Consultation Skills

Systematically gathers and organises relevant and targeted information to address the needs of the patient and their problem(s).

Adopts a structured and informed approach to problem-solving, generating an appropriate differential diagnosis or relying on first principles where the presentation is undifferentiated, uncertain, or complex.

Data gathering

Systematically gathers information, using questions targeted to the problem, ensuring patient safety.

Makes effective use of existing information about the problem and the wider context.

Establishes the presence or absence of red flags.

Elicits relevant psychological and social information to place the patient’s problem(s) in context.

Making a diagnosis

Uses a structured and evidence-based approach to diagnostic reasoning.

Uses an understanding of probability based on prevalence, incidence, and natural history to aid decision-making.

Revises hypotheses as necessary in the light of additional information.

Addresses problems that present early and/or in an undifferentiated way by integrating all the available information to help generate a reasonable working hypothesis.

Demonstrates ethical awareness.

Shows ability to communicate in a person-centred way.

Demonstrates initiative and flexibility in using various consultation approaches in order to overcome any communication barriers and to reach a shared understanding with the patient.

Fitness to practise

Shows respect for patients, treating them fairly and without discrimination.

Takes ownership of decisions and with confidence, whilst being aware of own limitations.

Maintaining an ethical approach

Recognises cultural and personal differences in patients and/or colleagues.

Recognises that everyone has their own values and beliefs.

Acts non-judgmentally with equity and fairness.

Recognises and respects patient autonomy.

Acts with beneficence, and in the patient's best interests.

Shows awareness of medico-legal concepts, such as informed consent, mental capacity and best interests of the patient

Communication and consultation skills

Explores and clarifies the patient’s agenda, health beliefs and preferences.

Employs a range of communication skills, both verbal and non-verbal, including active listening skills.

Responds to important, significant cues (verbal and non-verbal). Uses language that is understandable and takes into consideration the needs and characteristics of the patient.

Uses a variety of communication techniques and materials to adapt explanations to the patient.

Uses the patient’s understanding, agenda, health beliefs and preferences to help tailor any explanation offered.

Works in partnership with the patient, negotiating a mutually acceptable plan which is clear and understandable.

Checks the patient’s understanding of the consultation including any agreed plans.

Demonstrates an empathic approach, including a willingness to help and care for the patient.

Working with colleagues

Works collaboratively, understanding the context within which different team members work, respecting their role, and valuing their opinions.

Shows respect for colleagues, treating them fairly and without discrimination.

Practising holistically, promoting health, and safeguarding

Recognises and acknowledges the impact of the problem on the patient, their family and/or carers.

Challenges assertively unhelpful health beliefs or behaviours, whilst remaining respectful and maintaining a continuing and productive relationship.

Recognises what matters to the patient and works collaboratively to enhance patient care.

Demonstrates the ability to formulate safe and appropriate management options which includes effective prioritisation, continuity and time and self-management.

Demonstrates commitment to providing optimum care in the short and long-term, whilst acknowledging the challenges.

Clinical management

Considers a “wait and see” approach where appropriate.

Encourages patient understanding, skills, and confidence with suggestions for self-care or lifestyle modification.

Applies local and/or national guidelines, including for drug and non-drug therapies.

Demonstrates principles of safe prescribing.

Refers when required, being mindful of available resources.

Suggests safe and sensible follow-up arrangements, as well as continuity of care.

Ensures care is coordinated within the practice team and/or with other services, where necessary.

Varies management options responsively according to the circumstances, priorities and preferences of all those involved.

Makes safe, evidence-based decisions that are defensible even when difficult.

Thinks flexibly around problems, generating functional solutions.

Medical complexity

Concurrently manages all health conditions, both short and long-term, acute and chronic, and multi-morbidity.

Prioritises management options based on an understanding of risk.

Manages uncertainty, including that experienced by the patient.

Adjusts care as necessary in the management of multiple problems, recognising the implications of multi-morbidity and polypharmacy.

Manages health improvement, rehabilitation, prevention, and health promotion.

Practising holistically, promoting health, and safeguarding

Engages support agencies targeted to the needs of the patient and/or their family and carers.

Recognises and responds to adult and child safeguarding concerns including ensuring information is shared and referrals are made when required.