Doctor’s Passport

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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
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Difficult conversations, concerns and shared decisions

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Synopsis

Respond constructively to distress, disagreement, complaints and unwelcome information while protecting safety, preserving trust and reaching a clear shared or professionally justified plan.

  • Prepare privacy, time and support where possible, then identify who is present, what may be discussed and whether the patient wants another person involved.
  • Name and acknowledge emotion without guessing its cause; allow a pause, listen to the concern and summarise it before defending a decision or adding more information.
  • Separate the person's goals from the requested intervention: explore why the request matters, assess risk and offer reasonable routes toward the underlying goal.

Reasoning priorities

01
Concern mapping

Identify the event, impact, desired outcome and unanswered question.

Reflect the account back and ask which issue matters most now; do not assume that a request for treatment is the whole concern.

Worked reasoning

Worked caseRespond after a delayed abnormal result

A fictional scenario supplies a delayed abnormal result, a patient who is angry and frightened, no current physiological instability, and confirmation that urgent follow-up is now being arranged.

  1. Check immediate clinical safety and privacy, introduce your role, acknowledge that the delay and uncertainty have been distressing, and invite the patient to describe the impact without interruption.
  2. State the confirmed facts in a clear timeline, distinguish what is not yet known about consequence, apologise for the delay and avoid blaming an individual before investigation.
  3. Explain the urgent follow-up now arranged, what it aims to determine, who owns the referral and how the patient will receive updates; address current symptoms and questions.
  4. Describe the route for organisational review or complaint support and record the concern and conversation, while ensuring the complaint does not reduce ongoing care.
  5. Verify through teach-back that the patient knows the immediate plan and contact route, then seek supervisor feedback on candour, factual accuracy, emotional response and concrete closure.
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Sources and review status4 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Apply principles in context and verify current guidance when a decision affects care. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom