Consent PLUS: improving the consent process in elective lower limb arthroplasty Abertawe Bro Morgannwg University Health Board

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.

Contact information

For more information about this project, please contact Dr Paul YF Lee, BOA Clinical Leadership Fellow, Princess of Wales Hospital, Bridgend.