Theme playbooks
For each theme: what the keys usually reward, what they usually mark down, and the nuance that changes the order. They describe patterns, not a script: each question's own facts decide.
Candour & your own errors
17 practice questions.
Usually ranks high
- Make the patient safe and limit harm
- Tell them promptly, plainly and specifically, with an apology (an apology isn’t an admission of liability)
- Put it right, or arrange for someone who can
- Write accurate notes, with late entries dated and nothing altered
- Report it as an incident and check whether anyone else is affected
- Inform your ES and reflect
Usually ranks low
- Concealing it, or waiting to see if they notice
- Altering, deleting or tidying records
- Blaming a colleague, or asking the nurse to keep quiet
- Calling your defence organisation before telling the patient
Nuance: In “immediate” questions, urgent safety steps come before informing your ES or reflecting.
Raising concerns about colleagues
19 practice questions.
Usually ranks high
- Act on any immediate risk, discreetly
- Speak to the colleague privately and directly first
- Give them the chance to correct things or self-report
- If it’s repeated or serious, go up one rung: ES, practice manager, owner or lead
- Make factual notes, and think about which patients were affected
Usually ranks low
- Staying silent, covering for them, or just “keeping an eye”
- Confronting them in public, gossiping or posting in group chats
- Covert workarounds, such as asking the nurse to swap items
- Going to the GDC before any local route
Nuance: You don’t need proof to raise a concern, and the duty overrides loyalty. If a quiet word has already failed, don’t repeat it; move up a rung.
Consent & capacity
22 practice questions.
Usually ranks high
- Presume capacity and support the decision (simpler explanations, visual aids)
- Explore their reasons before you advise
- Explain risks, benefits, alternatives (including doing nothing) and costs
- Respect a competent decision and record it
- Under-16s: assess Gillick competence
- Lacking capacity: follow the best-interests process, and inform an LPA attorney and work with them
Usually ranks low
- Pressure, coercion or scaring them
- Carrying on after a refusal
- Accepting consent from someone without legal authority
- Treating an unwise choice as incapacity
- Giving irreversible treatment just because it was asked for, or overriding a valid attorney
Nuance: Autonomy lets patients refuse. It doesn’t oblige you to provide treatment you believe is against their interests; offer a second opinion instead.
Confidentiality & information
19 practice questions.
Usually ranks high
- No disclosure without consent, and that includes confirming attendance and costs
- A kind refusal, plus a way forward (offer to pass on a message)
- A private word with whoever breached it, plus a system fix
- Get posts taken down fast
- For disclosure decisions: consent, then the law, then a serious public interest
Usually ranks low
- Public replies to reviews or posts
- Screenshots or anything that spreads the information further
- Disclosing to keep the peace or save time
- Proof of identity treated as a right to information
Nuance: Confidentiality gives way to safeguarding, serious crime or a legal requirement, and then only the minimum necessary is shared.
Safeguarding & vulnerable patients
18 practice questions.
Usually ranks high
- Meet the immediate clinical need
- Record findings and what was said, objectively
- Involve the practice safeguarding lead promptly
- 999 if someone is in immediate danger
- With adults who have capacity: support them and seek their agreement
Usually ranks low
- Investigating yourself, or examining beyond your clinical remit
- Confronting the suspected abuser
- Waiting for proof, or for the next appointment
- Promising secrecy
- Sharing information outside the proper process
Nuance: A child’s welfare is paramount. For competent adults, consent is central unless someone is in immediate danger or others are at risk.
Working within competence & safe conditions
19 practice questions.
Usually ranks high
- Don’t start what you can’t do safely
- Get on-site supervision, or defer the complex part
- Work with a trained nurse; look after them if they’re unwell
- Stop using equipment that has failed a test
- Stay within your scope, including prescribing
- Be honest with the patient if you need to rebook
Usually ranks low
- Going ahead on theory, or “the ES said I’d be fine”
- Working without a second person when nothing about the situation is exceptional
- Untrained helpers, or “re-test and carry on”
- Disclaimers presented as a fix
Nuance: Refusing all new, supervised work is wrong too. DFT exists to extend your competence safely.
Communication & complaints
20 practice questions.
Usually ranks high
- Pause, acknowledge feelings, explore before fixing
- Examine and find the cause
- Give an honest explanation and agree a plan
- Use a professional interpreter for anything important
- Take criticism offline and treat it as a complaint
Usually ranks low
- Dismissive or lecturing responses
- Defensiveness, or offering the complaints leaflet as a first move
- Handing the conversation to someone else
- “You’d have to pay privately for better”
- Threats, or public replies
Nuance: Stay calm with angry patients and protect everyone’s dignity. Threatening the police is only right if there’s violence.
Prioritising & workload
18 practice questions.
Usually ranks high
- Clinical urgency first; send red flags to hospital
- Tell waiting patients, apologise and offer choices
- Raise workload directly with whoever is causing it
- Involve your ES in problems built into the system
- Make realistic plans
Usually ranks low
- Cutting clinical corners to catch up
- Quietly withdrawing help, so patients lose out
- Moving your load onto colleagues
- Cancelling everything, which is disproportionate
Nuance: Routinely working through lunch or staying late is “proactive but”: it sits in the middle, above secrecy or corner-cutting.
Team relationships & feedback
19 practice questions.
Usually ranks high
- A private, direct conversation, assuming good intent
- Explain why it matters, and offer support or training
- A practice-meeting fix
- Accept feedback and ask for specifics
- Own your behaviour and repair it
- Challenge discrimination, whoever it comes from
Usually ranks low
- Public correction or threats
- Trying to find out who complained
- Swapping staff to avoid the issue
- Gossip, blame, or standing by
Nuance: Disciplining staff isn’t an FD’s role. Support colleagues and point them to the proper routes.
Health & wellbeing
17 practice questions.
Usually ranks high
- Tell your TPD or ES early
- Get occupational health advice rather than judging your own risk
- Don’t work if you’re infectious or impaired
- Follow the sharps policy straight away
- A colleague at risk: ask directly, get help today, be honest about the limits of confidentiality
Usually ranks low
- Soldiering on, or hiding it
- Assessing your own risk
- Minimising someone’s distress
- Delaying help until later in the week
Nuance: Looking after your health is part of patient safety, not a sign of weakness.
Probity: honesty, records & rules
19 practice questions.
Usually ranks high
- Refuse to collude, and explain why calmly
- Honest, factual letters, records and references
- Decline shortcuts and offer a proper alternative
- Encourage self-correction before escalating
- Record unusual requests in the notes
Usually ranks low
- Backdating or fabricating anything
- Vague wording or omissions meant to mislead
- Accepting a false sign-off, even “with a note”
- Being signed in by someone else, or fake reviews
Nuance: Dishonesty is the category most likely to end a career, even when the underlying issue was minor.
Money, NHS & private care
17 practice questions.
Usually ranks high
- Present every option, including NHS care, neutrally
- A written plan showing costs and NHS or private status
- Let the patient’s values decide
- Set recalls and claims by clinical need and the rules
- Challenge target pressure calmly; check the rules if unsure
Usually ranks low
- Saying a treatment is only available privately when it isn’t
- Pressure, or assuming what they can afford
- Splitting claims, or complying to hit targets
- Reporting before you’ve discussed it
Nuance: The claims you submit are your responsibility, whoever asked you to make them.