Using chaperones

CSP professional advisers Marie-Therese McDonald and Pip White offer advice about the use of chaperones in physiotherapy practice

Using chaperones

Physiotherapy practice often requires a hands-on approach to assessment and treatment where patients are partially dressed. Physiotherapists may also undertake intimate and/or close examinations.  

What is a chaperone?

A chaperone is an impartial adult who is present during a patient examination and/or treatment. The role of a chaperone is to observe and to protect the patient’s dignity and confidentiality and provide reassurance and emotional support. Chaperones may also play a role in safeguarding. For physiotherapists, a chaperone may safeguard against potential misunderstanding or unfounded allegations of improper behavior. 

For the patient, chaperones act as an advocate, ensuring that any examinations and procedures are conducted appropriately. If they identify unusual or unacceptable behavior from the physiotherapist, the chaperone is responsible for immediately reporting this behavior using the relevant reporting structures. Family members and children must not be used as chaperones.

Training for chaperones

All healthcare workers undertaking chaperoning roles should be educated, trained and competent in the task. The competencies required for chaperoning may vary according to the exact nature of the chaperoning role.

When is a chaperone required?

Not every patient will want or require a chaperone. Services should make it clear that patients can request a chaperone if they want one.  

All patients should be provided with a chaperone if they ask for one.  

A chaperone must be offered to all patients before any examination which involves the pelvic floor complex, genitalia or breasts. 

Consider offering a chaperone for close examinations, when there will be close contact between a patient and therapist, handling intimate areas, and/or where patients are unclothed to their underwear or need to remove underwear.  

Some situations can cause discomfort or anxiety and offering a chaperone can alleviate some of these concerns. Some patients may require a chaperone for other examinations too. You should use your professional judgment and consider the patient’s views to decide.  

Members should understand that some working situations may have a higher risk of regulatory complaints. The Health and Care Professions Council will investigate any complaint made to it if it is alleged that a registrant has failed to meet either the Standards of Proficiency for Physiotherapists, or the Standards for Conduct, Performance and Ethics

What is an employer’s role?

The employer/organisation providing physiotherapy services should provide a chaperone when a patient asks for one. It should have a robust chaperoning policy in place for staff and patients to read.

It should consider the services offered and workplace operating procedures and ensure that risks have been considered and they may need to provide a chaperone. 

What to do if no chaperone is available?

If there is no chaperone available and if you and/or your patient does not want the examination to go ahead without a chaperone present, you should delay the examination to a later date when a suitable chaperone will be available unless there is an immediate concern for the patient’s health. 

During an examination

Obtaining informed consent from the patient is essential before any examination or procedure. Touching a person without their consent may be a criminal offence. Members should read the CSP information paper Consent and Physiotherapy practice for comprehensive information.

Prior to any examination it is important that the nature and purpose of any proposed examination and treatment is explained, and the level of undress that may be required and why. 

How to record decisions

You should record any discussion about chaperones and the outcome in the patient’s medical record. If a chaperone is present, you should record that fact and make a note of their identity. If the patient does not want a chaperone, you should record that the offer was made and declined. 

Professional Advice team

The CSP’s Professional Advice Service gives advice and support to members on complex and specialist enquiries about physiotherapy practice, including professional practice issues, standards, values and behaviours, international working, service design and commissioning, and policy in practice.

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