How much do healthcare professionals know about informed consent? A bristol experience

It is important that healthcare professionals have a thorough knowledge of consent practice. The purpose of this study was to compare understanding against the agreed standards found in consent guidelines and UK case law.

Twelve 'true or false' questions testing knowledge of the consent process were completed by 118 healthcare professionals from the United Bristol Healthcare NHS Trust. The questions addressed areas of fundamental importance, difficult clinical situations, and common consent dilemmas. The answers were marked against pre-validated answers determined using published guidelines and case law. Results were analysed for differences between pre-determined population sub-groups.

A 100% response rate was achieved. Significant areas of weakness were identified including the role of consent forms, Gillick competence and mentally-ill patients. Performance was generally better by medical staff, those in surgical specialties, and more junior doctors. For example, 30.9% of doctors versus 62% of non-doctors (p=0.05) thought, incorrectly, that if an adult is unable to provide consent for an emergency procedure, the patient's next of kin must sign the consent form. Doctors also demonstrated a greater understanding of Gillick case law and scored significantly higher than non-doctors (68% vs. 48.5%, p=0.027).

National guidelines and case law provide the gold standard for ideal consent practice. Many healthcare professionals have either not read these documents or are unable to reliably recall them. Improvements in knowledge and practice could be possible with further education, particularly targeting those most closely involved in the consent process