Lesson 2.5: Safety Netting, Follow-Up, and Time Management
The final minute of a station is where safety-netting, follow-up, and a clean close happen. These are small in time but high in marks — and the first to disappear when candidates run short.
Safety Netting — Specific, Not Vague
| Example | Why It Fails / Works | |
|---|---|---|
| Too vague | "Come back if things get worse." | Patient does not know what 'worse' means, what to watch for, or where to go. |
| Specific | "If you develop sudden severe chest pain, breathlessness at rest, or your calf becomes much more swollen and painful — go straight to A&E or call 999." | Patient knows exactly what to watch for and exactly what to do. |
Good safety netting answers: What should the patient watch for? Why does it matter? What should they do and when?
Follow-Up Timing
| Condition / Situation | Recommended Follow-Up |
|---|---|
| Hypothyroidism (new medication) | 3 months |
| Parkinson's disease | 3–6 months |
| Hypertension (new medication) | 4 weeks |
| Depression (under 30 years) | 1 week |
| Depression (over 30 years) | 2 weeks |
| Postpartum depression | 1 week |
| Acute otitis media | Return if no better after 4 days |
| Suspected safeguarding / abuse concern | 1–2 weeks |
Always offer at the end: a leaflet, the NHS website link, or a written summary.
The 8-Minute Clock
| Time | Phase | Priority Actions |
|---|---|---|
| 0:00 – 0:30 | Opening | Introduce, confirm identity and GMC number, open question. |
| 0:30 – 4:00 | History | HPC (SOCRATES or FODPARA), differential screening, background history (PMAFTOSA). Examination if required. ICE throughout. |
| 4:00 – 7:00 | Management | Tell-Ask-Explain-Check. Management plan. Shared decision-making. |
| 7:00 – 8:00 | Closing | Specific safety-net. Follow-up plan. Check for remaining concerns. Close warmly. |
Priority when time runs short: safety-netting first, then the key management plan, then any remaining history gaps. Never finish a station without safety-netting.
Closing the Consultation
- Summarise: "Just to go over what we've discussed today..."
- Check for remaining concerns: "Is there anything else on your mind that we haven't covered?"
- Thank and close: "Thank you for coming in. If anything changes before we next speak, please don't hesitate to get in touch."