5

Clinical management

This competency is about the recognition and management of common medical conditions in primary care.

Insufficient Evidence

From the available evidence, the doctor’s performance cannot be placed on a higher point of this developmental scale.

Needs Further Development

Recognises the presentation of common physical, psychological and social problems.

Competent

Utilises the natural history of common problems in developing management plans.

Excellent

Monitors the patient’s progress to identify quickly unexpected deviations from the anticipated path.

Responds to the problem by routinely suggesting intervention.

Considers simple therapy/expectant measures where appropriate.

Uses drug and non-drug methods in the treatment of the patient, appropriately using traditional and complementary medical approaches.

Uses appropriate but limited management options with little flexibility for the preferences of others.

Varies management options responsively according to the circumstances, priorities and preferences of those involved. 

Generates and offers justifiable approaches where specific guidelines are not available.

Makes appropriate prescribing decisions, routinely using important sources of information.

Routinely checks on drug interactions and side effects and shows awareness of national and local prescribing guidance.

Prescribes cost-effectively but is able to justify transgressions of this principle.

Performs up to, but does not exceed, the limits of their own competence.

Refers appropriately and co-ordinates care with other professionals in primary care and with other specialists.

Identifies and encourages the development of new resources where these are needed.

Ensures that continuity of care can be provided for the patient’s problem e.g. through adequate record keeping.

Provides continuity of care for the patient rather than just the problem, reviewing care at suitable intervals.

Contributes to an organisational infrastructure and professional culture that allows continuity of care to be facilitated and valued.

Responds rapidly and skilfully to emergencies.

Appropriately follows-up patients who have experienced a medical emergency, and their family.

Ensures that emergency care is co-ordinated within the practice team and integrated with the emergency services.