Patient Consent Guidance for Recorded Consultation Assessment

The Recorded Consultation Assessment (RCA) is a summative assessment tool designed to temporarily replace the Clinical Skills Assessment (CSA) component of the Membership of the Royal College of General Practitioners (MRCGP) exam during the COVID-19 pandemic. It aims to evaluate a GP trainee’s ability to apply knowledge and skills pertinent to general practice.

The candidate is required to submit 13 recorded consultations in any combination of audio, video, or face-to-face encounters. Owing to the sensitive nature of a patient consultation, it is crucial you adhere to the principles of informed consent law when completing this assessment. This article serves as an advice guide on obtaining patient consent for your RCA.

What is Informed Consent?

So, what is consent in healthcare? As articulated in GMC ethics guidelines, consent refers to the principle that a patient must give permission before a consultation or medical treatment takes place. It must be a voluntary and informed decision based on the clinician’s explanation. Valid consent to treatment further requires the patient to possess the capacity to consent, i.e. demonstrate adequate decision making ability to weigh up the risks and benefits of any medical procedures that need to be carried out. Any wording when seeking consent should be neutral and consistent; there should be no signs of coercion.

Requesting Informed Consent for RCA:

In a normal consultation there is implied consent for the fact that client confidentiality expands to the medical team involved in the patient’s care. For the purpose of RCA, however, consent for the patient’s use of their data must be obtained explicitly, i.e. either verbally or written (paper or electronic form). In addition to seeking consent prior to the consultation, you must also confirm their consent post-consultation; this is because the outcome of the consultation may be distressing to the patient and they may eventually change their mind. 

Usually, an RCA call will be initiated on the FourteenFish IT platform and consent will be built into the system at the beginning of the recording. There is also an opportunity for the patient to revoke consent after the consultation, in which case the recording will not be saved.

Should the consultation take place elsewhere or consent is not incorporated into the recording platform, evidence of consent must be submitted separately; this may be done in the following ways:

• A text message with details and links to further guidance may be sent. The patient can then read and respond with confirmation of consent prior to the consultation.
• A different member from the practice staff may call the patient to seek consent prior to the consultation. This may be favourable in cases of:
  • Communication/literacy difficulties
  • A very ill patient
  • Mental health problems
  • Children
  • Learning difficulties

An appropriate medical consent form will still need to be signed by the patient to confirm their continued consent to the use for their data.

References:

1. MRCGP RCA guidance and proforma consent form. Royal College of General Practitioners. 2020. Available from: https://www.rcgp.org.uk/gp-training-and-exams/mrcgp-exam/-/media/F0C813F4063D4496A5231FD723938AB8.ashx
2. MRCGP: Recorded Consultation Assessment. Royal College of General Practitioners. Available from: https://www.rcgp.org.uk/gp-training-and-exams/mrcgp-exam/mrcgp-recorded-consultation-assessment.aspx
3. Overview – Consent to Treatment. NHS. Available from: https://www.nhs.uk/conditions/consent-to-treatment/