Terms and Conditions
1. INTERPRETATION AND VARIATION
1.1 In the Terms and Conditions the following definitions apply:
"Company" means Sayer Clinics Limited.
"Patient" means any person who has completed and submitted the online registration form (the "Registration Form") at the Sayer Clinics Limited website, and who's registration has been accepted by the Company.
"Clinic" means any one of the Sayer Clinics Limited clinics at
Sayer Clinic: Kensington: 8, Sunningdale Gardens, London W8 6PX,
Sayer Clinic: Mayfair: 11, Welbeck Street W1G 9XZ and the
Sayer Clinic: City Of London, 80, Coleman Street EC2 and a reference to a Clinic in the Terms and Conditions will be to the relevant clinic at which a Patient has booked to attend treatment sessions.
"Terms and Conditions" means these terms and conditions.
1.2 References in the Terms and Conditions to the singular will include the plural and vice versa and references to the masculine gender will include references to the feminine gender.
1.3 The Terms and Conditions are incorporated into the Registration Form.
1.4 The Company reserves the right to vary and revoke the Terms and Conditions from time to time which variation it may consider necessary or desirable for the regulation of the affairs of the Clinic and the conduct of Patients. Any such changes will be notified to Patients and, until revoked, are and will be binding on Patients.
1.5 The Terms and Conditions will be governed by the laws of England and subject to the exclusive jurisdiction of the English courts.
2. REGISTERED PATIENT
2.1 Subject to these terms and conditions, when a person has completed the Registration Form he will become a Patient of the Clinic.
2.2 Acceptance of a person as a Patient is at the absolute discretion of the Company.
2.3 Patients must be 18 or over or have their parents’ written consent before becoming a Patient of the Clinic (which consent must be made available on request).
3. CLINIC OPENING TIMES
Details of treatment times at the Clinic may vary from time to time. Session times will be published by the Clinic and will be available either at the Clinic or at www.sayerclinics.com
4. PAYMENT TERMS
4.1 Details of treatment fees are available either at www.sayerclinics.com or directly from the Clinic and will be such fees as determined by the Company from time to time.
4.2 A Patient may not attend treatment at the Clinic without first booking and paying for the relevant treatment (apart from an EC2 patient's optional free spinal assessment which is complimentary).
4.3 Payments for treatments in any amount are non-refundable unless otherwise stated in the Terms and Conditions.
5. BOOKINGS AND CANCELLATIONS
5.1 A Patient may only book or reschedule treatments for themselves via their personal Clinic booking facility at www.sayerclinics.com
5.2 Patients will be charged for a treatment where cancellation or the rescheduling of a session is not made online or notice of the same is not emailed to the Clinic at least 24 hours prior to the booked time.
5.3 Treatments are booked on a first-come first-served basis. A Patient may use the waiting list facility at www.sayerclinics.com in the event that his first choice session is unavailable. If a Patient joins the waiting list for a particular session and then books that session his booking will be subject to the Terms and Conditions in the usual way.
5.4 Sessions are valid for 12 months from and including the date of purchase and are non-refundable.
6. SAFETY & HYGIENE
6.1 In the interests of safety and hygiene, no food is permitted in the Clinic. With the exception of guide dogs no pets are permitted in the Clinic.
7. GENERAL
7.1 Patients are required to give written notice to the Company of any change of address or email address. Failing such notice, all communications will be assumed to have been received by the Patient within five days of mailing to the last address notified to the Company.
7.2 The Company is committed to keeping your data secure in accordance with GDPR and has updated terms and conditions in line with GDPR and may, if a Patient wishes, communicate with the Patient by electronic mail ("email"). By providing an email address to the Company the Patient consents to receiving email communications from the Company, including notices pursuant to the Terms and Conditions. The Patient also accepts the risk that email may not be a secure and confidential means of communication. The Company will not be liable for any loss or damage suffered as a result of communicating with a Patient by email.
7.3 Patients must at all times observe the Clinic guidelines which may be notified to them from time to time and are requested to comply with any reasonable directions which the management of the Clinic may issue to ensure the smooth operation of the Clinic for the convenience of all Patients.
7.4 Any marketing, educational or other materials of any nature whatsoever produced by the Company in connection with the Clinic and which are made available to Patients at the Clinic will at all times remain the property of the Company and will be subject to the Company's copyright.
VALID CONSENT – Sayer Clinics POLICY
1. Introduction
Patients have a legal and ethical right to determine what happens to their own bodies. This right is enshrined in the Mental Capacity Act 2005, the Human Rights Act 1998 and in common law. Valid consent to treatment is therefore absolutely central in all forms of healthcare.
Gaining valid consent protects staff from charges of assault and is also a matter of common courtesy between health professionals and patients.
This policy addresses the procedures and responsibilities for obtaining consent to examination or treatment.
2. Purpose
The aim of this document is to ensure that all staff are aware of the need to obtain valid consent for treatment, and that they obtain that valid consent in an appropriate way.
3. Definitions
Valid Consent: The patient’s agreement for a health professional to provide care or treatment. For consent to be valid, the patient must:
⦁ Have capacity to make the particular decision;
⦁ Have received sufficient information to make it; and
⦁ Not be acting under duress.
The giving of consent by a patient is not the same as the consent process. The consent process encompasses the whole process of information provision, discussion and decision-making.
Capacity: The patient’s ability make decisions. To do so they must:
⦁ understand the information about the decision to be made
⦁ be able to retain that information in their mind;
⦁ evaluate the information
Gillick Capacity: A child under the age of 16 is considered to be “Gillick” competent if they have sufficient understanding and intelligence to understand fully what is involved in the proposed intervention. In these circumstances, consent is valid and it is not necessary to obtain additional consent from a person with parental responsibility.
Intimate Treatment: treatment in close proximity to the genitals, anus or breasts.
Invasive Treatment: any treatment involving puncture of the skin (eg acupuncture or dry-needling), or any per rectum or per vaginal treatment.
Notes: the official record of treatment (otherwise known as the Case History)
4. Documentation
4.1 In general, oral consent to examination and/or treatment is sufficient, but must be given at the time of each intervention and must be documented in the patient’s case history. It is acceptable to use the abbreviation “VCO” (valid consent obtained) for this purpose. This abbreviation need only be applied once, in which case it will be deemed that consent has been obtained for each aspect of treatment
4.2 Written consent
4.1.1 It is not sufficient to obtain written consent at the commencement of an appointment. Consent must be given contemporaneously with the procedures concerned.
4.1.2. Written consent is required for invasive procedures unless a patient is physically unable to sign. For PR and PV procedures, patients should be given 24 hours to consider the treatment before proceeding.
4.1.3. Patients may, if they wish, withdraw consent after they have signed a form: the signature is evidence of the process of consent giving, not a binding contract.
4.3 Waiver of Consent
4.3.1. A patient may opt not to be warned of the risks and benefits, or to receive other information about their treatment. If so, this must be clearly and explicitly documented in their notes at the appointment when the decision is first made.
4.3.2. It must be confirmed at the outset of each subsequent appointment that this continues to be their choice, and the abbreviation “WOC” (Waiver of Consent) must be used to record this.
4.3.3. A waiver of consent can be withdrawn at any time, including within an appointment.
5. Capacity
5.1 There is a presumption that patients who are 16 or over have the mental capacity to make decisions for themselves unless this is assessed to be otherwise at the time.
5.2 Children under the age of 13 might have capacity to give valid consent (“Gillick Capacity”), but this will be the exception, not the rule. Practitioners should exercise great care in making this decision; normally parental consent will be required.
5.3 Staff must never assume that a patient lacks capacity simply because they are suffering from a mental disorder.
5.4 Capacity might vary according to the patient's mental condition, their medication or other factors, and must be assessed in every case in relation to the particular decision being made.
5.5 Where an adult patient lacks the mental capacity (either temporarily or permanently) to give or withhold consent for themselves, only an attorney appointed under a Lasting Power of Attorney by the patient or a court appointed Deputy may give consent or refuse treatment on their behalf if authorised to do so. However, treatment may be provided by clinicians in the patient’s best interests provided the patient has not made a valid and applicable Advance Decision refusing the specified treatment.
6. Consent
6.1 Valid consent applies only to the treatments discussed with the patient, and only at the time of that discussion.
6.2 While patients between the ages of 16 and 18 are likely to be able to give consent to treatment, if they refuse then a person with parental responsibility may override that decision. However, if the young person agrees to treatment, the parent may not refuse it.
6.3 Consent can be withdrawn at any time.
6.4 A patient with capacity may refuse treatment even if the practitioner deems it would be in their best interest to proceed.
6.5 Refusal to consent should be documented in the patient’s notes.
6.6 Patients are not required to justify their refusal to accept examination or treatment.
7. Confidentiality
7.1. Practitioners have a duty of confidentiality to patients who have “Gillick capacity” and to patients between the ages of 16 and 18.
7.2. It is good practice to involve the child's family in the decision making process provided the Gillick competent child consents to their involvement. Where a child is seen alone, efforts should be made to persuade the child that his or her parents should be informed except in circumstances where it is clearly not in the child’s best interest to do so.
7.3. Healthcare professionals must however respect the views of the Gillick competent child in the event that they do not wish for their parents to be involved.
7.4. When a patient between under 18 attends treatment alone, their case may not be discussed with anyone, including parents, without the patient’s consent. This consent can be oral or written, but must be documented in the notes.
8. Responsibilities
All practitioners carrying out examination or treatment are responsible for ensuring that valid consent is obtained; it is they who will be held responsible in law if this is challenged later.
9. Consent Process
9.1 In most cases the practitioner may initiate a procedure immediately after discussing it with the patient. For example, during an ongoing episode of care a practitioner might suggest a manipulative technique and explain how it might help the patient’s condition and whether there are any significant risks. If the patient is willing for the technique to be used, they will then give their consent and the procedure can go ahead immediately. In most such cases, consent will be given orally.
9.2 If a proposed procedure is invasive written consent will be required, and the patient must be given sufficient time to absorb the necessary information.
10. Provision of Sufficient Information
Before patients can come to a decision about treatment, they need sufficient information about their condition and about possible treatments, including risks and benefits (including the risks/benefits of doing nothing). Practitioners must ensure that they provide patients with sufficient information to enable them to make an informed judgment on whether to give or withhold consent. They must inform the patient of any significant, unavoidable or frequently occurring risks. Risks and benefits can be expressed in whichever way is felt best to facilitate patient understanding, but should not be expressed in a way designed to unreasonably influence their decision.
11. Emergencies
11.1. In emergency situations patients may not be able to consent to treatment. At such times clinicians can act in the patient’s best interests.
11.2. Some patients might have completed a Do Not Attempt Resuscitation (DNAR) form. Provided the practitioner has seen a copy of this form, with an original signature (not a photocopy or image) it is acceptable not to attempt CPR.
11.3. Any treatment (emergency or otherwise) made without consent but in the patient’s best interests must be clearly documented in their notes.
12. Parental Reponsibility
12.1 Only the biological parents of a child under 18, adoptive parents, foster parents or a guardian appointed by the court are deemed to have parental responsibility and can give consent to treatment. This responsibility may NOT be delegated to other family members, and is NOT assumed by step-parents.
12.2 Parental responsibility gives the right to give or refuse consent for a child under 16, and to override a decision to refuse treatment by a child between the ages of 16 and 18.
Only one person with parental responsibility is required to give or refuse consent for the consent to be valid.
Checklist
Capacity
Can the patient understand the information necessary to make this decision at this time?
Yes/No
Can the patient retain the information for long enough to make this decision?
Yes/No
Can the patient weigh up the information in order to make this decision? Yes/No
Can the patient communicate their decision? Yes/No
Consent
Has the patient been given sufficient information for them to make an informed decision?
Yes/No
Has the patient had sufficient time to process that information (especially if the recommended treatment is invasive)?
Yes/No
Is consent voluntary? Yes/No
Have the risks and benefits been explained adequately (including the option of doing nothing)?
Yes/No
Is written consent required (invasive procedures)? Yes/No
Is it necessary to renew consent (eg a long time has passed since risks and benefits were last explained)?
Yes/No
Has the patient been told that they may withdraw consent at any time? Yes/No
Is a chaperone necessary, and if so, has one been offered, and an appropriate person found?
Yes/No
Is valid consent documented in the notes? Yes/No