Emergency Hormonal Contraception requests are a common scenario in General Practice, although they are available from alternative providers depending on the UK location, and as such the skills required are able to be assessed in examinations. 

Not all EHC Requests will have a hidden agenda, but clearly in a teenage patient there may be safeguarding concerns to take into account. The role of the GP is the ensure the request is dealt with adequately with attention towards effective longer term contraception and sexual health once it's clear that the relationship is appropriate, free from coercion or a safeguarding concern. 

The GP here makes a summarising statement to indicate that she understands the nature of the relationship which doesn't demonstrate significant safeguarding issues. This statement gives the patient a sense of safety and security to discuss the wider issues. Without this communication from the GP, the teenager would have remained in a nervous and apprehensive state, embarrassed to be discussing issues of a sexual nature with an adult she's not met before. Notice the non-verbal elements of the patient whose body posture and facial expression changes, to the point that she verbally expresses that she's happy to come and see this GP again about onward contraception needs, before they discuss the necessary topic of Sexually Transmitted Infections.

Each of these aspects of care arrive in incremental stages, each one building on the stage before:

Validation of a consensual sexual relationship and that EHC is effective and available

Clear Prescribing instructions for the preferred method of EHC

Long-term contraception requirements

Sexual Health Screening through the practice or online, whether full screen or just Chlamydia & Gonorrhoea

Checking the patient's understanding of the management plan

It would be easy to treat such encounters as transactional, customer-oriented and simplistic, but highest quality General Practice is nuanced, complex and involves attention towards maintaining long-term relationships with patients!

Fraser guidelines information is contained within the RCGP Safeguarding Toolkit where the GP is satisfied that

• the young person cannot be persuaded to inform their parents or carers that they are seeking this advice or treatment (or to allow the practitioner to inform their parents or carers)
• the young person understands the advice being given
• the young person's physical or mental health or both are likely to suffer unless they receive the advice or treatment
• it is in the young person's best interests to receive the advice, treatment or both without their parents' or carers' consent
• the young person is very likely to continue having sex with or without contraceptive treatment.

Helpful patient-facing contraception resources include the UCL website Contraception Choices, backed by the College of Sexual & Reproductive Healthcare (CoSRH)