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Critical Analysis of a Consultation Model

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Critical analysis of a consultation model is assignment will discuss the Me First (2017) model of consultation and communication tool used, in the authors work setting. The aim of the consultation is to develop a therapeutic relationship with the patient and their family and to ensure accurate history taking in order to reach an accurate diagnosis. Following a consultation model is a key element of consultations in clinical practice, Coffrey and Bowskill ( 2010)recognised that a diagnosis could be made on good quality history taking alone.

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The Me First (2017) consultation and communication tool is widely used as part of a paediatric consultation whether this be consultant or nurse-led. Neighbour (1989) check point of consultation emphasises the need to be on the same wavelength as the patient and Me first (2017)communication tool does this effectively as it is specifically designed as a child orientated tool. Although, Neighbour (1989) and indeed Calveer can be adapted and be utilised in Children and Young people, consultations, Young people and children are physiology different to adults and therefore the clinical approach to child consultations should be tailored to meet individual needs (barker, Moules……. . ) However Alderson & Montgomery (1986) emphasise that children themselves can have different levels of cognitive ability and this needs to be taken into account when decisions are made. Cabral (2014) suggests that the parents speak on behalf of the child and often it is the parents agenda that is therefore addressed. The Me First tool encourages discussion with both parent and child to empower them to make informed choices.

Department Health (2003) advocate empowering patients to take more ownership of their health condition. Zolierek &Dimattoo 2009) research found that communication training had a positive impact to medical treatment with improved concordance. Resources can be used in the consultation to aid communication when choices need to be made, for example, The Medicine for Children (2018) provides patient friendly leaflets (although it could be argued that they are not necessarily child friendly) when exploring views and negotiating a contract, around the choice of medication, it provides clear explanation of the medication for example, how the medication can be given ie tablet, or liquid? When to give? And discusses the side effects of the medication and not forgetting addressing safety netting for example, in the section What to do if you forget to take your medication? Anecdotal evidence has found these leaflets are a valuable resource when making decisions around medication. NHS Plan (2010) encourages shared decision making with the patient and family to aid concordance.

The medicine partnership ensures safety ansbetter health outcomes and helps reduce cost and wastage for the NHS. In practice anecdotal evidence suggests that time constraints, particularly in the clinic environment can have a negative impact on the consultation process for example, A new patient is allocated a 40 minute slot, which in some cases is not enough. To overcome this barrier, the Specialist Nurse is a key point of contact for the patient and their families and follows up patients consultations with support and advice around diagnosis, safety and medication management (Epilepsy Action 2018). It is therefore essential that the consultation is documented and good record keeping adhered to, to ensure safe and effective continuation of care (NMC 2009)

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