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All Wales Decision Making and Consent Improvement Programme

patient signing consent for treatment

Health professionals need to obtain valid consent for any examination, treatment or intervention involving a patient who has the capacity to give it. Exceptions to this would be in an emergency, when it is not possible to obtain consent, or when the law prescribes otherwise, such as when compulsory treatment for a patient’s psychiatric disorder is authorised by mental health legislation.

In order for consent to be valid, the patient must:

  • Have capacity
  • Have been offered relevant information which includes awareness of all treatment options, benefits, risks (including material risks), complications associated with the procedure and alternatives
  • Be acting voluntarily
  • Be aware that they can refuse.


The case of Montgomery v Lanarkshire Health Board (2015) has closed the gap between legal and regulatory frameworks, enshrining the concepts of informed consent and material risks for individual patients into law.

Consent may be implied or explicit, verbal or in writing. It is also a continuing process, rather than a one-off decision and patients can change their mind about treatment at any time. Competent adult patients are also entitled to refuse treatment even if that will result in their death or serious harm.

Proceeding with treatment without valid consent may put the patient at risk of harm. It also leaves the clinician who is carrying out the procedure and, the clinician who sought consent at risk of criticism and, potentially, legal and/or regulatory sanctions.