Patients guide cardiac surgeons on good practice for informed consent - ombudsman joins surgeons in move to improve communications of risk with new guide
14 June 2005
Press release 05/05
Improving the way surgical teams inform patients about options and risk so that they can properly consent to cardiac surgery is the aim of a guide launched today by the Health Service Ombudsman and the Society of Cardiothoracic Surgeons (SCTS) of Great Britain and Ireland.
The A5-sized booklet, Consent in cardiac surgery: a good practice guide to agreeing and recording consent 
(224kb) is based on feedback from patients and is designed for use by cardiac teams, to ensure patients’ genuine understanding of the risks associated with available treatments. Today’s official launch coincides with the guide’s roll out to surgical teams.
The main feature of the guide is a loose-leaf ‘ready reckoner’, containing up-to-date data on risk (collated by the SCTS), and a risk assessment chart on which the surgeon plots the frequency of an undesirable outcome against its impact for the patient. The chart is divided into green, yellow and red areas to allow the patient to clearly judge the severity of their risk - the wording of these categories was decided on in the patient workshops. The remainder of the booklet describes the ‘new’ informing process and explains the thinking behind each stage.
During workshops, patients rejected metaphors - widely used to explain risk - as inappropriate for use in medical practice, as they are based on assumptions about the patient’s prior knowledge, their cross-cultural awareness and values. This detailed patient input will assure the language, format and delivery of the guide to maximise patients’ understanding. It is hoped this format will be applicable to other medical specialties.
This guidance is the first of its kind to be overseen by the Ombudsman’s office and is driven by the Ombudsman’s commitment to learning from complaints - in this case, acting on a significant number of complaints about the quality and quantity of information patients have received prior to giving consent for surgery.
Trish Longdon, Deputy Ombudsman has been involved throughout with the guide’s development. She says: ‘We see far too many complaints where the patient had no idea what they were consenting to and suffered hardship as a result. If the guide is as widely accepted as early feedback suggests, it will help to reduce unnecessary distress to patients and their families and limit avoidable complaints.’
David Richens, Consultant Cardiothoracic Surgeon and Internal Professional Advisor to the Ombudsman drew on his experience to develop the project. He says ‘Key to this project has been in its focus on the patient as decision-maker. We made sure patients were involved from conception to production and as a result are rolling out a detailed guide to providing patients with the level of information they have requested, in their preferred format. We’ve been delighted by the response from patients and expect other specialties to benefit from what’s been achieved here’.
End
Notes to Editors
- The Guide - Consent in cardiac surgery: a good practice guide to agreeing and recording consent will be available online from Tuesday 14 June on the OPHSO website at: www.ombudsman.org.uk
- About the Ombudsman - The Health Service Ombudsman for England looks into complaints made by or on behalf of people who have suffered because of unsatisfactory treatment or service by the National Health Service (NHS). The service is free and the Ombudsman is completely independent of the NHS and the Government. The Ombudsman also looks into complaints against private health providers, but only if the treatment was funded by the NHS. For further information, see the website at: www.ombudsman.org.uk
For further information about the launch or to request a copy of the guide, please call the press office on 0300 061 4996 or email press@ombudsman.org.uk
