• Led by Abertawe Bro Morgannwg University Health Board, in partnership with the Royal College of Surgeons of Edinburgh.
  • Consent initiative tested with patients undergoing elective hip and knee replacement at Princess of Wales Hospital, Bridgend, with the aim of improving patient understanding of the risks of surgery and its implications.
  • Introduced a web-based educational checkpoint approach that enhances the consent process by empowering patients and their families to make informed decisions.
  • Project ran from September 2016 to November 2017.

Despite signing consent forms, many of the 160,000 patients undergoing hip and knee replacements in England and Wales each year do not remember or fully understand the risks of their surgery. 

Consent PLUS is an innovative solution to this problem. It is an easy-to-use, web-based programme which introduces a documented checkpoint to the consent process. It enables bite-sized information to be given to patients and their families, and facilitates dialogue between doctors and patients. It also generates hard-copy documents that demonstrate patients’ knowledge and understanding of the risks – enabling truly informed consent. 

The approach has been implemented with all patients undergoing elective hip and knee replacement at Princess of Wales Hospital in Bridgend, and has also been accessed by other hospitals across the UK.

More than 1,000 patients completed the Consent PLUS online system during the 12-month project period. Of those, 98% were satisfied with the system’s quality of service and the information given. It increased users’ self-rated knowledge by 29% and produced supportive documentation for all users. It produced an efficiency saving of around £100,000 over the 12 months.

Consent PLUS is not meant to replace the current legal consent system, but to enhance the consent process by empowering patients and their families to make informed decisions – a key point which needed to be explained to policy makers and surgeons.

Consent PLUS continues to be implemented in other orthopaedic units, and users in other countries have also accessed the service. The team is now looking to have the system accredited via the British Orthopaedics Association.


Valerie Louvain Francis

I attended an Assessment/ecg appointment at the Princess of Wales Hospital, Bridgend, at 11 am on 2nd February, 2017. I found it to be superbly done by Staff Nurse Sara (apology - I was not really aware of, or needed, her surname because she was such a caring person) with courtesy and consideration for any points that needed explanation on personal issues. It was very informative on the personal points which I had concerns over and I am very glad that I attended, and would recommend attendance to everyone who may be on the list for hip replacement.

Rebecca Clegg

Hi Valerie

Pleased to hear that you have a positive experience.

Kind regards

peter sanigar

I Attended the pre assessment clinic at the Princess of Wales Hospital , It was well organised , every staff member was approachable and friendly which set the scene for my appointment it went to time and I did not have to wait long .Well done to every professional from Consultant ,Doctor and the nursing Team.

Rebecca Clegg

Hi Peter

Thanks for sharing your positive experience.

Kind regards

Sherrill Jones

I have been given the web address to visit consentplus.com after I have been placed on the waiting list for hip replacement. By the time I left the hospital I have forgotten most of the stuff the surgeon told me about the surgery. It was great that when I visited the site with my son later that week it reminded me what it is all about.

Great work!

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