Consent at a glance

In law, everyone has the right to determine what happens to their bodies regardless of the procedure or intervention [1]. To be valid, consent must be:

• Voluntary
• Given by an appropriately informed person (usually the patient or parent/carer)
• Given by an adult authorised to act on the patient’s behalf if the patient lacks capacity.

In healthcare, informed consent must be obtained at the point of care and throughout treatment. A patient has the right to refuse or withdraw their consent at any point (even in the middle of a procedure).

These principles apply to hearing tests and the supply of hearing aids.

For community hearing services, applying these criteria is largely a matter of common sense and professional judgement.

• Explicit consent is when a patient gives you specific permission to do something orally, in writing or by an affirmative sign or signal

• Implied consent can be assumed from a patient’s actions – e.g. entering a soundproof booth for a test they have been informed about or when a regular patient books and attends for a hearing test, enters the consulting room and accepts an invitation to sit in the chair.

Note, consent cannot always be assumed, however. For instance, it may be the patient’s first hearing test, even though they have attended the practice before, aspects of the hearing test may have changed or they may have changed their mind about elements of the test since their last visit.

The more intimate or intrusive a procedure (e.g. moving close to a patient to perform), the more important it is to check that explicit consent has been given.

Obtaining consent is part of an ongoing discussion and decision-making process between you and your patient. Various routine questions can be used as part of the hearing test or other procedure to ascertain consent (with varying degrees of double check), for example:

• “I am just going to/need to [PROPOSED ACTION] in order to [PURPOSE].”

• “Would you mind sitting here/turning your head so that I can [PURPOSE]?”

• “I am just going to come close so that I can [PURPOSE].”

• “Are you still comfortable?”

• “I am just going to/need to [PROPOSED ACTION] in order to [PURPOSE] – is that all right/do you mind?”

Special care should be taken with vulnerable patients such as children, people with learning disabilities, cognitive impairment, or in domiciliary situations. Using a colleague/chaperone to double-check may be useful in such circumstances.

When in any doubt, consent should always be re-checked and the record noted. This can be by ticking a printed checklist in the patient record. The record should also clearly record if consent is withdrawn, together with any reason the patient gives. The patient however does not have to give a reason.

Always check with your line manager, a senior colleague, the NCHA, the British Society of Audiology (BSA), or take legal advice if you are in any doubt about what form of consent is acceptable or appropriate in any particular circumstance, or how consent should be ascertained in complex or difficult cases.

Originally published: September 2020

Reviewed: October 2025

Next review date: October 2028

This guidance was last reviewed in October 2025. No material changes were made. The next review date is October 2028.

This guidance was last reviewed in August 2023. No material changes were made. The next review date is August 2025.

[1] There are some exceptions to this general rule but these do not apply in hearing care, except in cases of incapacity.