SCA practice case · Telephone consultation
Professional: SCA practice case
A telephone call from children’s social care
Telephone consultation
Child patient
Someone else speaking
Hard
Children & young peopleProfessional & ethical dilemmas
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
Kayden Marsh (caller: Dawn Achebe, duty social worker) · 6-year-old boy
Setting
Telephone consultation with a duty social worker who is asking about a six-year-old registered at the practice.
Past history
- Asthma since age 3
- Emergency department 8 months ago: scald to left hand (“pulled a cup of tea over”), health visitor informed
- Emergency department 3 months ago: forehead laceration, glued (“fell off the sofa”)
Medication
- Beclometasone 100 micrograms two puffs twice daily via spacer
- Salbutamol inhaler as needed
Allergies
No known drug allergies
Recent notes
Asthma review ’was not brought’ twice in the last 12 months; preventer inhaler last issued 7 months ago. Sister Lily (2): 12-month immunisations not given; health visitor entry 4 months ago: ’home cold, little food in the kitchen, early help offered and declined’. Mother Jade Marsh (27): depression, sertraline 100 mg, attends reviews; told you 5 months ago that Ryan ’gets handy when he’s had a drink’, declined referral, asked that he must not find out; termination of pregnancy 3 years ago. Mother’s partner Ryan Cole (31): alcohol dependence, declined referral; brought to the emergency department by police 12 months ago, intoxicated after a fight; treated for chlamydia last year. No consent to share recorded for any family member.
Reason for contact
Telephone call from the children’s social care duty social worker, who wants information for a strategy discussion at 2pm today. Reception have called back via the council switchboard and confirmed her identity.
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)
When children’s social care are making enquiries because a child may be suffering significant harm, the GP’s duty is to share relevant information promptly, and consent is not required. The examinable skill is proportionality: a clear, factual summary of what bears on the children’s safety, including information about the adults, without handing over four complete records or sexual and reproductive histories that have no bearing. The domestic abuse disclosure is the most valuable and most dangerous piece of information; share it and protect its source. Stay a colleague to an anxious, inexperienced social worker.
The guidance behind it
Similar SCA cases
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