SCA practice case · Video consultation
“Can we talk privately? It’s not about a patient — it’s about Richard”
Video consultation
Adult patient
Someone else speaking
Hard
Professional & ethical dilemmasMental health & addiction
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
Bernadette (Bernie) Walsh — senior practice nurse (colleague) · 54 years · female
Setting
Video — the practice’s senior nurse asks for a private call with you (a GP partner) during the lunchtime break.
Past history
- Not a patient consultation — staff concern
- Senior practice nurse, 15 years at the practice; line-managed by Dr Richard Hale (senior partner)
Medication
- Not applicable
Allergies
Not applicable
Recent notes
Message from Bernie at 12:30: “Could we talk privately on video before 2pm? Not about a patient.” Today’s rota: Dr R Hale — minor surgery list 14:00–16:30 (6 patients), duty/on-call doctor 16:30–18:30. Significant event log (last week): warfarin 10 mg prescribed instead of 1 mg (Dr Hale) — intercepted by community pharmacist; no harm.
Reason for contact
Private video call with a colleague, 12:40.
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)
A concern that a colleague is impaired is a patient-safety issue first and a welfare issue at the same time. GMC Good medical practice (2024) requires doctors to act promptly when patient safety may be compromised — it overrides personal and professional loyalty — and to support colleagues. Deal with today first (a private, supportive conversation before the next clinical session; stand him down if impaired; get him home safely), recognise that doctors with alcohol problems and life crises are at increased risk of suicide, then escalate proportionately within the practice and to the responsible officer, while signposting confidential help (NHS Practitioner Health, LMC, occupational health). Never promise confidentiality you cannot keep, document facts, and protect the person who raised the concern.
The guidance behind it
Similar SCA cases
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