Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

SWBTB (2/10) 037 (b)
Appendix C
Sandwell and West Birmingham Hospitals NHS Trust
Assessment of Capacity for Young People under 16 years of Age
Nb this is NOT a consent form
Insert Sticky Label
Patient’s Name …………………………………….
Hospital Number …………………………………..
Patient’s Age ………………………………………
Prior to taking verbal or written consent form a person under 16 years of age it is your responsibility
(as the person taking consent) to follow the current Trust guidelines. If you have assessed that this is
not an emergency situation and every effort has been made to contact a person with parental
responsibility it is essential to complete this document.
Recent legislation means that children and young people have a choice and may consent to
treatment in their own right, further legislation has also added that where there are life threatening
issues people with parental responsibility (or the courts) may override refusal of consent.
The person taking the consent must be assured that the child or young person wants to give
consent, has received sufficient information to come to a decision and can retain information. The
child or young person must demonstrate to the person taking consent that they are able to use and
weigh up the information in the decision making process and arrive at a decision.
An information booklet is available and it is recognized as good practice to allow the young person
time to read this booklet prior to giving consent. (CONSENT – WHAT YOU HAVE A RIGHT TO EXPECT, A
GUIDE FOR YOUNG CHILDREN DOH JULY 2001)
Assessment of Capacity for Young People under 16 years of age.
Questions for the child or young person to answer
1. What language do you speak?
2. Can you speak and write in English or do you need an interpreter?
3. What is the procedure/treatment you are being asked to consent to?
4. What are the benefits of the treatment/procedure do, how will it help you?
5. What are the chances of you getting such benefits?
6. Are there any alternatives?
7. What do you think about the risks and benefits, are they big or small?