2.2 Ensuring the patient receives sufficient information

NHS Ayrshire & Arran guidelines
NHS Ayrshire and Arran

All patients have a right to access information in relation to their condition and care.

  • The information should be accurate and delivered at the appropriate time in a place and manner that has been mutually agreed between the patient and the health professional.
  • It should be delivered with regard to the patient’s illness and their readiness and ability to absorb information.
  • It should be available in a variety of formats and from a variety of sources according to the patient’s needs.
  • It should be delivered by the patient’s key health professional and the person delivering the treatment (see section 3.1)
  • Information may need to be provided on more than one occasion to promote retention.

Information delivery should be regarded by staff as a two-way and ongoing participative process, with a meaningful dialogue between themselves and the patient. It necessitates time for discussion on the implications of treatment and treatment choices and allows time for patient feedback and question. The health professional should determine what matters to the patient, and attempt to provide additional information to meet these needs, if required. Following these discussions, patients who express a desire for more knowledge about their condition or who have doubts about the treatment offered should be given time to consider his/her decision and supported where appropriate, in order to allow them to come to an informed decision.

2.2.1 Providing sufficient information

Sufficient information is necessary to ensure consent is informed and constitutes valid consent. The core information that the health professional may discuss with the patient include:

  • The nature of the patient’s condition, the reason for the intended treatment and the degree of urgency.
  • The benefits to be reasonably expected of the procedure.
  • The discomforts of the procedure.
  • The nature and probability of material risks associated with the treatment, including discussion of any serious risk of harm.
  • Any additional procedures which are likely to be necessary as part of the procedure.
  • The alternatives to the treatment, including those not provided by the Board or NHS.
  • The consequences of not undergoing the treatment.
  • The name of the healthcare professional who has overall responsibility for the care of the patient.
  • Whether health professionals in training will be involved, and the extent to which students may be involved in an investigation or treatment.

Following the UK Supreme Court’s decision (Montgomery v Lanarkshire Health Board, (Scotland) 11th March 2015) , it is important to appreciate that the standard of information expected to be shared about risks associated with a procedure changed. Health professionals must take reasonable care to ensure that the patient is aware of any material risks, and of reasonable alternatives. The risk is considered material if a reasonable person in the patient’s position would be likely to attach significance to it, or if the doctor should reasonably be aware that the patient would attach significance to it. The significance of a risk is not defined simply by the frequency of an adverse outcome.

When discussing risks of interventions and procedures, the health professional should ensure that s/he determines if there are particular concerns or outcomes that have unique relevance to the patient. For example, a musician may consider the risk of minor sensory loss in his/her hand to be of more significance than the average patient. In addition, the patient should be asked if they have any questions they wish to ask.