General Pharmaceutical Council Registration Assessment (GPhC Assessment) Patient Care, Consultation and Public Health Syllabus

Patient Care, Consultation and Public Health syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Patient Care, Consultation and Public Health in General Pharmaceutical Council Registration Assessment (GPhC Assessment), not a summary of it.

1. 1

   Consultation and Communication Skills

   4 topics

   • Structured Consultation Models
     • Calgary-Cambridge and patient-centred approaches
     • Open and closed questioning
   • Shared Decision-Making
     • Eliciting patient ideas, concerns and expectations
   • Communicating with Diverse Patients
     • Health literacy and language barriers
     • Reasonable adjustments and accessibility
   • Counselling on Medicines
     • Device technique demonstration
     • Adherence support strategies
2. 2

   Responding to Symptoms and Self-Care

   4 topics

   • Triage and Differential Assessment
     • WWHAM and ASMETHOD frameworks
     • Red flags and referral criteria
   • Minor Ailments Management
     • Common conditions amenable to OTC treatment
   • Over-the-Counter Medicine Selection
     • Cautions, interactions and limits on sale
   • Referral and Onward Signposting
     • Urgent versus routine referral
3. 3

   Public Health and Health Promotion

   4 topics

   • Smoking Cessation
     • NRT and pharmacological aids
   • Sexual Health and Contraception
     • Emergency hormonal contraception
     • Routine contraceptive options
   • Substance Misuse Services
     • Opioid substitution and supervised consumption
     • Needle exchange
   • Screening and Lifestyle Advice
     • Weight, alcohol and cardiovascular risk
4. 4

   Special Patient Populations

   4 topics

   • Pregnancy and Breastfeeding
     • Teratogenicity and risk assessment
     • Drugs in lactation
   • Paediatrics
     • Age-appropriate formulations and dosing
   • Older People and Polypharmacy
     • Deprescribing and STOPP/START criteria
     • Falls and anticholinergic burden
   • Renal and Hepatic Impairment
     • Prescribing adjustments

Patient Care, Consultation and Public Health flashcards for General Pharmaceutical Council Registration Assessment (GPhC Assessment)

25 of 50 cards from the Patient Care, Consultation and Public Health deck — real questions with worked answers.

1. In the Calgary-Cambridge consultation model, what are the five sequential tasks (the 'main vertical' of the framework)?

   1) Initiating the session, 2) Gathering information, 3) Physical examination, 4) Explanation and planning, and 5) Closing the session. These run alongside two continuous tasks: providing structure and building the relationship.

2. What does each letter stand for in the WWHAM mnemonic used to assess a patient requesting an OTC product?

   W - Who is it for? W - What are the symptoms? H - How long have the symptoms been present? A - Action taken (any treatments tried)? M - Medication being taken (other medicines/conditions)?

3. What are the elements of the ASMETHOD mnemonic for symptom-based OTC consultations?

   A - Age/Appearance; S - Self or someone else; M - Medication; E - Extra medicines; T - Time persisting; H - History; O - Other symptoms; D - Danger symptoms.

4. Define 'shared decision-making' (SDM) in a clinical consultation as described by NICE.

   A collaborative process in which the clinician and patient work together to make decisions about tests, treatments and care, based on clinical evidence and the patient's informed preferences, balancing risks and expected outcomes with what matters most to the patient.

5. What three questions form the basis of the 'BRAN' / Ask 3 Questions approach to support shared decision-making?

   What are the Benefits? What are the Risks? What are the Alternatives? (BRAN, sometimes with N = What if I do Nothing?) This helps patients weigh options.

6. In the consultation, what is meant by eliciting the patient's 'ICE'?

   Ideas (what the patient thinks is going on), Concerns (what they are worried about), and Expectations (what they hope to get from the consultation). Exploring ICE underpins patient-centred and shared decision-making.

7. When communicating with a patient who has limited English proficiency, why should a professional interpreter be used rather than a family member?

   A trained interpreter ensures accurate, impartial, confidential translation of clinical information and avoids errors, omissions, breaches of confidentiality, and conflicts of interest that can arise when family members (especially children) interpret.

8. What is the 'teach-back' (or 'show me') technique and why is it used when counselling patients?

   The patient is asked to explain back in their own words, or demonstrate, what they have understood about their medicine or instructions. It checks comprehension and identifies misunderstandings without making the patient feel tested.

9. List the core points a pharmacist should cover when counselling a patient on a new medicine.

   What the medicine is and what it is for; how and when to take it (dose, route, timing, with/without food); how long to take it; common and serious side effects and what to do; key interactions/foods/alcohol to avoid; how to store it; and what to do if a dose is missed.

10. What is the recommended advice if a patient misses a dose of a once-daily medicine and remembers later the same day versus close to the next dose?

    Take the missed dose as soon as remembered; but if it is almost time for the next dose, skip the missed dose and continue as normal. Never double the dose to make up for a missed one.

11. Define 'triage' in the context of community pharmacy.

    The process of rapidly assessing a patient's presenting symptoms to determine the urgency and appropriate level of care: self-care, pharmacy management, routine GP referral, urgent referral, or emergency (e.g. call 999).

12. What is the purpose of identifying 'red flag' symptoms during minor ailment assessment?

    Red flags are warning features suggesting serious or potentially life-threatening pathology that require urgent referral rather than self-care or OTC treatment (e.g. unexplained weight loss, blood in stool/urine, severe pain, neurological deficit).

13. In England, what is the NHS Pharmacy First service designed to allow community pharmacists to do?

    Assess and, where appropriate, supply prescription-only medicines under Patient Group Directions for seven common conditions, plus manage minor illness and provide urgent repeat medicine supply, reducing GP and urgent care demand.

14. Name the seven clinical conditions covered by the NHS Pharmacy First (England) clinical pathways.

    Acute otitis media, acute sore throat, sinusitis, impetigo, infected insect bites, shingles, and uncomplicated urinary tract infections (UTIs) in women aged 16-64.

15. For acute sore throat, what scoring tools are used in Pharmacy First to assess the likelihood of bacterial (streptococcal) infection?

    The FeverPAIN score and the Centor criteria. Higher scores indicate greater likelihood of streptococcal infection and may support antibiotic supply; low scores favour self-care.

16. What five clinical features make up the FeverPAIN score for acute sore throat?

    Fever (in last 24h), Purulence (pus on tonsils), Attend rapidly (within 3 days of onset), severely Inflamed tonsils, and No cough or coryza. Each scores 1 point (0-5).

17. What four criteria make up the Centor score for sore throat?

    Tonsillar exudate, tender anterior cervical lymphadenopathy, history of fever (>38C), and absence of cough. Each scores 1 point; a score of 3-4 suggests higher probability of streptococcal infection.

18. When selecting an OTC analgesic, why is ibuprofen generally avoided in a patient with a history of peptic ulcer or on warfarin?

    NSAIDs like ibuprofen increase the risk of GI bleeding (direct mucosal damage plus antiplatelet effect) and potentiate the bleeding risk of warfarin, so paracetamol is usually preferred.

19. What is the maximum recommended OTC daily dose of paracetamol for an adult, and why does exceeding it cause harm?

    4 g per day (typically 1 g up to four times daily). Excess saturates conjugation pathways, producing the toxic metabolite NAPQI, which depletes glutathione and causes hepatocellular necrosis.

20. What is the antidote for paracetamol overdose and how does it work?

    N-acetylcysteine (NAC). It replenishes hepatic glutathione stores, allowing detoxification of the toxic metabolite NAPQI and preventing liver damage; it is most effective when given early.

21. What is meant by 'signposting' versus 'referral' when a patient's needs cannot be met in the pharmacy?

    Signposting directs a patient to another service or information source without a formal handover (e.g. to a website, helpline, or self-care). Referral is a formal recommendation/handover to another healthcare professional or service for assessment and management.

22. What is the structure of the '5 A's' framework for smoking cessation brief intervention?

    Ask (about tobacco use), Advise (to quit), Assess (willingness to quit), Assist (with a quit plan/treatment), and Arrange (follow-up).

23. What is the 'Very Brief Advice' (VBA) model for smoking, and what are its three elements?

    A 30-second evidence-based intervention: ASK and record smoking status; ADVISE on the best way to stop (with support and medication); ACT by offering referral to a stop-smoking service and/or pharmacotherapy.

24. Compare the mechanisms of nicotine replacement therapy (NRT), varenicline, and bupropion in smoking cessation.

    NRT supplies nicotine without tobacco toxins to reduce withdrawal/cravings; varenicline is a partial agonist at alpha-4 beta-2 nicotinic receptors (reduces cravings and blocks reward); bupropion is a noradrenaline/dopamine reuptake inhibitor that reduces cravings.

25. Why is combination NRT (e.g. a patch plus a faster-acting form) often recommended over a single product?

    A long-acting patch provides steady baseline nicotine to control background cravings, while a fast-acting form (gum, lozenge, inhalator, spray) handles acute breakthrough cravings; the combination is more effective than a single product.

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