SCA consultation practice for structure, ICE and safety-netting

A structure that fits inside twelve minutes

Consultation models — Calgary–Cambridge, Neighbour, Pendleton and others — are not there to be recited. A flexible structure can help you gather what matters, respond to the patient and preserve time for explanation, shared planning and safety-netting. The RCGP does not prescribe a preferred consultation model, so choose a structure you can adapt rather than a script you must remember.

• A consultation structure practised until it no longer requires conscious thought
• Eliciting ideas, concerns and expectations as conversation, not as an interrogation
• Explaining in plain language, then checking what the patient actually took away
• Safety-netting that names the symptom, the action, and the timeframe

What separates a good consultation from a safe-looking one

Use these questions to review what was observable in the consultation, rather than what you intended to do. If local policy and consent allow recording, a replay can make that review more concrete.

• You asked about concerns — but did you respond to the answer, or note it and move on?
• You explained the diagnosis — but would the patient repeat it in their own words?
• You agreed a plan — or did you present one and pause briefly for objection?
• You safety-netted — but did you say which symptom, to whom, and within what timeframe?
• You finished on time — or did you finish because the time finished you?

• Rehearse these behaviours under time
• How "relating to others" is assessed

Consultation behaviours by clinical context

Some contexts expose particular behaviours: paediatrics tests safety-netting, mental health tests risk within rapport.

• Communication skills
• Time management
• Consultation models
• Ethics and professionalism