2. Good Medical Practice 2013
Domain 1: Knowledge, skills and
performance
Domain 2: Safety and quality
Domain 3: Communication, partnership
and teamwork
Domain 4: Maintaining trust
7. Introduction
Remember to introduce yourself!
Think about the physical situation
Be safe
Be non confrontational
Acknowledge anger if there and state openly your
intention to address it
Always be aware of your body language
Ideally get people to sit down….it is harder to stay
angry once you’ve sat down and someone is
listening to you
8. Receiving… Silence is fine
Listen
Demonstrate with body language (ie nodding) and minor
verbal ques that you are hearing what the person is
saying
Clarify things that you are not clear about
Understand that in a scenario with an angry patient /
relative then the listening is likely to be a prolonged
process and in a breaking bad news station likely to be
much shorter
Where necessary you must lead this with both open and
closed questions
9. Giving… You know the problem now
Address the concerns that the patient has
If appropriate, this is the time to raise your
agenda
Do not be judgmental
Do not express what you are saying as your
personal opinion
Be honest about the limits of your knowledge
At the end of the giving phase both you and the
other party should understand each others
position…
Remember “chunks and checks”
10. Agreement and Planning
Summarise the established nature of the
concern
Establish a plan of action to address this
Be aware that in frankly confrontational
situations this might involve you dictating a
plan of action….if this is the case involve
senior support early and document this fact
11. Confirming
This is the time to summarise and confirm
Involve the other party in this to be sure
they understand
If appropriate establish what happens next
and an appropriate time frame
Ask if there are any outstanding concerns
that you can address
12. Tomorrow
We have examples of 4 scenarios
The purpose of our practice tomorrow is not to
assess your knowledge, it is to assess your
communication
Without familiarising yourself with the
background, no matter how good a
communicator you are you won’t do yourself
justice
