Important new guidance

The Royal College of Surgeons (RCS) has published new guidance on patient consent. Consent: Supported Decision-Making - A Guide to Good Practice – has been developed in response to the UK Supreme Court decision in Montgomery –v- Lanarkshire Health Board [2015] which reshaped the law in relation to informed consent.

The new RCS guidance applies to elective treatment as opposed to emergency situations. The key aspects of the guidance include:

  • Not making assumptions regarding the wishes of patients, what they may perceive as the best treatment option, or the materiality of any risks of treatment, even where the risk is small. Each patient’s wishes and views must be respected, including their right to withhold consent to treatment, even if this is potentially dangerous or fatal.
  • Where possible, providing written information regarding diagnosis and treatment options, either in the form of booklets or details of websites. A copy of that information should be included in the patient’s notes along with the consent form.
  • Ensuring the surgeon discussing the treatment with the patient is suitability trained and qualified and has sufficient knowledge of the associated risks and benefits. It is the surgeon’s responsibility to ensure informed consent has been obtained before they start treatment.
  • Ensuring patients have been given enough time to make informed decisions.
  • Ensuring a signed consent form is on file prior to treatment commencing and as soon as a decision has been made. Where possible, patients should be provided with a copy of the consent form to take away with them, allowing time for reflection.
  • In addition to the consent form, maintaining written decision-making documents that contain contemporaneous records of the consent discussions. This could be in the form of a letter to the patient’s GP, a copy of which should also be sent to the patient.


We have been providing training nationally, focussing on the practical implications of the decision in Montgomery, and are assisting in the drafting of new policies and forms for a number of different NHS clients. Please contact David Locke for further information.