Consultation Models: Neighbour

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Consultation ModelsNeighbour

• Helen Locking
• VTS
• January 2005

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Consultation Models

• Roger Neighbour who is he?
• What did he do?
• Why do we need to know about him?
• What is it?
• Case Study

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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

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What did he do?

• The Inner Consultation - 1987
• The Inner Apprentice - 1992

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Why do we need to know?

• MRCGP Exam
• Easy Model to adopt adapt.
• Encompasses both Patient and Dr wellbeing

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Neighbours Consultation Model
4. Safety netting
3. Handing Over
5. House keeping
2. Summarising
1. Connecting
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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

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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?

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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.

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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 doesnt come back?
• How will I know if I am wrong?
• What will I do then?
• What to say to the patient

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5. House Keeping

• Long term
• In between Patients
• During Consultations

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Neighbours Consultation Model
4. Safety netting
3. Handing Over
5. House keeping
2. Summarising
1. Connecting