Children, companions, records and escalation

Consent can be more complex when children, young people, parents, carers or companions are present. Support staff should keep the person at the centre, follow local procedures and escalate if authority, confidentiality, capacity or safeguarding is unclear.

Children and young people

Parents or carers commonly attend optical appointments with children. Their presence can help, but staff should address the child or young person in language and tone suited to their age, maturity and understanding.

If a young person asks to speak privately, appears distressed, disagrees with a parent, or raises questions about confidentiality, staff should not improvise. Involve the optometrist, dispensing optician, safeguarding lead or manager according to local procedure.

Companions, carers and family members

Adults may be accompanied by family, carers, advocates or friends. A companion can assist with memory, communication, mobility or confidence, but they do not automatically have authority to decide, receive confidential information or override the patient.

If a companion is controlling, answers for the patient, demands information without authority or pressures a decision, staff should protect the patient's privacy and escalate. This may indicate a consent, confidentiality, capacity or safeguarding issue.

Recording and escalation

Follow local procedure when recording consent, refusal, withdrawal, communication needs, companion involvement, concerns and escalation. Records should be factual: what was said, who was present, what the patient appeared to agree or refuse, what action was taken and who was informed.

Escalate promptly if there is uncertainty about clinical advice, capacity, parental authority, safeguarding, confidentiality, consent to images, refusal of an important clinical step or any sign that the person is being pressured.

Children, young people and GOC follow-on learning

When children, companions, confidentiality or records are involved, support staff should keep the patient central, record facts and escalate uncertainty promptly.