Integrated consultation timings with RCA mark scheme

RCA changes applicable to the 30 September 2021 submission and onwards

• Breast lumps (apart from those associated with the postnatal period) will no longer be considered for the mandatory criteria of maternal and reproductive health

• Clinical examination will no longer be a mandatory criterion

• Safety-netting will need to be ‘appropriate’ and ‘realistic’

• All submissions will be extended from 10 minutes to 12 minutes

• The marking descriptors will be reviewed to ensure that they are still appropriate and if necessary, amendments will be proposed

RCA Mark Scheme

RCA Mark Scheme from RCGP Handbook

Questions that encourage ‘rich scoring’ opportunities

DG & Ex

CM

IPS

How did it all begin?
Did you have any thoughts on what is causing this?
What made you attend?
What concerns you the most?
What were you hoping to achieve today?
How does it affect your everyday home or work?
How are you coping with all of this?
Does it stop you from doing anything?

I was asking you XYZ to rule out…

Like you, I agree that it could be X, but we also need to consider…

I had thought about ****** but as your ****** is clear/not painful this is unlikely….

Given the diagnosis, do you any ideas on moving forward and treatment?

We covered a lot of information today, was there something, in particular, you wanted me to go over again in case I had not made it clear?

Examples of RCA cases in Obstetrics and Gynaecology

Abbreviations

ICE Ideas, concerns, expectations of the patient
PSO Psycho-social-occupational context
History taking Current symptoms, previous episodes, PMHx, drugs/allergies, FHx, smoking/alcohol/illegal drugs)