consultation skills

describe consent and capacity as a legal requirement

• consent and capacity are a legal requirement

• the mental capacity act 2005 and case law such as Montgomery v Lanarkshire (2015) establish that healthcare professionals must ensure patients are informed, capable and free to make decisions

describe consent and capacity in terms of patient safety and ethical practice

• obtaining valid consent protects patients from harm and respects their autonomy

• assessing capacity ensures decisions are made by those who can understand the information and make an informed choice

define consent

voluntary, informed and ongoing agreement of a patient to receive a treatment, intervention or care - it must be specific to the procedure and given by someone with capacity

define capacity

• the patient’s ability to make a decision about their care or treatment at the time it is need - a patient has capacity if they can:

  • understand information relevant to the decision

  • retain that information long enough to make a choice

  • weigh the information to make an informed decision

  • communicate their decision

describe the mental capacity act (2005)

• presumes adults have capacity unless proven otherwise

• decisions must be made in the person’s best interests if they lack capacity

• supports use of the least restrictive option

• requires documentation of capacity assessments

what is Gillick competence?

a legal principle used in the UK to decide whether a child (under 16) can consent to their own medical treatment - without parental knowledge or permission - if they have enough understanding and intelligence to fully comprehend what is being proposed

• fraser guidelines are a subset of Gillick that applies specifically to contraceptive advice

what are the five key principles of the MCA 2005?

• presumption of capacity

• support to make decisions

• unwise decisions do not mean lack of capacity

• best interests

• least restrictive option

describe the seven components of the pendleton framework

• define the reason for the patient’s attendance

• consider other problems the patient may have

• choose appropriate action for each problem with the patient

• achieve sa shared understanding of the problems

• involve the patient in management and encourage responsibility

• use time and resources appropriately

• establish or maintain a relationship with the patient

describe the calgary-cambride consultation guide

• initiating the session

• gathering information

• physical examination

• explanation and planning

• closing the session

describe what is meant by patient-centred care

providing care that is respectful of and responsibe to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions

describe the ICE mnemonic tool

• I - ideas - patient ideas, thoughts and beliefs regarding the cause

• C - concerns - patient concerns and worries regaring each problem

• E - expectations - patient expectations and goals regarding what help and outcome is expected for each problem

describe the TED mnemonic tool

• T - tell

• E - explain

• D - describe

describe the LICEF acronym

• L - lifestyle - how the patient’s condition or medication impacts their day to day life

• I - ideas - what can the patient tell you about their medicine or health problem?

• C - concerns - sometimes a patient may have concerns that you have not considered

• E - expectations - what does the patient think the outcome will be

• F - feeings - how does the patient feel about what is happening to them