Consulting in a Nutshell: A practical guide to successful general practice consultations before, during and beyond the MRCGP

Praise for the first edition:

‘…a unique book, written by a unique GP. There is no one better placed to pull together decades of learning and experience on how to achieve the greatest success in the general practice consultation. The relaxed pace of writing, the accessible examples, the clear narrative and the engaging anecdotes make this a resource that is accessible and useful to all who seek to improve their clinical consulting skills.’

Helen Stokes-Lampard, former Chair of the Royal College of General Practitioners

‘Excellent and easy to remember structure; this is the approach I’ll use daily.’

GP ST3

The second edition of this well-received book, fully revised to reflect changes to the RCGP Membership examination, helps GPs to establish ways of thinking, talking and behaving in the consultation that are most likely to lead to good outcomes. It describes a simple three-part approach to the consultation’s essential task, which is to convert a patient’s problem into a plan acceptable to both patient and doctor. It combines reader-friendly explanations, helpful illustrations and examples from everyday practice.

Consulting in a Nutshell will help GPs at every career stage – from medical student to SCA candidate to experienced practitioner – to analyse, develop and grow their personal consulting style. At a time of ongoing and profound change in primary care, it aims to ensure that seeing patients and having good consultations becomes and remains a source of satisfaction and fulfilment.

About the author

Roger Neighbour OBE MA MB BChir DSc FRCP FRCGP FRACGP

Roger qualified from King’s College, Cambridge, and St Thomas’ Hospital, London. After vocational training in Watford, he practised as a GP in Abbot’s Langley, Hertfordshire, from 1974 to 2003. He was a trainer and programme director with the Watford Vocational Training Scheme for many years, an MRCGP examiner for 20 years and the Royal College of General Practitioners’ Chief Examiner from 1997 to 2002. In 2003, he was elected President of the RCGP for a three-year term. In 2011 he was made an OBE for services to medical education. Having studied experimental psychology instead of biochemistry as an undergraduate, Roger found himself fascinated by the psychology of the consultation and the doctor–patient relationship in general practice. This interest led him to write his ‘Inner’ trilogy: The Inner Consultation (1987), The Inner Apprentice (1992) and The Inner Physician (2016). A collection of his medico-philosophical writings, I’m Too Hot Now, was published in 2005. Now retired from clinical practice, Roger has continued to write, teach and lecture in the United Kingdom and worldwide on consulting skills and medical education. He is a Visiting Professor of Medical Education at Brunel University Medical School, London. Roger is a practising Zen Buddhist; he plays the violin to semi-professional standard, and is something of an authority on the music of Franz Schubert.

About the illustrator

Jamie Hyes MB ChB FRCGP DRCOG PGCertMedEd

Jamie is an enthusiastic and fulfilled GP, committed husband, and father to two boys. Qualified from Birmingham in 2002, he is currently a training programme director for West Birmingham VTS and Chair of the RCGP Midland Faculty. He recalls that when as a medical student he was questioned about his CV’s mention of artistic interests, he described the practice of medicine as an art. He is delighted to keep utilising the creativity from life before training in this book, as well as in his practice, VTS websites and social media activities as @ArtfulDoctor. Jamie’s video-poem extolling the virtues and privileges of general practice, ‘The National Health,’ won the RCGP Midland Faculty’s ‘Inspiration’ competition. Further pieces on general practice followed, with #GP150w (GP in 150 words), and cross-Faculty collaborations such as the Christmas-themed ‘The Night Before CQC,’ #12daysofGP, and #GPKipling, a video communicating the diversity of our workforce in a GP-themed rewrite of Kipling’s ‘If.’ The #GPKipling video launched the RCGP Annual Conference in 2019, and the Billy Joel-inspired, GP-themed 'Start the Fire' launched the RCGP Annual Conference in 2021. He was awarded RCGP Faculty Champion in 2022. His short illustrated film examining the evidence for continuity of care within a storytelling narrative entitled 'GP's a Wonderful Life' featured on The General Practice Podcast in 2023. His illustrations have featured at RCGP Annual Conference, in GPfrontline, RCGP InnovAiT, and of course in Roger Neighbour’s The Inner Physician (2016).

About the Foreword to 1st Edition author

Helen Stokes-Lampard DBE MBBS(Lon) PhD FRCGP DSc(Med) DFSRH DRCOG

Helen Stokes-Lampard is a practising GP partner in Lichfield, Staffordshire. She was Chair of the Academy of Medical Royal Colleges, the umbrella organisation for all medical disciplines, from 2020 to 2023. She is also a past Chair of the RCGP 2016–2019, having held many other roles there over the years. Additionally, she is a Professor of GP Education at the University of Birmingham and Chair of the National Academy for Social Prescribing, an independent charity established to promote the concepts and build the evidence base around social prescribing. Helen is naturally enthusiastic, a passionate advocate for person-centred care in its widest sense, and an experienced public speaker.

About the Foreword to 2nd Edition author

Rich Withnall KHS OStJ MA MD MSc MBBS FRCGP FRCP FAcadMEd SFFMLM CMgr

Rich is a Professor of General Practice, the Royal College of General Practitioners’ Chief Examiner, and Medical Director for International Education and Training. He is also Chief Executive and Responsible Officer of the Faculty of Medical Leadership and Management, the professional home for medical leadership in the UK. He qualified from the Royal Free Hospital School of Medicine, University of London, in 1992. He served in the Royal Air Force for 34 years, rising to the rank of Air Vice-Marshal and becoming Director of Defence Healthcare. He has been an Honorary Surgeon to Her Late Majesty Queen Elizabeth II and His Majesty King Charles III.