The information provided for patients should include information on what will happen to them in the anaesthetic room in the operating theatre and after discharge.99
Information should be provided in a range of formats, including written leaflets or electronic material.100 Details of websites that provide reliable, impartial and evidence based information should be made available to patients when appropriate. Where possible this should include large print, Braille and audio formats. Information should conform to the ‘accessible information’ standard set by the Department of...
Consultation skills for shared decision making should be used to prepare patients for anaesthesia, surgery and analgesia. Patients should also be informed of the increasing number of decision aids available from NHS Direct to help them with their choices.66,102,103 The use of shared decision making tools such as ‘Benefits, Risks, Alternatives, Nothing’ and ‘Ask 3 questions’ should be considered.104,105
Information should be provided sufficiently far in advance to allow the patient to consider and reflect on this information prior to anaesthesia and surgery.
Patients from non-English speaking groups may require interpreters. Wherever possible, this need should be identified in advance.101 Hospitals should have arrangements in place to provide language support, including interpretation and translation services (including sign language and Braille).101,107,108,109,110 Patients with learning and other difficulties may require special assistance and consideration.
The Mental Capacity Act, Adults with Incapacity (Scotland) Act or the Mental Capacity Act (Northern Ireland) must be complied with.111,112,113 Staff should have regular training in the application of the Mental Capacity Act and have defined access to patient advocates. This is a rapidly changing area, and clinicians should have access to expert advice if...
Some patients, both adults and children, may need parents or other members of their family to be with them. This need is best determined at the preassessment clinic visit, so that sensitivities can be taken into account in the operative process.39
All practitioners must follow the practices outlined in the GMC Decision making and consent guidance. Documentation of the risks discussed or the dialogue leading to a decision is required in accordance with paragraphs 50–55.67 Equally, completion of a consent form is not a substitute for a meaningful dialogue tailored to the individual patient’s needs.
Ideally, as part of shared decision making, consent for surgical and anaesthetic procedures should be obtained prior to the day of surgery (see recommendation 4.3), allowing sufficient time for the patient to reflect on their consent discussion.67 The competent patient has a fundamental right, under common law, to give, or to withhold, consent to examination, investigation and treatment.66,67,99
