CSA Course Case Housing Report PDF

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CSA course case
CANDIDATES BRIEF
Patient medical records
Name:
Andrew Dobbs, (24 year old)
Past medical history: Schizophrenia (5 years ago)
Drug history:
Consultation (2 weeks ago)
Olanzapine
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
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CSA course case Housing report - CSA prep 2011

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



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
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
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:

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
Offers factually incorrect letter to patient or accepts gifts


CSA course case
CARDS
No examination required


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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CSA course case

Patient medical records

Andrew Dobbs, (24 year old)

Past medical history: Schizophrenia (5 years ago)

Consultation (2 weeks ago)

Consultation (6 months ago)

Contact us: csaprep123@gmail.com visit us www.csaprep.co.uk

CSA scenarios with REAL CSA actors

As close to the CSA exam as possible

Book your place on the course for NOW