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Published on: August 1, 2019
Electronic versus paper surgical consent in NHS plastic surgery: A prospective evaluation of the Concentric platform
Koushikk Ayyappan1, Abhishek Saha1, Kian Daneshi2
1Medical Sciences Division, University of Oxford, Oxford, UK.
Background:
The Montgomery ruling mandates patient-specific disclosure of material risks in surgical consent, yet paper-based documentation remains common and is prone to omission and inefficiency. Electronic consent (eConsent) platforms may address these limitations, but their real-world impact in UK surgical practice remains understudied.
Methods:
A prospective observational study was conducted in two NHS plastic surgery clinics from November 2024 to June 2025. Patients aged ≥16 years undergoing minor procedures were recruited as they attended clinic. Consent was obtained using paper forms or, following phased introduction, the Concentric eConsent platform. Consent duration was recorded, and documentation was assessed against a standardised procedural risk framework to determine omission rates. Patient experience was measured using a five-point Likert scale.
Results:
Forty-nine consent episodes were included. eConsent had no risk documentation errors, while paper consent demonstrated a 32% risk-omission rate, most commonly swelling or fluid accumulation. Completion time also reduced by 42.56% when utilising eConsent (179.2 vs. 312 s, p<0.0001). Patient satisfaction was high and comparable between consent methods (4.82 vs 5.0 out of 5, p=0.0622).
Conclusions:
eConsent improves the completeness and efficiency of surgical consent with comparable patient experience, supporting closer alignment with contemporary legal standards.
