1. Participants

Participants are Trust clinicians, GPs, primary care staff, service users andthe voluntary sector.

2. Topic

The topic is medically unexplained symptoms. This is not focusing specifically on MUS with a known mental health problem, although such cases may form part of the discussion.

3. Learning objectives

What the participants should be able to do as a result of the workshop

  1. To describe the criteria for medically unexplained symptoms and its associated risks
  2. To develop a management plan for medically unexplained symptoms
  3. To plan and deliver effective shared decision-making with patients with medically unexplained symptoms

4. Supporting Content

The materials are in the pack provide

  • summarised essential clinical information to use in the sessions if necessary
  • information on voluntary sector groups (this is the database we are using for the Enablement Directory which the Primary Care Academy is developing by borough)
  • scenarios for problem solving in the session

5. Service User involvement

Service users attending are part of service user organisations, and will participate in that dual role. They have been briefed to:

  • give a balanced view of the service, positive as well as negative experiences.
  • avoid coming across as anti-doctor and alienating professionals
  • take an objective overview of experiences
  • be flexible to reflect varying levels of knowledge and learning need
  • refer to services their group offers for service users
  • acknowledgethat other groups also offer support services

The service user and clinician will act out a brief role play to demonstrate the type of skills that may be helpful in consultation with patients with medically unexplained symptoms.

Sometimes,no matter how well prepared,people may lose concentration or focus during the role play.If so , you may find it helpful to interject some of the following prompt questions:

  • What might reduce the doubt or anxiety of someone with MUS about their condition?
  • What would reassure someone with MUS that they are being taken seriously

If this does not move the role play along, I would suggest: “That is really useful. Perhaps we can consider these issues further when we look at the scenarios in our small groups and see what else emerges on enabling people to recover.” It is a good idea to warn those involved that the role play cannot run over because there is a lot to get through in the small group sessions. They can write any extra points on the graffiti board while you move the sessionon, so nothing is lost.

6.Programme

A programme is shown overleaf for guidance. Facilitators may prefer another approach.

7. Evaluation

Each session will be evaluated and feedback used to adjust the approach.

NB A Graffiti board is a flipchart entitled ‘Graffiti’, for comments/queries for later follow up. It can help to move a discussion on without ignoring concerns or queries

ACTIVITY / m.
PLENARY Introductions and Graffiti - FACILITATOR
  • What we aim to get from the session
  • Graffiti to record queries & comments for follow up/record/response
/ 5
2. Go through handouts in pack and discuss if necessary. FACILITOR AND CLINICIAN
(NB focus more on the practical things that GPs can do, less on the clinical theory underlying the problem, not omitting the possibility that there may indeed be a physical problem) / 15
3. PLENARY SHARED DECISION-MAKING
Service user and clinician act out consultations – a) how to do it b) how not to do it.
Refer to handout what and what does not help with word scripts attached. / 15
Group divide into multi-disciplinary group(s). Clinician and service user to rotate round if more than one group
5. SMALL GROUP WORK
How to enable the patient to develop an action plan with goals to restore function. / Small Group work on Clinical scenario 1. Discussion in each group and top three actions plus any unknowns / 30
Small Group work on Clinical scenario 2. Discussion in each group and top three actions plus any unknowns
Small Group work on Clinical scenario 3. Discussion in each group and top three actions plus any unknowns
Feedback / Each group feeds back their actions and unknowns and others see if they agree or can answer / 20
7. Summarise - What have we learnt. What do we need. Scribe record on flipchart. Remind about evaluation. / 5

SEE PACK FOR SUPPORTING MATERIAL