Safety Netting between consultations
Patient comments need adding to C and reupload to YT
The complexity of the case means there's much to manage for the GP.
It's a bit too long for an infection, but a bit too short for an Urgent Suspected Cancer Referral. There's no other obvious symptoms that pushes this into one category or another- no proof of infection of other Cruise Passengers and no PR bleeding, weight loss or loss of appetite to support a gut instinct about something serious.
Throw in the patient's concerns about Diverticulitis and the impact of a fluid-losing state on her medications and you've got a typically complex GP case.
Gut instinct should be making us think of the possibility of a cancer in a patient of this age (eligible for Shingles Vaccination) who experiences a persisting change in bowel habit, and there's various approaches to discussing Safety-Netting within the consultation;
Neighbour's Consultation Model (1987) describes the following checkpoints:
- Connecting
- Summarising
- Handing Over
- Safety-Netting (what I expect to happen if I'm right, what would indicate that we need to review)
- Housekeeping
There should be systems for Safety-Netting between consultations, in the event that continuity of care is lost or if the GP is, for some reason, not there to follow the patient up. Sending yourself a task on your system doesn't account for what happens if you suddenly aren't available, unless your Practice identifies medium-term absences and triggers a review of open Tasks.
Think to yourself: what happens if I'm not here in three weeks to follow this lady up? The system can enable safety for patient care to avoid being contingent on one individual healthcare professional.
What's up with my Gut? is a patient-facing resource with pathways for professionals to address the issues covered by this case and more, one for Adults and their likely diagnoses, one for Child diagnoses.