Consent Policy

1.1 This Consent Policy sets out how we obtain, record, and review consent when providing care and treatment. It applies to all clinical consultations and related services provided by Your Menopause Care with Rupa.

1.2 This Policy should be read together with:

• Our Terms and Conditions (including medical disclaimer, clinical care, and complaints clauses)
• Our Privacy Policy (covering how we handle personal data and health information)
• Our Safeguarding Policy (setting out our approach to safeguarding adults and responding to abuse or neglect)
• Any additional patient information or guidance we provide on our website

1.3 This Policy is designed to comply with:

• Regulation 9: Person-centred care
• Regulation 11: Need for consent
• Regulation 13: Safeguarding service users from abuse and improper treatment
• Mental Capacity Act 2005 and its Code of Practice
• Accessible Information Standard
• Equality Act 2010
• UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018

1.4 Our service is aimed at adults who are ordinarily able to give their own consent. However, we recognise that capacity can fluctuate and that we have duties under the Mental Capacity Act 2005 where a person may lack capacity for a specific decision at a specific time.

1.5 All staff involved in seeking consent are trained in this policy, the Mental Capacity Act 2005, and the principles of person-centred care and safeguarding.

2.1 Consent is a continuing process, not a one-off event.

2.2 We provide person-centred care by:

• Involving people in decisions about their care and treatment
• Respecting their values, preferences, and beliefs
• Taking account of any communication needs or disabilities

2.3 We will only provide assessment, treatment, or share information where we have:

• The person’s valid consent; or
• A clear legal basis to act without consent (e.g., where they lack capacity and we act in their best interests, or where there are safeguarding or legal obligations to disclose information)

2.4 Our approach to confidentiality, information sharing, and data protection is set out in our Terms and Conditions and Privacy Policy.

3.1 For consent to be valid it must be:

• Voluntary: Given freely, without coercion, undue pressure, or manipulation
• Informed: Based on a clear explanation of the nature, purpose, benefits, risks, and alternatives of the proposed assessment or treatment, including what may happen if no treatment is chosen
• Given by someone with capacity: The person must have capacity to make the specific decision at the time it is made

3.2 Consent may be given verbally, in writing (e.g., via online forms or email), or, for minor matters, implied by the person’s actions (e.g., joining a video consultation after receiving clear information). For prescribing and treatment decisions, we rely primarily on verbal or written consent, which is recorded in the clinical notes.

3.3 Consent for care is separate from consent for data processing. How we obtain and rely on consent and other lawful bases for processing personal data is explained in our Privacy Policy.

4.1 We seek consent at several stages, including:

• When a person registers as a patient and books an appointment
• At the start of a consultation, before taking a history and discussing symptoms
• Before recommending or prescribing treatment, including hormone replacement therapy and any diagnostic tests
• Before sharing information with the person’s GP or other healthcare professionals, except where disclosure is required or permitted by law without consent (e.g., safeguarding or serious risk of harm)
• Before involving third parties such as pharmacies or laboratories where additional information is needed beyond the usual prescribing and dispensing processes

4.2 During consultations, we will explain in clear, accessible language:

• The nature and purpose of the proposed treatment or investigation
• The likely benefits and expected outcomes
• Relevant risks, side-effects, and uncertainties, including off-label use where applicable
• Significant alternatives, including the option of no treatment

4.3 We give people the opportunity to ask questions and time to consider their options, having regard to the clinical urgency of their situation.

5.1 We take reasonable steps to ensure informed consent, including:

• Using clear, jargon-free language
• Checking understanding by asking the person to summarise key points in their own words where appropriate
• Providing written information or patient leaflets where available
• Offering follow-up opportunities (e.g., further consultations or email support) where clinically appropriate

5.2 In line with the Accessible Information Standard and the Equality Act 2010, we make reasonable adjustments to support decision-making, which may include:

• Arranging an interpreter or translator where language is a barrier
• Using alternative formats (e.g., larger print or different languages) where practicable
• Allowing a partner, family member, friend, or carer to be present
• Adjusting the pace or structure of appointments to support understanding

5.3 Where we consider that a person may require independent support to understand or express their views, we may suggest or signpost to advocacy services, including independent mental capacity advocates (IMCAs) or local advocacy services where appropriate.

5.4 Feedback and concerns about the information provided or the consent process can be raised under our complaints process.

6.1 A person with capacity has the right to refuse treatment or to withdraw consent at any time, even if this may lead to a deterioration in their health.

6.2 If someone refuses or withdraws consent, we will:

• Check that they have capacity to make that decision
• Ensure they understand the possible consequences of refusal or withdrawal
• Respect their decision, except where we have legal or safeguarding obligations that require us to act
• Record the decision and our discussion in their clinical notes

6.3 If a person withdraws consent during a consultation, we will normally stop the consultation and discuss any next steps, including alternative options or signposting to other services (e.g., their GP or urgent care).

6.4 If withdrawal of consent affects our ability to continue providing services safely, we may discontinue care in line with our Terms and Conditions.

6.5 If a person is unhappy about how consent has been obtained, they may raise this under our complaints process.

7.1 Where a person lacks capacity to make a particular decision, we will consider whether there are any legally recognised representatives, including:

• An attorney under a valid and applicable Lasting Power of Attorney (LPA) for health and welfare
• A court-appointed deputy for personal welfare decisions
• A decision of the Court of Protection

7.2 We will:

• Take reasonable steps to verify the authority and scope of any LPA or deputy order
• Involve the attorney or deputy in decisions within their legal remit
• Continue to involve the person themselves as far as possible, in line with the Mental Capacity Act 2005 principles

8.1 We apply the five statutory principles of the Mental Capacity Act:

• A person must be assumed to have capacity unless it is established that they lack capacity
• A person is not to be treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success
• A person is not to be treated as unable to make a decision merely because they make an unwise decision
• Any act done, or decision made, for or on behalf of a person who lacks capacity must be done, or made, in their best interests
• Before the act is done, or the decision is made, regard must be had to whether the purpose can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action

8.2 We are responsible for ensuring that:

• The Clinician understands and applies these principles in practice
• Concerns about capacity are identified and explored during consultations
• Appropriate capacity assessments and best-interests decisions are carried out and recorded where required

9.1 Our service is designed for adults who can normally consent to their own treatment. However, where there is reason to doubt capacity for a specific decision (e.g., due to cognitive impairment, confusion, severe distress, or communications that suggest lack of understanding), the Clinician will carry out a proportionate capacity assessment.

9.2 Capacity assessments will:

• Be decision-specific and time-specific
• Consider whether the person can:
  • Understand the information relevant to the decision
  • Retain that information long enough to make the decision
  • Use or weigh that information as part of the process of making the decision
  • Communicate their decision (by any means)

9.3 The Clinician will:

• Document the reasons for believing capacity may be impaired
• Record the outcome of the capacity assessment in the clinical notes
• Where the person lacks capacity, record the best-interests decision, including who was consulted and how the least restrictive option was chosen

9.4 We may decide that our online service is not suitable where capacity issues mean that safe, person-centred care cannot be provided remotely. In such cases, we will advise on more appropriate services, such as the person’s GP or other NHS or specialist services.

10.1 Consent may not be valid where a person is subject to coercion, control, or abuse.

10.2 Where we have safeguarding concerns, we will:

• Consider whether consent is truly voluntary and informed
• Follow our Safeguarding Policy and any relevant local or national guidance
• Make safeguarding referrals or contact emergency services where required
• Act in accordance with Regulation 13 and applicable safeguarding duties

10.3 We may share information without consent where there is a risk of serious harm to the person or others, or where required by law. Any such disclosure will be limited to what is necessary and proportionate, and will be recorded in the clinical notes.

11.1 Our service is delivered remotely and does not provide accommodation or continuous supervision. It is therefore highly unlikely that our care will amount to a deprivation of liberty.

11.2 If we become aware that a person using our service may be subject to, or require, a Deprivation of Liberty authorisation (e.g., in a care home or hospital), we will:

• Take account of any existing authorisation or Court of Protection order
• Liaise with the relevant professionals or local authority where appropriate
• Ensure that any decisions we make are compatible with the person’s human rights and the least restrictive principle

11.3 If we believe that a person’s circumstances may amount to an unauthorised deprivation of liberty, we will raise this with the appropriate local authority or NHS body in line with safeguarding and Mental Capacity Act guidance.

12.1 We will keep clear records of:

• Discussions about consent, including information provided and questions asked
• Any refusal or withdrawal of consent and the person’s stated reasons where given
• Any capacity assessments and best-interests decisions
• Involvement of attorneys, deputies, or advocates

12.2 These records form part of the clinical record and will be handled in accordance with:

• Our Privacy Policy
• UK GDPR and the Data Protection Act 2018

12.3 We will respect confidentiality and only share information in line with:

• The person’s consent
• Legal or regulatory obligations
• Safeguarding duties, as described in this Policy, our Safeguarding Policy, and our Terms and Conditions

13.1 We will take reasonable steps to identify and record any information or communication needs at registration and during consultations.

13.2 Where practicable, we will provide information in a way that is accessible to the person, having regard to disability, language, and cultural needs, consistent with the Accessible Information Standard and the Equality Act 2010.

13.3 We will not unlawfully discriminate in relation to consent or decision-making on the grounds of protected characteristics under the Equality Act 2010 (including age, disability, race, religion or belief, sex, sexual orientation, gender reassignment, pregnancy, or maternity).

13.4 Requests for reasonable adjustments or alternative formats may be made using the contact details set out in our Terms and Conditions and Privacy Policy.

14.1 If a person is unhappy with how consent has been sought or recorded, they can raise this as a concern or complaint under our complaints process.

14.2 Our complaints and feedback arrangements explain:

• How to make a complaint
• How we will handle, investigate, and respond
• Timeframes and escalation routes, including to the CQC, GPhC, and ICO

15.1 This Consent Policy will be reviewed at least annually, or sooner if there are significant changes in legislation, CQC guidance, or our service model.

15.2 The updated version will be made available on our website and will show a new “last updated” date.

15.3 Where material changes are made, we will take reasonable steps to notify existing patients, for example by email or a notice on our website.