a minor procedure, then their presence should also have been consented and documented.”

The same applied to GP registrars, Dr Civil said.

“If the supervisor is sitting in with a registrar while they are consulting, then consent should be obtained and noted,” he said.

“If the supervisor is seeing a patient and wishes to show the registrar an interesting clinical sign, or aspect of history, then they should seek the consent of the patient before getting the registrar and ideally noting that the registrar was involved and attended the consult.”

The patient’s permission should be confirmed when they make their appointment or arrive at reception, but not in the presence of the third party, the revised draft says.

The second draft of the RACGP’s 5^th edition standards was released earlier this month and is being trialled by 100 practices until 30 September.

The college is seeking feedback from GPs, practice staff, other stakeholders and members of the public.

Five new proposed mandatory standards remain intact, including rules on email and social media policy, and information on out-of-pocket costs.

Two proposed standards – involving rules on patient reminders and measuring progress towards practice goals – have been reduced to optional status.

During six weeks of consultations on the first draft earlier this year, more than 300 recommendations, ideas and suggestions were received.

“This next consultation is a further opportunity for all involved in general practice to put forward their thoughts and perspectives,” RACGP President Dr Frank Jones said.