A chaperone is not simply another person in the room. Used properly, a chaperone helps preserve dignity, supports clear professional boundaries and provides an impartial observer during an examination. Used badly, the role becomes little more than a name added to the report.
The claimant is not attending for treatment, but the ordinary standards of consent, privacy and professional conduct still apply. The expert should decide in advance whether the proposed examination may require a chaperone and ensure that suitable arrangements are available.
When should one be offered?
The clearest case is an intimate examination. GMC guidance states that a chaperone should, wherever possible, be offered when an intimate examination is carried out. The doctor should explain the examination, tell the person what it will involve, obtain consent and make clear that the examination can be stopped at any time. The offer and the claimant’s decision should be recorded.
“Intimate” should not be interpreted too narrowly. It plainly includes examination of the breasts, genitalia and rectum, but the GMC guidance may also apply where the doctor must touch or work close to an intimate part of the body.
Medico-legal examinations can create less obvious situations in which a chaperone is sensible. A spinal, hip, abdominal or widespread-pain assessment may require significant undressing, close observation, palpation or repeated changes of position. The claimant’s age, vulnerability, cultural expectations, previous trauma, communication needs and expressed discomfort may all affect the decision.
The expert should not wait for the claimant to request a chaperone. Many people will not know that they can do so, and some will be reluctant to appear difficult. The offer should be made clearly, preferably before the appointment and again if the nature of the examination changes.
A supporter is not necessarily a chaperone.
Claimants commonly attend with a partner, relative, friend, interpreter or caseworker. That person may provide reassurance or help with communication but should not automatically be treated as the formal chaperone.
The GMC describes a chaperone as an impartial observer who is trained for the role, familiar with the proposed examination or properly briefed, able to remain throughout it and positioned so that the examination can be observed without unnecessarily compromising dignity. A relative or friend is not usually a suitable substitute, although the claimant may wish to have both a supporter and a chaperone present.
This distinction matters in medico-legal work. A family member may have their own interest in the outcome, may answer questions for the claimant or may be unable to describe events independently if a complaint later arises. An interpreter has a separate responsibility to facilitate communication and may not be able to perform both functions properly.
The chaperone’s task is limited but real.
A trained chaperone should understand why the examination is being performed and what their presence is intended to achieve. They should respect confidentiality, remain alert to distress or discomfort and know how to raise a concern about the expert’s conduct.
They are not there to decide whether a clinical test was necessary, comment on diagnosis or provide a second expert opinion. NHS England’s 2025 guidance describes the chaperone primarily as a person who supports the individual, acts as an advocate, protects privacy and dignity, observes continuing consent and raises concerns about unacceptable behaviour. It also makes clear that chaperoning is not a second-opinion function.
Positioning is important. A chaperone placed behind a screen, outside the room or at a desk with no view of the examination cannot meaningfully observe it. At the same time, their position should not expose the claimant more than the examination requires.
The expert should continue to speak directly to the claimant. The presence of a chaperone does not reduce the need to explain each stage, obtain consent before touching, minimise exposure and stop if consent is withdrawn.
What if the claimant refuses?
A claimant may decline a chaperone because of embarrassment, cultural preference, previous experience or a wish to limit the number of people present. That choice should not be treated as suspicious.
The expert must then decide whether it remains professionally appropriate to proceed. For a limited examination, it may be reasonable to continue after recording the offer and refusal. For an intimate or particularly sensitive examination, the expert may decide that they are unwilling to proceed without a suitable chaperone.
The reasons should be explained without pressure. Where the examination is not urgent, it can be rearranged. GMC guidance recognises that an examination may be delayed when no suitable chaperone is available or when either party is uncomfortable with the proposed arrangement.
In medico-legal work, postponement may cause inconvenience and expense, but administrative convenience should not dictate professional boundaries.
The record must do more than tick a box.
The report or examination note should record that a chaperone was offered, whether the claimant accepted or declined, and the name and role of any chaperone who attended. It should also identify other people present and explain their function.
Where part of the assessment involved undressing, intimate contact or another sensitive procedure, the expert should record the explanation given, the claimant’s consent and any limitation placed on the examination. Current NHS England guidance recommends auditable records covering the offer, decision, identity of the chaperone, reason for the examination and any decision to proceed, postpone or cancel.
A chaperone does not make an examination safe merely by being present. Nor does the absence of a complaint prove that arrangements were satisfactory. Good practice lies in planning, explaining, seeking consent, respecting refusal and making a proper record.
The best chaperone is almost unobtrusive, but never pointless. They help create the conditions in which an examination can take place without avoidable uncertainty about what was explained, what was observed and whether the claimant remained comfortable. That protects the claimant first. It also protects the integrity of the evidence and the expert who produces it.
