1. Consultation Models: Neighbour Helen Locking VTS January 2005

2. Consultation Models Roger Neighbour – who is he? Roger Neighbour – who is he? What did he do? What did he do? Why do we need to know about him? Why do we need to know about him? What is it? What is it? Case Study Case Study

3. Roger Neighbour GP Principal & Trainer in Hertfordshire until 2003 Course Organiser of Watford VTS Inaugural Fellow of Assoc of Course Organisers MRCGP Examiner President of RCGP 2003

4. What did he do? “The Inner Consultation” - 1987 “The Inner Apprentice” - 1992

5. Why do we need to know? MRCGP Exam Easy Model to adopt & adapt. Encompasses both Patient and Dr wellbeing

6. Neighbour’s Consultation Model 1. Connecting 2. Summarising 3. Handing Over 4. Safety netting 5. House keeping

7. 1. Connecting Rapport Gambits & Curtain Raisers Minimal cues What is said & not said Eye movements 3 cardinal mental thought processes Speech censoring Internal Speech Acceptance Set

8. 2. Summarising What information do we need? I, C, E. Feelings Effects of symptoms, treatment etc When should you elicit that information? What signals can the patient give to suggest that more information could be elicited? How should we elicit the information?

9. 3.Handing Over Negotiating Give the patient options Influencing in my opinion… Use questions instead of statements Reframing Shepherding Pre-empting My friend John… Gift Wrapping Chunk & Check How to give instructions – rule of 3.

10. 4. Safety Netting “General Practice is the Art of Managing Uncertainty” If I am right, what do I expect to happen? Worst case scenario Instructions to patient F/U - What if patient doesn’t come back? How will I know if I am wrong? What will I do then? What to say to the patient

11. 5. House Keeping Long term In between Patients During Consultations

12. Neighbour’s Consultation Model 1. Connecting 2. Summarising 3. Handing Over 4. Safety netting 5. House keeping