January 14, 2026
N. Turner
14 years experience as an RCGP examiner
Look at your "Shared and tailored plan" score and "Average conversational balance" - are you really having a conversation with your patients?
🎯 Key Features of Effective Sharing:
✅ Build on what the patient already told you (their ICE, concerns, expectations)
✅ Interactive not lecture - "chunks and checks"! Share small bits of info, then let them respond
✅ Go at their pace with language they understand
✅ Pick up on their concerns (verbal and non-verbal)
🤝 NICE Guidance Highlights:
📋 Start: Agree an agenda together and set time expectations
💬 During:
Discuss what matters to THEM
Explain aims, risks, benefits of each option (including doing nothing!)
Use "chunk and check" technique
Give them TIME to decide
✨ End:
State clearly what's been decided
Agree review dates
Remind them they can change their mind anytime
💪 Action Steps:
📝 Review a recent consultation in CliniTalk - look at the feedback and transcript. Ask yourself:
Did I verbalise my thinking clearly?
Was I sharing options or just telling the patient what to do?
Did I check what the patient understood and wanted?
Does my conversational balance show real interaction?
🎬 Try in your next recording to listen back for "chunks and checks" and patient involvement
When done well, patients leave feeling involved and confident about their care
📚 More info:
RCGP toolkit: https://www.rcgp.org.uk/mrcgp-exams/simulated-consultation-assessment/Toolkit-relating-others#8-Shares-and-uses-ICE-in-plan
NICE guidance: https://www.nice.org.uk/guidance/ng197/chapter/Recommendations#putting-shared-decision-making-into-practice
Author
N. Turner
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