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How to record a consultation

Written by Sonja Gebhardt

A consultation is a structured client record completed from a template. This guide covers choosing a consultation template, recording the answers and saving the result.

It does not cover reusable text for ordinary contacts, notes and actions; see How to create and use record templates. Adding documents and choosing codes are covered in How to attach a document to a record, note or consultation and How to add a clinical code to something sent to the GP record.

Before you start

The Consultation option only appears when your organisation has at least one consultation template assigned to it.

The templates are set up for your organisation. They are different from the text templates you manage yourself with Templates on the Client record tab.

Start the consultation

  1. In the Case Management sidebar, select Client cases.

  2. Open the client you want.

  3. Select the Client record tab.

  4. Select Create new.

  5. Select Consultation.

If your organisation has more than one consultation template, New consultation opens with the instruction Choose a consultation template. Select the template you need.

If there is only one available template, Joy opens it straight away. The seeded QA organisation currently offers Social Prescribing; the Frailty (FAA) template was not available in the organisation checked for this guide.

Complete the template

  1. At the top, choose how the consultation happened. The choices are In person, Phone, Video chat, Email, Message and Letter.

  2. Choose the case the consultation belongs to, or No case.

  3. Work through the pages listed under Content on the left.

  4. Complete the questions on each page. A template can contain text boxes, tick boxes, number-and-unit fields, lists and multiple-choice questions.

  5. Check the Date, Time and Time spent (min) at the bottom.

  6. If needed, use Attach files to add documents.

When there is more than one template, Change template takes you back to the template choice. Changing it clears the answers already entered, so do this before you start recording the consultation.

Save a draft

Select Save as a draft if the consultation is not finished.

Joy confirms with Draft saved. The consultation appears on the Client record timeline with Consultation and Draft badges.

Open its edit control to return to the structured consultation and continue with the saved answers. A draft is not sent to the clinical record.

Complete the consultation

  1. Check the Clinical record destination. Joy uses Detect automatically unless the client has a linked clinical system or you choose a destination.

  2. Select Send to clinical record.

Joy confirms with Consultation saved and closes the form.

The consultation is saved even if Joy cannot resolve a clinical destination. It is only queued for the GP record when an explicit destination or the client's linked clinical system can be resolved.

What appears afterwards

The Client record timeline shows a record titled with the consultation template's name. It carries a Consultation badge, the contact method, date, time spent, case and any attachments.

Joy builds the readable record text from the answers. Open the record to see its Details, Consultation, Record history and Clinical record sections. The consultation section shows the Template and any SNOMED codes taken from the completed template.

The clinical badge says what is known about filing, such as Sending to clinical record, Sent — awaiting confirmation, Filed to clinical record or Sending failed. Saving a consultation is not, by itself, confirmation that it has reached the GP record.

Related guides

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