Outpatient/Follow-up ConsultationWha

  1. WIPE (wash hands, introduce self, check patient details, explain the purpose of the consultation)
  2. 5 C’s
    1. Check
      1. Check how the patient is doing; their background understanding of the condition/treatment and why they need a consultation (NB this may involve taking a focused history from the patient, particularly if you have never met them before)
    2. Current Complaints/Problems
      1. Ask if the patient has any new/worsening/unresolved symptoms that are bothering them.  What is the biggest impact on daily life? etc
      2. NB it may be that some of these are nothing to do with the original condition (in which case, it may be an option to explore further or note them but focus only on the condition)
    3. Control
      1. What is the patient taking/doing for treatment?
      2. Check/explain any test results
      3. Explore then summarise how well condition is controlled
    4. Compliance
      1. Ask (non-judgmentally) whether the patient thinks they are fully compliant with management (particularly if these are lifestyle changes; it also could be reasonably to take a detailed social history to explore the reasons behind poor compliance)
    5. Complications/Events
      1. Ask specifically about potential complications the patient may not have noticed and should be wary of
      2. Remind them of the risk of complications in context with previous points (e.g. poor compliance)
  3. Summarise the current situation
  4. 4 A’s
    1. Advise
      1. Make a plan together with the patient as to what should happen next
    2. Agree
      1. NB it is a good idea to summarise the consultation at this point too
    3. Assist
      1. Offer any help where appropriate, including input from other members of the team e.g. specialist nurses/services, INFORMATION sheets etc
    4. Arrange follow up

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