Consent Policy for Intimate Pelvic
Floor Examination
Private Physiotherapy Practice
 

1. Purpose
This policy sets out the standards and procedures for obtaining, maintaining, and
documenting informed consent for intimate pelvic floor examinations in a private
physiotherapy practice. It aims to protect patient dignity, autonomy, and safety, and
to ensure compliance with CSP guidance, HCPC Standards of Conduct,
Performance and Ethics, and relevant UK legislation.
2. Scope
This policy applies to all physiotherapists, associates, assistants, students, and
locum staff working within the private practice who may undertake or assist with
intimate pelvic floor examinations, including vaginal or rectal assessments.
3. Definition of Intimate Pelvic Floor Examination
An intimate pelvic floor examination includes:
 Internal vaginal or rectal examination
 External examination of the pelvic, perineal, or genital area
Such examinations may be perceived as intrusive or sensitive and therefore require
explicit informed consent.
4. Legal and Professional Framework
This policy is informed by:
 Chartered Society of Physiotherapy (CSP) guidance on consent and intimate
care
 HCPC Standards of Conduct, Performance and Ethics
 The Mental Capacity Act (2005)
 UK common law on consent
 Data Protection Act (2018) and UK GDPR
5. Principles of Consent
Consent must be:

 Informed – the patient understands what is proposed
 Voluntary – given freely without pressure
 Ongoing – can be withdrawn at any time
 Capacity-based – the patient has the ability to consent
 Specific – applies only to the agreed examination
Consent is a continuous process, not a one-off event.
6. Obtaining Informed Consent
Before undertaking an intimate pelvic floor examination, the physiotherapist must:
 Explain clearly:
o The clinical reason for the examination
o What the examination involves
o Potential benefits and any material risks
o Reasonable alternatives, including non-internal assessment
o The option to decline or defer the examination
 Use clear, non-technical language
 Allow sufficient time for questions
 Confirm the patient’s understanding
 Explicitly ask for consent before proceeding
While written consent may be used according to practice preference, explicit verbal
consent must always be obtained immediately prior to the examination.
7. Right to Decline or Withdraw Consent
Patients have the right to:
 Decline an intimate examination
 Request adjustments or pauses
 Withdraw consent at any stage, including during the examination
Declining or withdrawing consent will not affect the patient’s right to respectful,
ongoing care. Alternative assessment or treatment options should be discussed.
8. Chaperones
 Patients must be informed of their right to request a chaperone
 In a private practice setting, availability of a chaperone should be clearly
explained
 If a chaperone is requested but unavailable, the examination should be
postponed unless clinically urgent and the patient agrees to proceed
 The patient’s decision regarding a chaperone must be documented
Where the physiotherapist is working alone, this should be made transparent to the
patient.

9. Privacy, Dignity, and Professional Boundaries
The physiotherapist must:
 Conduct examinations in a private, appropriate clinical environment
 Use suitable draping and positioning to maintain dignity
 Expose only the area necessary for examination
 Maintain clear professional boundaries and respectful communication at all
times
 Stop the examination immediately if the patient expresses discomfort or
withdraws consent
10. Capacity and Vulnerable Adults
If there are concerns about a patient’s capacity to consent:
 Capacity must be assessed in line with the Mental Capacity Act (2005)
 If the patient lacks capacity, the examination must only proceed if it is in the
patient’s best interests and lawful to do so
 Where appropriate, involve carers, advocates, or legal representatives
 Intimate examinations should be avoided unless clinically essential
11. Documentation
The physiotherapist must document clearly in the patient’s clinical record:
 Information provided to the patient
 Confirmation that informed consent was obtained
 Whether a chaperone was offered and accepted or declined
 Any refusal or withdrawal of consent
 Any patient concerns or significant discussions
Records must be stored securely in line with UK GDPR and practice data protection
policies.
12. Fees and Treatment Decisions
Consent for an intimate examination is separate from consent to treatment and
payment. Patients must not feel pressured to consent due to financial
considerations. Declining an examination does not invalidate agreed treatment plans
or professional care.
13. Training, Competence, and Insurance
Physiotherapists performing intimate pelvic floor examinations must:
 Have appropriate postgraduate training and competence

 Practice within their scope of practice
 Hold valid professional indemnity insurance covering intimate examinations
 Engage in ongoing professional development and reflective practice
14. Complaints and Concerns
Patients should be informed of how to raise concerns or complaints. Any concerns
relating to consent or professional conduct must be taken seriously and managed in
line with the practice complaints policy and CSP/HCPC guidance.
15. Policy Review
This policy will be reviewed regularly to ensure it reflects current CSP guidance,
legal requirements, and best practice within private physiotherapy services.