Consent for treatment is a key element of care, in terms of the quality of clinical decision-making, experiences of patient-centred care, and organisational medico-legal risk.
Following recent landmark cases (Montgomery 2015, Thefaut vs Johnston 2017, Paterson Inquiry 2020), informed consent practices have been brought to the forefront, with new standards needing to be met around personalisation and documentation of the consent process. New guidance requires adequate time to be allowed for consideration of consent and the necessity to provide information in lay language addressed directly to the patient.
In parallel, significant evidence has been demonstrated of the benefits of increased patient engagement in shared decision-making and the consent process, leading to better, often more conservative, decisions.
The current paper consent process has been demonstrated to be associated with significant errors and inappropriate variation in practice, contributing to both medico-legal risk, system inefficiencies, and poor patient experiences.
A broken paper process
The traditional paper-based consent process is outdated. It’s been demonstrated to be associated with significant errors and inappropriate variation in practice, contributing to both medico-legal risk, system inefficiencies, and poor patient experiences.
- Significant errors in 51% of paper consent forms - work published in the BJS
- Over 50% of ‘consents’ done on day of surgery
Where this is the case some new information is shared on the day in the majority. Thefault vs Johnston case highlights that such information may not be considered as part of an informed consent defence.
- Minority of patients reporting best practice in shared decision making (SDM)
20% of operations may be appropriately avoided with better SDM - £10bn / year opportunity cost for NHS England
- £50m+ per year in consent related NHS Resolution (England) costs
From combination of above reasons and cases of lost consent forms. Area of rapid increase in litigation costs post-Montgomery.
How does it work?
This 4-minute video is a demonstration of the Concentric digital consent application:
Digital transformation of your consent process with Concentric will lead to the following:
- Reduced consent form errors, omissions and medicolegal risk, with improved documentation of the consent process.
- Remote consent functionality to reduce need for physical consent consultation.
- Improved patient experience of decision-making process and understanding of decisions.
- Release of clinical time through reduced administrative time.
- Improved operational efficiency such as reduced day-of-surgery cancellations and delays.
- Reduced paper use, both consent forms and patient information leaflets.
Evidence of impact
- Improve shared decision making and reduce legal risk
Increase from 28% to 72% of patients reporting gold-standard SDM following introduction of digital consent (Dyke et al. The Surgeon. 2022).
- Improve efficiency and reduce costs
Remote, paperless pathways and 5-10% reduction in day-of-surgery delays / cancellations (NHS England digital playbook, 2022).
- Improve patient and clinician experience
4.5 ⭐️ rating across 7,000+ responses. (Early experience data publised in the BJS)
Whilst the quality and financial case for each organisation will be slightly different, we generally see:
- Improvement in quality and efficiency from month 2 of implementation period
- Cost neutral/saving from transition to BAU at end of 6 month implementation period onwards (Concentric cost is balanced by removal of paper processes, cost saving if efficiency improvements can be translated into increased activity)
- Cost saving from the medium-term with reduction in medicolegal risk
An example benefits realisation table, including benefit description, outcome and measurement appropriate for use in a business case can be found here. For an example business case template please contact us at email@example.com.