csa_course_case_housing_report.pdf

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Contact us: [email protected] visit us www.csaprep.co.uk CSA course case Housing report - CSA prep 2011

CSA course case CANDIDATES BRIEF

Patient medical records Name: Andrew Dobbs, (24 year old)

Past medical history: Schizophrenia (5 years ago)

Drug history: Olanzapine

Consultation (2 weeks ago) Practice manager: Patient has discussed the need for a report. Has paid practice 90 fee. Has booked appointment with doctor to discuss matters further

Consultation (6 months ago) Doctor - QoF Mental Health Review: Patient is stable. Not taken medications for 2 years. Has been discharged from the services 3 years ago and is on Job seekers allowance as he has been deemed fit for work. Denies hearing voices or low mood. No other history noted. Recently participated in marathon to raise money for charity





CSA course case Housing report ACTORS BRIEF You are Andrew Dobbs, 24 year old and currently unemployed

Approach: You attend casually dressed, clean shaven and presentable. You are unsure that the doctor will help you and will try to convince them anyway possible

Opening statement: Doctor you have gotta help me. They are moving me to another place and I need a housing letter...

History Open history:

You were diagnosed with schizophrenia 5 years ago and attend today requesting a housing letter

You were given your current accommodation sheltered housing, for the last 5 years when you were unwell (hearing voices). You are happy with the current arrangement

However, now that you are well you have recently been told to move to a new accommodation located in an area that you are not familiar with and some distance from your friends and family where you currently are

This accommodation is no longer on the ground floor but rather a flat that is on the 5th floor, some distance up with no lift access. This is not convenient for you

You have spoken to the housing manager who has told you that you need a medical report from your GP stating your current mental state if you are to stay where you are

You met with the practice manager and paid the 90 and expect a strong letter

They have also started cutting your benefits and have returned you back on Job Seekers Allowance (JSA) which you are not happy about

Reveal history if asked:

Ideas You have paid the practice nurse 90 already and feel you are deserving of a strongly worded housing letter

Concerns You are worried that the housing authority will relocate you to a less desirable accommodation that is on the 5th floor and some distance away

Expectations You want to be given a strongly worded letter to give to the housing authority stating that you are still mentally unwell and need to remain in the house you are in

You are always honest to your GP and tell him if they probe your predicament

You want him to write a medical report that states that you still suffer from schizophrenia and hearing voices and need to stay where you are as you need support

If the doctor asks if you still hear voices, state: well kind of you are always hearing your mother on the phone telling you to clean your room. She rings you without fail everyday

If doctors seeks to clarify, inform them that you have not heard voice that you could not explain

You deny feeling low, being depressed, having any delusions or hallucinations





Medical history

Schizophrenia (5 years ago)

Drug history

You are meant to be taking Olanzapine 1 tablet a day but have not taken it for several years. No previous allergies

Social history

You are single, unemployed and have no children

You still smoke 10 cigarettes a day and drink 2 lagers of alcohol at the weekends

You have not used any elicit drugs for many years now

You want to make a new start in life but want to remain where you live as you have friends and family locally

You live in sheltered housing that is specifically for mental health clients and if you remain this will mean someone who is more needy is unable to stay there

Family history

Nil

If the doctor refuses to state that you still hear voices on the letter, suggest instead they should write that you suffer from back pain and you cannot walk up 5 flights of stairs as a result

Inform the doctor that you have had it for 3 years but did not want to bother them about it and have not visited to discuss it as a result

Stress to the doctor the importance of the letter stating 3 years of back pain

If the doctor refuses again to give you the report; inform him that you did not feel 90 was enough and that you are willing to pay another 200 immediately as a gift to the doctor for the report. Insist that the doctor takes it and be disgruntled if they do not

Threaten that you would register at another practice if they do not accept your persistent requests for a letter I heard that Dr Jones from down the road gives medical letters without this much headache and he is happy to accept gifts. Sounds as if I am at the wrong practice

If the doctor offers a mildly worded housing letter or visiting Citizens Advice Bureau state that it will not help your application and you expected more for your 90

Be willing to storm out demanding a full refund if all avenues are exhausted

If the doctor does offer you the letter you sought thank them but ask if they can recommend that the authorities restart your mental health benefits as well. Offer them a larger gift as an incentive





CSA course case Housing report EXAMINER DATA GATHERING Positive indicators:

Gathers information and clarifies problem (patients demand for a housing letter)

Establish that patient is currently well and does not have any mental health symptoms

Establish psychosocial context (patient wanting accommodation closer to friends for social support)

Negative indicators:

Disorganised and unsystematic in approach

INTERPERSONAL SKILLS Positive indicators:

Explores patients ideas and concerns i.e. fears of being relocated

Explores context of request and adopts a non-confrontational manner

Empathise with the patients request and attempts to negotiate alternative options

Backs own judgment appropriately declines politely to write factually incorrect letter Negative indicators:

Fails to explore patients concern about relocation

Offers letter with factually incorrect details i.e. still hearing voices or back pain not states on records CLINICAL MANAGEMENT SKILLS: Positive indicators:

Does not provide factually incorrect letter despite pressure applied by patient

Offers suitable explanation as to why unable to do so i.e. ethically unable to provide inaccurate information

Offers alternative solutions i.e. offer supportive but factually accurate letter to authority. Encourage patient to contact Citizens Advice Bureau

If patient is still dissatisfied offer full refund of money

Refuses to accept gift as monies beyond stated amount quoted for letter

Negative indicators:

Offers factually incorrect letter to patient or accepts gifts





CSA course case CARDS

No examination required





CSA course case Housing report MX NOTES The GMC advice regarding writing reports You must be honest and trustworthy when writing reports, and when completing or signing forms, reports and other documents. You must do your best to make sure that any documents you write or sign are not false or misleading. This means that you must take reasonable steps to verify the information in the documents, and that you must not deliberately leave out relevant information. If you have agreed to prepare a report, complete or sign a document or provide evidence, you must do so without unreasonable delay.

csa_course_case_housing_report.pdf

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