SCA practice case · Telephone consultation
“The positive FIT result”
Telephone consultation
Adult patient
Typical
Long-term conditions & cancerInvestigations & resultsHealth 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
Trevor Bailey · 61-year-old man
Setting
Results call-back — booked by GP after lab report.
Past history
- Hypertension
- Haemorrhoids (diagnosed in his 40s)
- Family history: brother died of bowel cancer aged 66
Medication
- Antihypertensive on repeat
Allergies
No known drug allergies
Recent notes
Nurse appointment 3 weeks ago: 8 weeks of looser, more frequent stools and vague lower abdominal discomfort. FIT 47 µg Hb/g faeces (referral threshold 10). FBC: Hb 128 g/L; ferritin 18 µg/L. Two NHS bowel-screening kits not returned. Results not yet given to the patient.
Reason for contact
Telephone call-back booked by the GP to discuss results.
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)
NICE NG12: FIT ≥10 µg Hb/g warrants a suspected cancer pathway (urgent) lower-GI referral. His weight loss and iron-deficiency anaemia are why FIT was offered (NICE HTG690) and add to the urgency — under current NG12 they lead to FIT rather than to referral on their own. The consultation skill is the reframe: the brother’s late diagnosis is the reason FOR the colonoscopy, not against it. Letting "it’s just piles" stand, or softening the urgency to spare his feelings, is how this station is failed.
The guidance behind it
Similar SCA cases
gpreasoning.uk is not affiliated with or endorsed by the RCGP. Our cases are original teaching material written for practice; none is an exam recall. For anything official about the SCA, check the RCGP SCA pages.