GP Stage 3 Simulated Consultation - Healthcare Professional 1
You are working an on-call shift on the oncology ward, and Toby a HCA who you have worked with a number of times previously on your normal day ward has asked to speak to you about his father who is a patient on the oncology ward. You are aware that Mr Matthews (Toby’s father) had a CT scan this afternoon which showed advanced pancreatic cancer. Mr Matthews is presently sleeping.
You are Toby, a HCA (Healthcare Assistant) who works with the doctor on their normal day-shift. You have arranged a meeting with the doctor after your regular shift in order to discuss your father’s recent CT scan, which he had this afternoon. You have been worrying all afternoon about the result, and are very keen to know the outcome, and ask directly if the scan report is available. Unfortunately, your father is presently resting and you do not wish to wake him. You become very upset if the doctor suggests that they are unable to disclose the CT result to you, especially since you have worked together for the last few months.
On further probing, you report that your father is presently looking after your mother who is bedbound and very unwell. If your father were to also become unwell, you would likely have to take time away from work, and you fear that this would impact your ability to provide financially for your young family. Presently, you do not feel that the circumstances have affected your ability to complete your job safely.
This task highlights the importance of confidentiality, including amongst closely aligned colleagues. It requires a sensitive exploration of social circumstances as well as a discussion of possible clinical implications of family stressors. Candidates breaching confidentiality or offering responses which are not entirely factual (‘I am unsure if the scan results are back’) would likely be classified as ‘Unsuitable for GP Training'
Appropriate solutions include agreeing to re-discuss the matter when Toby's father is awake, with Toby also present (provided that this is also agreeable with Toby's father) as well as suggesting that Toby discuss the home and social challenges with his GP, Social Services and Citizens Advice Bureau given that additional support may well be available. A further 'open follow-up' policy with Toby would also be appropriate, allowing Toby the opportunity to speak with you again in the future should he have any concerns.