Recording patient consultations about consent could avoid litigation

Having systems in place to routinely record consultations when getting consent for treatment could help patients to retain the information and potentially reduce the risk of clinical negligence claims against healthcare professionals, an article in the latest Medical Defence Union (MDU) journal argues.

Allegations about inadequate consent are a common feature of claims reported by members to the MDU, the UK’s leading medical defence organisation. As treatments are ever more complex, the process of getting consent has become increasingly scrutinised. However, technology can come to doctors’ aid in recording what was said.

The MDU has supported members involved in cases in which a recording, such as that made to NHS 111, has helped to investigate and resolve claims.

Dr Michael Quinn, a consultant in acute medicine and nephrology at Belfast Trust and clinical lecturer in medical informatics at Queens University Belfast, argues there is a compelling case for recording consent discussions and sharing these with patients. He explains the benefits for both doctors and patients:

“An increasingly frequent complaint is that a patient wasn’t properly warned about a ‘material risk’ that would have affected their decision-making. Since the 2015 Montgomery judgment doctors are expected to disclose any risk to which a reasonable person in the patient’s position would attach significance.

“We know up to 80% of what gets said during a consultation can be forgotten when the patient goes out the door, and if we say anything scary it can stop the patient taking in the rest of it. With a recording, patients can go back and hear what was said or ask a family member to do so for them.

“It may feel strange at the outset and there are barriers, such as privacy concerns, but we’ve all got a lot to gain from recording consultations. My wife is a GP and there have been occasions where a concern has been raised about a telephone consultation where the recording has protected her. We might worry about the level of scrutiny but in the vast majority of circumstances, it will show we’ve done the right thing.”

Dr Michael Devlin, MDU head of professional standards and liaison, said:

“Informed consent is about a dialogue, which explores a patient’s understanding and needs. There is no one-size-fits-all approach to making sure consent is truly informed.

“There may be some anxiety about technology intruding into the consultation itself, but where patients are better informed as a result of it, and doctors have a more complete record of what was discussed, then it could be genuinely better for everyone.”

Dr Quinn jointly founded a start-up technology company, Round Safely, with the idea of recording ward rounds, clinic visits and interactions using audio and video technology, and sharing these with patients and their families, as well as for training purposes.

Read the MDU journal here.