Who can sign NHS consent form 2
Only a person with parental responsibility can sign a child consent form. Being a relative, a step-parent or the adult who brought the child to hospital is not enough on its own.
- The child's mother, automatically
- The father, if married to the mother at birth or named on the birth certificate after December 2003
- A legal guardian, special guardian or adoptive parent
- A local authority holding a care order, or a person named in a child arrangements order
Record who signed and their relationship to the child. This mirrors the evidence expected on a child travel consent form when authority to act is questioned.
Gillick competence and when form 2 is not needed
A child under 16 who understands the proposed treatment fully, and can weigh up the decision, may be Gillick competent. If so, they consent themselves and form 1 is used instead.
Competence is judged for the specific decision at hand, not awarded permanently. A young person may be competent to agree to a vaccination yet not to complex surgery.
Involving the child in the decision
Form 2 includes space for the child's own agreement. Even where they cannot legally consent, children should be told what will happen in language they understand.
Recording the child's assent shows that their views were taken seriously. Where a child objects strongly, the disagreement should be documented and discussed before proceeding.
Disagreement between parents
Consent from one person with parental responsibility is normally sufficient. For a small group of decisions, courts expect agreement between everyone holding responsibility.
- Non-therapeutic circumcision
- Immunisation where one parent objects
- Contested decisions about withdrawing life-sustaining treatment
Where parents cannot agree on such a decision, treatment should be deferred, unless it is an emergency, until legal advice or a court ruling is obtained.
Child consent across tier-1 countries
The parental agreement principle is consistent internationally, but the paperwork and age thresholds vary by jurisdiction.
United Kingdom
NHS trusts use form 2 with the Children Act 1989 defining parental responsibility, and Gillick competence allowing capable under-16s to consent themselves.
United States
Parents or legal guardians sign facility consent documents, with state mature-minor statutes covering areas such as reproductive and mental health care.
Canada, Australia and New Zealand
Canadian provinces apply a capacity-based mature-minor standard, Australia follows Marion's Case, and New Zealand allows those aged 16 and over to consent to most treatment themselves.
Emergencies and unaccompanied children
If a child needs urgent treatment and no one with parental responsibility is contactable, clinicians may act in the child's best interests without a signed form. Document the attempts made to reach a parent.
For planned care where a grandparent or carer attends, ask the parent to provide written authorisation in advance. A medical consent form for a minor can cover routine care while a parent is away.