Consent principles (Health and Care Professions Council, 18 December 2025)

Summary

Failures in consent are a leading cause of patient harm and litigation. NHS Resolution data shows claims for failures in informed consent have nearly doubled over the past decade. The NHS Long Term Plan emphasises empowering patients with choice and control—consent is central to achieving this.

These consent principles from the Health and Care Professions Council are aimed at improving informed decision-making and reducing patient and service user harm. They were developed with a cross-sector working group including the Nursing and Midwifery Council, General Pharmaceutical Council, General Optical Council, General Osteopathic Council, the Patient Safety Commissioner, the Patients Association, and the Council of Deans for Health, supported by other regulators including the General Medical Council, General Dental Council and General Chiropractic Council.

Content

The five consent principles

Start with shared decision making

The process starts with unbiased conversations about all reasonable options available to patients and their potential risks and benefits, including the option to take no action. This discussion should include expected outcomes for varying options to support a shared understanding between patient and practitioner about the expectations and limitations of the available options.

Individualise the risks and benefits

Risks and benefits should be individualised to the (clinical and personal) circumstances of the individual patient and communicated in a way that supports understanding, including what risk (s) they would be prepared to take in order to achieve a desired outcome. Patients should be supported to consider the options in the context of their own lives and their preferences and values. When a patient is not able to consent or understand the risks and benefits, conversations about options should involve the family, friends of the patient or advocate.

Ensure it is a continuous process

Decision-making and consent should be seen as a continuous process which may be distributed between multiple professionals across time and location, through which a patient can fully understand the options available to them, is supported to deliberate on these options and then freely give their consent to proceed with their chosen course of action, unless the decision is to take no action. Some patients may be supported by their friends or family or have someone making decisions on their behalf.

Conclude with consent

Once a decision has been reached through shared decision-making, there should follow a conversation that confirms this decision, answers any outstanding questions and provides any additional information required (including any risks that the patient is likely to attach significance to not previously discussed).

Patients are equal partners

Patients are equal partners and active participants in the decision-making and consent process. Practitioners should encourage and support patients to ask questions and share their thoughts and opinions. Patients should not be pressured into making any decision and they should be free to change their mind at any stage. Consent is given by patients, not taken by practitioners.