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New guidelines may be impossible to implement

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New guidelines from the Joint Specialty Committee for Genitourinary Medicine of the Royal College of Physicians on chaperoning patients in clinics for genitourinary medicine may have far reaching implications in terms of cost and staffing levels and may be impossible to implement, at least in their current form.

The guidelines were issued in response to guidance from the General Medical Council on doctors performing intimate examinations. The guidelines are more concerned with the comfort and protection of patients, although they are also intended to defend doctors against wrongful accusations. The Royal College of Nursing has produced similar guidance for nurses.

The chaperone should ideally be a healthcare professional, and his or her name should be recorded in the medical notes; family, friends, and partners should only in exceptions be the chaperone in a genitourinary medicine setting as their use would have implications on confidentiality. A patient’s refusal of a chaperone may result in deferral of an examination, especially in the case of male doctors and female patients.

The impact of introducing these guidelines needs to be assessed with regard to numbers of patients accepting a chaperone, cost, and staffing implications, and acceptability to patients. They should be modified as appropriate.