SCA practice case · Video consultation
“I keep getting letters about the kids’ jabs — I’m not anti-vaccine, it’s just… complicated”
Video consultation
Child patient
Someone else speaking
Typical
Children & young peopleHealth 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
Isla Morgan, 20 months, and Leo Morgan, 4 years 3 months (video with their mother, Kezia Morgan) · Isla 1 year 8 months · female (index record); Leo 4 years 3 months · male
Setting
Video consultation with a mother about her two children’s overdue vaccinations.
Past history
- Isla: born at term; 8-week vaccines followed by fever 39.4 °C — out-of-hours attendance, diagnosis “post-vaccine fever”, no treatment needed
- Leo: well; no significant history
- Neither child has had chickenpox (per records)
Medication
- None for either child
Allergies
NKDA (both)
Recent notes
Immunisation record — Isla: 8, 12 and 16 week vaccines given; 12-month vaccines (incl. MMRV dose 1) and 18-month vaccines (incl. MMRV dose 2) NOT given; 3 recall letters. Leo: all primary and 1-year vaccines given (MMR dose 1 at 12 months); pre-school booster (4-in-1 and MMR dose 2) NOT given. Practice nurse note 14 months ago (Leo): “Mum declined pre-school booster today. Discussed risks.” UKHSA letter to nurseries last week: measles cases in the area.
Reason for contact
Video consultation booked by mother: “want to discuss the kids’ vaccines”.
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)
Behind most missed vaccinations are practical barriers and specific worries, not refusal. Explore without judgement, using open questions, and ask about past experiences of care. A fever after the 8-week vaccines is common (especially with MenB) and is not a contraindication; true contraindications are rare (confirmed anaphylaxis to a previous dose or component; live vaccines in significant immunosuppression or pregnancy). Catch-up principles: never restart a course; give missed doses as soon as possible; several vaccines can be given at the same visit. Since 1 January 2026, MMRV has replaced MMR in the routine schedule at 12 and 18 months for children born on or after 1 January 2025; UKHSA allows MMR to be offered where a parent prefers it. Leo needs his pre-school booster and second MMR-containing dose. Make access easy (combined, out-of-hours appointments) and document the parent’s decisions.
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.