Consent

It is a general legal and ethical principle that valid consent must be obtained before starting any treatment or personal care, including vaccination.

This reflects a patient's right to make informed decisions and is a core aspect of good clinical practice. To obtain informed consent, healthcare professionals must ensure the indiviual or their representative fully understands what they are consenting to. 

The consent discussion should cover:

• Which immunisations will be given
• The diseases being prevented
• The benefits and risks of vaccination versus the risks of the diseases
• Possible side effects and how to manage them

Further points on consent

• Consent must be given voluntarily and freely
• Information given should be relevant to the individual patient, explained properly and questions answered fully
• Consent can be verbally given but must be recorded on the NHS assured part of the system

Any healthcare professsional who does not respect this principle may be liable to legal action by the patient and to action by their professional body.

Capacity

For consent to be valid it must be given by an appropriately informed person who has the capacity to consent.

To have capacity, an individual must be able to:

• Understand relevant information, including the likely consequences of making or not making the decision
• Retain that information
• Use or weigh the information as part of decision-making
• Communicate their decision

Who Can Consent?

• Adults are individuals aged 18 and over
• Those aged 16-17 are presumed to have capacity to consent to their own treatment
• Children under 16 with enough understanding and intelligence to fully grasp the proposed intervention are considered Gillick Competent and can consent.
• If a Gillick Competent child or 16-17 year old consents, a parent/guardian cannot overide their decision
• If such a child refuses treatment, the refusal may be overruled if likely to result in death or severe permanent injury

Consent on Behalf of Others

• Individuals with parental responsibility (for patients under 18)
• Someone with a Lasting Power of Attorney
• A court-appointed deputy with authority over treatment decisions

Consent for Young Children

For young children not competent to consent, a person with parental responsibility may do so, providing they understand and can communicate the decision.

Children should receive an age-appropriate explanation of the vaccination process. Evidence shows that children are less traumatised when parents value vaccinations and the child is prepared.

For more information on parental responsibility see The Green Book Chapter 2.

For more information on consent see the Department of Health Reference Guide to Consent for Examination and Treatment