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					                                                           FURTHER DEVELOPMENT                                        COMPETENT                                                 EXCELLENT                                                        POSSIBLE QUESTIONS
MANAGING MEDICAL COMPLEXITY                                Manages health problems separately, without                Simultaneously manages the patient’s health               Accepts responsibility for co-ordinating the              What did you discuss with the patient re their
This competency is about aspects of care beyond            necessarily considering the implications of co-            problems, both acute and chronic.                         management of the patient’s acute and chronic             condition?
managing straightforward problems, including the           morbidity.                                                 Is able to tolerate uncertainty, including that           problems over time.                                       Patient specific questions
management of co-morbidity, uncertainty and risk,          Draws conclusions when it is appropriate to do so.         experience by the patient, where this is unavoidable.     Anticipates and uses strategies for managing
and the approach to health rather than just illness.       Appropriately prioritises management approaches,           Communicates risk effectively t patients and involves     uncertainty.
                                                                                                                                                                                                                                          How do you see the disease progressing over
                                                           based on an assessment of patient risk.                    them in its management to the appropriate degree.         Uses strategies such as monitoring outcomes               time?
                                                           Maintains a positive attitude to the patient’s health      Consistently encourages improvement and                   assessment and feedback to minimise the adverse
                                                                                                                      rehabilitation, where appropriate, recovery.              effects of risk.
                                                                                                                      Encourages the patient to participate in appropriate      Coordinates a team based approach to health
                                                                                                                      health promotion and disease prevention strategies.       promotion, prevention, cure, care and palliation and
PRIMARY CARE ADMINISTRATION AND IMT                        Demonstrates a rudimentary understanding of the            Uses the primary care organisational and IMT systems      Uses and modifies organisational and IMT systems to       Looking at the coding and diagnosing how
This competency is about the appropriate use of            organisation of primary care and the use of primary        routinely and appropriately in patient care.              facilitate:                                               could this have been improved?
primary care administration systems, effective             care computer systems.                                     Uses the computer during the consultation whilst           Clinical care to individuals and communities             Talk to me a bout practice alerts?
recordkeeping and information technology for the           Uses the computer record and online information            maintaining rapport with the patient.                      Clinical governance
benefit of patient care.                                   during the consultation                                    Produces records that are coherent and                     Practice administration.
                                                                                                                                                                                                                                          How confident are you that the notes reflect the
                                                           Routinely records and codes clinical contact in a          comprehensible, appropriately and securely sharing        Incorporates the computer record and online               patient?
                                                           timely manner and follows the record-keeping               these with others who have legitimate access to them.     information in the consultation to improve                How would you access NICE guidelines?
                                                           convention of the practice.                                                                                          communication with the patient                            How did you get the ….?X-ray result?
                                                                                                                                                                                Seeks to improve the quality and usefulness of the
                                                                                                                                                                                medical record e.g. through audit
WORKING WITH COLLEAGUES AND IN TEAMS                       Meets contractual obligations to be available for          Provides appropriate availability to colleagues           Anticipates situations that might interfere with          Who could you involve in this patients care?
This competency is working effectively with other          patient care.                                              Works co-operatively with the other members of the        availability and ensures that patient care is not         You go off sick……….what happens?
professionals to ensure patient care, including the        Appropriately utilises the roles and abilities of other    team, seeking their views, acknowledging their            compromised.                                              Is there a team forum?
sharing of information with colleagues.                    team members.                                              contribution and using their skills appropriately.
                                                           When requested to do so, appropriately provides            Communicates proactively with team members so that
                                                                                                                                                                                                                                          How do you ensure other people are aware of
                                                           information to others involved in the care of the          patient care is not compromised.                                                                                    your concerns and treatment plans?
                                                           patient.                                                   In relation to the circumstances, chose an appropriate    Encourages the contribution of colleagues and
                                                                                                                      mode of communication to share information with           contributes to the development of the team.
                                                                                                                      colleagues and uses it effectively.
COMMUNITY ORIENTATION                                      Identifies how the services of health care providers       Reconciles the health needs of individual patients and    Contributes to development and delivery of local          Patient relevant questions….(Why prescribe
This competency is about the management of the             and self-help groups can be used appropriately by          the health needs of the community in which they live      policy related to health.                                 ramipril?)
health and social care of the practice population and      patient and doctor.                                        in balance with available resources.                      Applies an understanding of the resources and the         What other resources??? Cardiologist
local community                                            Identifies the socioeconomic, geographic and cultural      Applies an understanding of these features to improve     financial and regulatory frameworks within which
                                                           features of the community that might affect health.        the care of patients and the health of the community.     primary care operates, to improve community
                                                                                                                                                                                                                                          What are the effects on the practice
                                                           Identifies the features of the doctor’s personal                                                                     healthcare.                                               population……….(resources, finances, PBC)
                                                           circumstances and workload that might affect health
                                                           care delivery
MAINTAINING AN ETHICAL APPROACH TO                         Observes the professional codes of practice, showing       Identifies and discusses ethical conflicts in clinical    Anticipates and avoids situations where personal and      Do you feel there was discrimination in this
PRACTICE                                                   awareness of his/her own values, attitudes and ethics      practice.                                                 professional interests might be brought into conflict.    case- Good or bad?
This competency is about practising ethically with         and how these might influence professional behaviour.                                                                Actively promotes equality of opportunity for patients    What are the patients’ rights in management
integrity and a respect for diversity                      Treats patients, colleagues and others equitably and       Recognises and takes action to address prejudice,         to access health care and for individuals to achieve
                                                           with respect for their beliefs, preferences ,dignity and   oppression and unfair discrimination within the self,     their potential.
                                                           rights.                                                    other individuals and within systems.                     Values diversity by harnessing differences between
                                                                                                                                                                                people for the benefit of practice and patients alike.
FITNESS TO PRACTICE                                        Understands and maintains awareness of the GMC             Observes the accepted cods of practise in order to        Encourages scrutiny and justifies professional            You find you have a lack of knowledge to deal
This competency is about the doctor’s awareness of         duties of a doctor.                                        minimise the risk of disciplinary action or litigation.   behaviour to colleagues.                                  with this case- how would you address this?
when his/her own performance, conduct or health, or        Attends to professional demands whilst showing             Achieves a balance between professional and personal      Anticipates situations that might damage the work’        Can you think of anyway your own health
that of others might put patients at risk and the action   awareness of the importance of addressing personal         demands that protects professional obligations and        life balance and seeks to minimise the adverse effects.
taken to protect patients                                  needs.                                                     preserves health.                                         Promotes an organisational culture in which the health
                                                                                                                                                                                                                                          would interfere with your performance as a
                                                           Attends to physical or mental illness or habit that        Proactive in taking steps to maintain personal health     of its members is valued and supported.                   doctor- How do you deal with this?
                                                           might interfere seriously with the competent delivery      Promptly, discreetly and impartially ascertains the       Provides positive support to colleagues who have          Tell me about an SEA you have been involved
                                                           of patient care.                                           facts of the case, takes advice from colleagues and, if   made mistakes or whose performance gives cause for        in?
                                                           Notifies when his/her own or a colleague’s                 appropriate, engages in a referral procedure.             concern.
                                                           performance, conduct or health might be putting            Where personal performance is an issue, seeks advice      Uses mechanisms to learn from performance issues
                                                           patients at risk.                                          and engages in remedial action.                           and to prevent them from occurring in the
                                                           Responds to complaints appropriately                                                                                 organisation.