Implementation of Digital Consent at Sandwell and West Birmingham NHS Trust: A Quality Improvement Project

Digital consent systems provide a modern alternative to traditional paper-based methods, improving legibility, documentation accuracy, compliance with National Health Service (NHS) medicolegal standards and patient understanding. This quality improvement project evaluated the implementation of a digital consent system in the Trauma and Orthopaedics department at Sandwell and West Birmingham NHS Trust, comparing paper-based consent with the digital system. Baseline data were collected retrospectively from July to August 2024 and compared with prospective data following implementation from August to October 2024, using quantitative measures of documentation quality and qualitative feedback from healthcare professionals (n=24) and patient (n=619) surveys. An iterative Plan-Do-Study-Act cycle approach was used to refine the process.Following implementation, legibility improved from 42-48% to 100% across all digital consents, and documentation of alternative treatment options increased substantially from 5% to 95% in trauma cases and from 0% to 98% in elective cases. Risks and benefits were documented in 100% of digital consents. Patient and clinician surveys demonstrated high satisfaction, with a mean System Usability Score of 77.5, comparable to high-performing consumer technology platforms. Identified barriers included accessibility issues for less digitally literate patients and technical challenges such as digital signing on smaller devices. The transition to digital consent resulted in a cumulative cost saving of £2552.90 over the first 7 months.The introduction of digital consent significantly improved documentation quality, patient and clinician satisfaction and generated measurable cost savings. Ongoing challenges relating to accessibility and technical usability require targeted interventions. This project demonstrates the potential for digital consent systems to support efficient, sustainable and patient-centred care, with opportunities for broader adoption across NHS specialties.