SCA practice case · Telephone consultation
“My son read me the letter — it says my sugar is high. Is it serious?”
Telephone consultation
Adult patient
Typical
Ethnicity, culture & diversityLong-term conditions & cancerInvestigations & results
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
Tesfay Gebremedhin · 46 years · male
Setting
Telephone — three-way call with a professional Tigrinya interpreter booked by the practice.
Past history
- No significant past history
- Registered 2023; preferred language Tigrinya — professional interpreter required (flagged)
- Night-shift warehouse worker
Medication
- No regular medication
Allergies
No known drug allergies
Recent notes
NHS Health Check with healthcare assistant 6 days ago: BP 142/88, BMI 29.5, waist 102 cm. Bloods: HbA1c 88 mmol/mol; random glucose 16.2 mmol/L; eGFR >90; ACR 4.2 mg/mmol; TC 6.1, LDL 4.0, HDL 0.9, TG 2.8 mmol/L; ALT 32; TSH 1.8. Results letter sent (English). Three-way interpreter call booked: Tigrinya interpreter Selam, ID 4471.
Reason for contact
Telephone appointment with interpreter to discuss blood 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)
With a professional interpreter on a three-way telephone call, the doctor’s job is to make the interpreting easy: brief the interpreter, check the patient is comfortable and private, speak directly to the patient in short chunks, avoid jargon and check understanding with teach-back — a polite “yes, yes” is not understanding. Clinically, HbA1c 88 with osmotic symptoms is type 2 diabetes in a 46-year-old with central obesity, but ketones and red flags still need checking. NICE NG28 (2026) now recommends modified-release metformin plus an SGLT2 inhibitor first-line for most adults, so sick-day rules, ketone awareness and caution during prolonged religious fasting matter. Find the fear behind “is it serious?” and give honest, specific reassurance; then fix the communication route so results never again reach him through his child.
The guidance behind it
Similar SCA cases
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