Consent to examination and treatment - Barts Health NHS Trust

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COR/POL/046/2012-001 Flowchart 3 : Patients under 18 Note: If the patient is currently detained under the Mental Health Act, first work through Flowchart 4 Does the patient have sufficient maturity and understanding to consent to the proposed procedure or care? (This is presumed for children 16+, and may be the case for younger children) No: document assessment of capacity if in any way contentious; for remainder of flowchart, “Consent- giver” is the person with parental responsibility] Yes: Document assessment. For remainder of flowchart, “Consent giver” may be EITHER the person with parental responsibility OR the patient Nature of treatment proposed Procedure treatment or care not requiring written consent Procedure requiring written consent Clinician giving care: explain the proposed care and seek informal consent from Consentgiver Consent indicated – give and document care Clinician doing procedure or approved delegate seeks written consent from consent giver at pre-admission Elective procedure Documented circumstances make it impossible to obtain consent preadmission Consent given. Complete Form 2 if general anaesthesia involved, otherwise Form 3. Emergency procedure Seek written consent from consent giver prior to procedure taking place Consent given. Complete Form 2 if general anaesthesia involved, otherwise Form 3. Confirm consent prior to procedure; document confirmation Consent in place. Undertake procedure Consent not given or consent withdrawn – do not continue; refer back to GP and seek immediate advice from Legal Team if proposed care/treatment is lifesaving 8
COR/POL/046/2012-001 Flowchart 4: Adults or Children detained under the Mental Health Act Note: This flowchart does not cover all aspects of the law that may apply to the patient, but will allow staff of Barts and the London to identify whether or not specialist Mental Health staff need to be involved in the consent process. Figures in brackets refer to paragraphs in this policy. Normal consent arrangments apply. Follow Flowchart 1 (adult capable patients) or Flowchart 2 (adult non-capable patients) or Flowchart 3 (Under 18s),. (NB Many patients detained under the MHA do have capacity to consent - the same assessment of capacity applies as for any other patient) Is the proposed treatment solely for PHYSICAL disorder or injury? Yes Is the patient being held under Section 4, Section 5(4), Section 5(2), Section 136 or Section 135? Yes No / not sure Is the treatment IMMEDIATELY ESSENTIAL to avoid IMMEDIATE AND SIGNIFICANT risk to patient or others? No No or not sure Does the treatment involve any of the following? • Electro-Convulsive Therapy (ECT) • Surgery to treat mental disorder or manage behaviour • Hormonal treatment for sexual deviation No Is the proposed treatment medication for mental disorder? Yes Yes Has the patient been subject to continuous detention under the MHA for the last 3 months or more? (include any immediately preceding treatment in another hospital and/or on a different section and/or any time “on leave” while subject to the Mental Health Act) Give minimum essential treatment and discuss with patient’s approved clinician or the Legal Team Yes or not sure No Psychiatric treatment can be given under MHA, with or without patient’s consent. Yes Treatment - including medication - may be subject to Section 57 or 58 of the MHA and may require written authorisation by the Approved Clinician (MHA) or a Special Opinion Approved Doctor (SOAD)..Consult the patient’s Approved Clinician (who will usually be an employee of East London Foundation Trust) - contact details will be available from the Site Manager if not known Consult Approved Clinician, document and follow advice, seeking new advice in relation to each new treatment type proposed 9
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Consent to examination and treatment - Barts Health NHS Trust

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