Those clinicians and nurses without experience of managing consultations with patients who opt for conservative kidney management and who are not nephrologists or renal nurses will be excluded.
However, previous studies have identified the problems GPs have in managing consultations and sickness certification for back pain, including for example the balance of maintaining the doctor-patient relationship whilst challenging patients' expectations and perceptions of the consultation [ 7, 8].
A paradox emerges between the need to manage consultations in a 'super-diverse' multilingual society, while also attending to increasing requirements for standardised protocol-driven approaches to care prompted by computer use.
Overall this qualitative analysis of GP and PN interviews found that the EDS tool had a positive impact on the quality of care of type 2 diabetes, and improved the ability of GPs and PNs to more effectively manage consultations in patients with type 2 diabetes, and the EDS tool was both feasible and practical for use in the clinical setting.
In turn this, in part, symbolised a successful, well managed, consultation for GPs because it had been neatly ended.
Renal physicians and clinical nurse specialists (CNS) recruited to the study must have experience of managing clinical consultations with patients who have stage 5 chronic kidney disease and are opting for conservative kidney management.
Community midwives were targeted as they are largely responsible for managing antenatal consultations, in particular the initial 'booking' appointment where height, weight, and BMI measurements should be taken, risks related to a raised BMI in pregnancy discussed, and guidance on nutrition and physical activity provided [ 6].
A reliable tool has been developed that can be used to analyse the number and range of problems managed in primary care consultations.
Those managing the consultation are duty bound to read them all.
Within this stepwise teaching approach managing the consultation skills simultaneously remains difficult, because students set high standards for themselves with the risk of feeling overloaded.
In addition, informal caregivers play an important role in supporting their older relative in health care consultations [ 23, 34], managing information [ 35], and in negotiating formal care in the community [ 36, 37] by ensuring high-quality services when patients are not able to demand this for themselves [ 38].
