SCA practice case · Telephone consultation
Older adults: SCA practice case
A follow-up call after repeated falls at home
Telephone consultation
Adult patient
Someone else speaking
Hard
Health disadvantage & vulnerabilitiesUrgent & unscheduled careGender, reproductive & sexual health
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
Leanne Darby · 36-year-old woman
Setting
Telephone consultation following an urgent treatment centre visit; her partner answers her phone and stays on the line.
Past history
- Anxiety (2021)
- Irritable bowel syndrome
Medication
- Sertraline 50 mg once daily
- Mebeverine 135 mg three times daily as needed
Allergies
No known drug allergies
Recent notes
Urgent treatment centre letter yesterday: “fall at home, struck head on door frame, no loss of consciousness, bruised right forehead, tender right wrist, no bony tenderness; imaging not indicated. GP to review recurrent falls.” Previous attendances: bruised ribs after a fall on the stairs (8 months ago); sprained left wrist after tripping over the dog (4 months ago). Did not attend two booked appointments for anxiety review this year. Lives with partner Craig and son Alfie, 6. Patient has online record access enabled.
Reason for contact
GP follow-up call after an urgent treatment centre visit: “recurrent falls”.
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)
Repeated injuries explained as falls, a partner who answers for her, missed appointments and anxiety form a pattern that should prompt enquiry about domestic abuse. On the telephone with the partner listening, direct questions put her at risk; the skill is safe remote enquiry: speak to her directly, check who can hear, use closed yes/no questions, agree a code phrase, and create a routine-sounding medical reason to see her alone the same day. Never reveal the suspicion to the partner, protect the record from his access, and remember the child.
The guidance behind it
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