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Assistant Practitioners Verifying Patient Identification and Seeking Consent

Assistant practitioners and trainee assistant practitioners are part of the non-registered workforce and must work under the supervision of a registered healthcare professional (normally a radiographer). Assistant practitioners, do not practise autonomously and must work effectively and safely within their defined area of practice, within relevant legal and ethical frameworks, and in accordance with agreed protocols.

Identification of the patient

Under a process of supervision, the assistant practitioner or trainee may identify the patient in accordance with local policies and protocols. Typically this would be using the well established three-point patient identification procedure:

  • first name
  • last name
  • date of birth.

This procedure was developed as a requirement for employers under IR(ME)R regulations [Regulation 4 (1) Schedule 1 (a)]. 


The assistant practitioner or trainee should ensure that the patient actively responds to identification questions. They should confirm with the patient that the requested examination corresponds with the patient’s clinical history ie check symptoms in case the wrong patient identifier has been attached to the request form.



Where possible, the NHS Number should always be used in conjunction with other verifiers when identifying a patient.



There may be exceptions where it may not be possible or may be difficult for the patient to be directly identified such as mute or non-English speaking. The employer will have clearly documented procedures in place to cover these eventualities.

As  long as consent to investigation or treatment has been gained from the patient, it is not necessary in law to seek additional consent to  treatment which will be undertaken by an assistant practitioner or trainee as the nature and purpose of the procedure remains the same whoever undertakes the task. 

The SCoR reaffirms its statement that from an ethical perspective, a patient must be made aware that the examination will be undertaken by an assistant practitioner or trainee and not a registered health professional and permission to proceed must be sought from the patient through his/her explicit verbal agreement.

The task of gaining consent may be delegated by a supervising radiographer to an assistant practitioner or trainee who is proven competent to do so following education and training. The radiographer retains the overall responsibility for the task and accountability for the decision to delegate. The person who has been delegated the task is responsible for their own actions. 



Assistant practitioners in clinical imaging undertaking limited protocol-driven standard imaging examinations on the co-operative, communicative and conscious adult patient may take responsibility for obtaining patient consent in these limited contexts provided s/he is proven competent to do so. 



Obtaining consent for radiotherapy is deemed to be beyond the scope of practice and role of the assistant practitioner in radiotherapy.

Presence of trainees during examinations

Whenever trainees are working with a radiographer or observing as part of their training, it is a requirement that their presence is explained to the patient and the patient’s permission is sought for the trainee to be present during the examination.



For trainee observation of intimate procedures (eg transrectal/transvaginal ultrasound, mammography, prostate brachytherapy, etc) as part of their training requirement, the patient’s explicit verbal consent for a trainee to be present must be sought prior to entering the examination room. Patients must be made aware of the type and number of students who will be present and be advised that they can decline without fear of offence or of compromising their examination or treatment.
 

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