The Complete SCA Package.

She was interrupted roughly fifteen seconds in, on the word “walk-in”, to pin down the date of the steroid course. The date mattered less than what she was about to say next.

Next time: Let the opening run until she stops on her own. Dates can be fixed once she has finished.

The consultation moved to closed questions early. The RCP 3 screen was asked as three direct questions in a row, which got the answers but closed down what she might have added.

Next time: Open with one broad question about how the asthma affects her week, then use the screen to fill whatever gaps she leaves.

“I’m a bit worried about where things are heading” was picked up rather than passed over, and it was the thread that led to the steroid concern later.

Control, adherence, technique and triggers were covered in an order that built on itself, and the prescription data was used to test the history rather than replace it.

She was asked directly what she thought was going on with her asthma, before any explanation was offered, so the explanation could start from where she actually was.

Her worry about steroids was drawn out rather than waited for, and the specific belief behind it, that the inhaler carries the same risk as the tablets, was named.

She was never asked what she was hoping for. Her question about an alternative to the steroid inhaler came from her, late, and it had been her reason for booking.

Next time: Ask what she was hoping would come out of today before moving to management. It is usually one sentence and it reframes everything after it.

The steroid concern was answered before the new inhaler was proposed, not after, so she was not asked to accept a decision she had already decided to be anxious about.

Her worry was treated as reasonable rather than corrected, and giving up Thursday yoga was acknowledged as a loss rather than logged as a symptom.

The difference between inhaled and oral steroids was explained in terms of dose and where the drug goes, and MART was described as one inhaler replacing two, which is the part that matters to her.

Fostair was offered with its reasoning and she was given room to agree rather than told. Her own goal of getting back to yoga was used as the measure of whether it works.

A written action plan was promised and the 999 threshold was mentioned, but the zones were not explained, so she left with a plan she could not use on her own.

Next time: Walk through green, amber and red once, in her words, and check she can say back what she would do after a cold.

Twelve minutes covered control, adherence, technique, the steroid concern and a plan, with a summary at nine and a half minutes that left room for her last question.