SCA practice case · Telephone consultation
“Fifteen-minute visits”
Telephone consultation
Older adult patient
Someone else speaking
Hard
Older adultsHealth disadvantage & vulnerabilities
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Doris Whitmore · 89 years · female
Setting
Telephone — niece (LPA holder) calling about her housebound aunt.
Past history
- Hip fracture last year — housebound
- Weight loss reported by family
Medication
- Regular medicines in weekly blister pack
- Oral nutritional supplements
Allergies
NKDA
Recent notes
⚠ Private agency home care twice daily (15-minute visits). LPA (health and welfare, property and finance) held by niece Susan — registered. No GP contact since hip fracture.
Reason for contact
Telephone call-back to niece. “A few things weren’t right on Sunday — probably nothing.”
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
Untouched food and medication, unexplained weight loss, an untreated pressure sore and "all care given" logs that contradict the evidence = organisational neglect until proven otherwise — a Care Act safeguarding referral to the local authority, with Doris’s own view sought first, alongside same-day clinical assessment (a weeping sacral sore in a drowsy 89-year-old is today’s job, with sepsis in the differential). The hidden agenda is the caller’s guilt: she chose the cheap agency under a finance LPA and fears the referral accuses her — absolve it accurately, and the referral she’s been blocking happens. Doris’s own minimising and her terror of "a home" must be answered, not bypassed: safeguarding’s stated goal is keeping her safely at home.
The guidance behind it
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