Does the RCGP publish a list of SCA case types?

It publishes a blueprint of 12 Clinical Experience Groups (for example "Patient less than 19 years old", "Prescribing" and "Investigation / Results") that spreads each exam across general practice, and says candidates "should prepare equally for all groups". It doesn't publish the cases themselves: they come from "a bank of hundreds" and "cannot be predicted in advance".

Are SCA cases all video?

No. The RCGP says that in the majority you will be able to see the simulated patient and that others will be audio only. It doesn't publish the split.

Will I have to examine the patient?

Physical examination is not assessed in the SCA; the RCGP covers it in WPBA. Some examinations can be done remotely, such as cognitive testing and mental health assessment including suicide risk (RCGP SCA toolkit).

What are the case notes for?

They give you the case information before the consultation starts (RCGP). One RCGP feedback statement is "Existing information about the case was insufficiently utilised", so use them.

Is the example case above a real SCA case?

No. It was written by Confetto for practice and isn't based on any RCGP case.

SCA Cases: Types of Consultation and a Worked Practice Case

Name: Confetto
Brand: Confetto
Price: 149 USD
Availability: InStock

The short version

12 cases, 12 minutes each, 3 minutes' reading before each, video or audio only (RCGP).
The RCGP blueprint has 12 Clinical Experience Groups and "candidates should prepare equally for all groups". The example consultations under each group are ours, not RCGP cases.
Cases come from "a bank of hundreds", all mapped to the GP curriculum, and the twelve on your day "cannot be predicted in advance".
Each case has case notes. The RCGP's feedback page tells candidates to use the information in them.
Physical examination is not assessed in the SCA (RCGP); some assessments can be done remotely, such as tests of cognitive function and mental health including suicide risk.
The RCGP SCA toolkit lists what good looks like in each domain. Practice cases against those items.
A worked example below shows a full case: the case notes, the patient's hidden agenda, a 12-minute outline and a domain-by-domain marking.

What an SCA case is

The RCGP describes the SCA as "twelve consultations with simulated patients, each lasting twelve minutes", with "3-minutes reading time at the start of each case". "In the majority of these you will be able to see the simulated patient. Others will be audio only." Each case is marked by a different examiner.

Every case has two parts for you:

The case notes you read in the 3 minutes. The RCGP: "The case information for each consultation will be provided in the reading time before the start of that case." Its feedback statement "Existing information about the case was insufficiently utilised" covers consultations that "would have benefitted from reference to information provided in the case notes".
The consultation: a role-player with their own story, worries and wishes, who answers what you ask. The RCGP tries to match role-players to the patient description, and asks you to approach the case "based on the description provided in the candidate case notes, rather than on the appearance of the role player".

The RCGP also warns that the reason for the visit isn't always obvious: "The 'purpose' of the consultation may therefore not be apparent in advance."

The RCGP blueprint: 12 Clinical Experience Groups

The RCGP publishes a "Blueprint list of Clinical Experience Groups" so that each exam "is representative and not focussed on any one area of practice". It says the list "does not represent a ranking of the value or importance of that area" and that "candidates should prepare equally for all groups". The group names in the first column are the RCGP's; the example consultations are ours (written for practice, not RCGP cases); the last column gives RCGP toolkit items and feedback statements (in quotes) that each kind of case often tests.

RCGP Clinical Experience Group	Example consultations to practice (Confetto's examples)	RCGP toolkit items / feedback statements it often tests
Patient less than 19 years old	A parent on video about a feverish toddler; a 15-year-old asking for contraception	"Clarifies and explores cues offered"; "Shares and uses ICE in plan"
Gender, reproductive and sexual health, including women's, men's, LGBTQ+, gynae and breast	Heavy periods; erectile dysfunction; a breast lump	"A judgemental approach was shown to the person"
Long-term condition, including cancer, multi-morbidity, and disability	A diabetes review with three problems; living with cancer	"Manages co-morbidity appropriately"; "Ineffective approach or prioritisation in data gathering, when presented with multiple or complex problems"
Older adults, including frailty and people at the end of life	A carer worried about memory; planning care at the end of life	"Demonstrates awareness of ethical implications"; "Uncertainty, including that experienced by the patient, was managed ineffectively"
Mental health, including addiction, smoking, alcohol, substance misuse	Low mood with suicidal thoughts; cutting down alcohol	Mental health and suicide risk assessment can be done remotely (toolkit); "Discovers patient's psycho-social context"
Urgent and unscheduled care	Chest pain on the phone; a same-day request with red flags	"Rules in / out a serious disease"; "The plan relating to the medical management of risk was inadequate or inappropriate"
Health disadvantage and vulnerabilities, including veterans, mental capacity, safeguarding, and communication difficulties	A small safeguarding cue; a patient who may lack capacity for a decision	"Identifies cues"; "Safeguarding concerns were inadequately recognised or responded to"
Ethnicity, culture, diversity, inclusivity	Health beliefs that shape a treatment choice	"The circumstances, relevant cultural differences and/or preferences of those involved were insufficiently responded to"
New presentation of undifferentiated disease	Tiredness, dizziness, weight loss	"Generates / tests diagnostic hypotheses"; "Reaches a working diagnosis and/or analysis"
Prescribing	Polypharmacy; a request for antibiotics or stronger painkillers	"The management plan relating to prescribing of medication was inappropriate or not reflective of current practice"
Investigation / Results	Explaining an abnormal blood test	"Interprets appropriate examination and tests"; "Verbalises diagnosis and/or analysis"
Professional conversation / Professional dilemma	A colleague or another professional on the phone; a request you can't agree to	"Teamwork and/or understanding of others' roles was insufficiently recognised or responded to"; "Ownership or responsibility for decision-making was inadequate or inappropriate"

Any of these can be a video or an audio-only case.

More on the remote cases: SCA telephone and video consultations.

What every case is marked on

Each case is marked in three domains (RCGP, Marking and results for the SCA):

Data gathering and diagnosis (DG&D): the toolkit items are "Opens consultation and explores problem", "Discovers patient's psycho-social context", "Identifies cues", "Discovers patient's ICE", "Interprets appropriate examination and tests", "Generates / tests diagnostic hypotheses", "Rules in / out a serious disease" and "Reaches a working diagnosis and/or analysis".
Clinical management and medical complexity (CM&C): "Offers a safe patient-centred management plan", "Manages co-morbidity appropriately", "Provides follow-up / safety net". This domain is weighted more than the other two.
Relating to others (RTO): from "Generates rapport" and "Uses open questions appropriately" through "Shares and uses ICE in plan", "Shares risks / safety of options" and "Supports in decision-making".

The toolkit also lists global skills, including "Structures consultation", "Avoids repetition", "Finishes data gathering by 6-7 minutes", "Uses clear language" and "Remains responsive to the patient". Full grading detail: SCA marking scheme.

Worked example: a video consultation about back pain

Example written by Confetto for practice (not a real RCGP exam case). Clinical content follows NICE guideline NG59 (low back pain and sciatica in over 16s) as of November 2026; check the current guideline and BNF in practice.

Case notes (what you read in the 3 minutes)

Daniel Price, 41. Video consultation, booked as "back pain". Past history: asthma since childhood, uses a salbutamol inhaler a few times a month. No other conditions. Medicines: salbutamol 100 micrograms inhaler, 2 puffs when needed. Last seen 2 years ago (asthma review). Works as a warehouse team leader.

The patient's brief (what the role-player knows, hidden from you)

Story: low back pain for 10 days after lifting a heavy box at work. Aching, worse when bending, no pain down the legs. Taking paracetamol, which "does nothing".
Red flags, if asked: none. No numbness around the bottom or genitals, no problems passing urine or stool, no leg weakness, no fever, no weight loss, no history of cancer.
Ideas: "I think I've slipped a disc."
Concerns (cue): "My dad was never the same after his back." His father had back surgery and stopped working. Daniel is scared this is the start of the same. Second cue: "I can't be off much longer."
Expectations: an MRI scan and "something stronger".
If the doctor ignores the cues twice: he becomes short and insists on a scan.

A 12-minute outline that would score well

Time	What the doctor does	Example line (written by Confetto)
0:00–1:00	Greets, confirms identity, checks he can talk privately, open question	"Hello, I'm Dr Shah, one of the GPs. Can you tell me what's been happening?"
1:00–3:30	Lets him tell the story; picks up the cue about his dad	"You mentioned your dad. What happened with his back?"
3:30–5:30	Red-flag screen, explaining why	"I'm going to ask some personal questions to make sure this isn't something that needs urgent treatment. Any numbness between your legs or around your bottom? Any change in passing urine?"
5:30–6:30	Ideas, concerns, expectations; work; asthma and painkillers	"What were you hoping we could do today?" / "Have you taken ibuprofen before, and did it affect your breathing?"
6:30–7:30	Summarizes, shares the working diagnosis, links to his concern	"From what you've told me, this sounds like a back strain, not a slipped disc pressing on a nerve. I can see why your dad's story worries you, and nothing you've told me suggests the same thing."
7:30–10:30	Explains why a scan won't help now, offers options, agrees a plan	"A scan often shows changes that are normal for our age and wouldn't change what we do. What usually helps most is keeping moving and the right painkiller. How does that sound?"
10:30–12:00	Specific safety-net, follow-up, teach-back	"If you get numbness around your bottom, problems peeing or opening your bowels, or weakness in your legs, go to A&E straight away. Otherwise let's speak in 2 weeks. Can you tell me back when you'd go to A&E?"

What scores in each domain (example marking, written by Confetto)

Domain	What a pass looks like in this case	RCGP toolkit item it shows	What would earn a fail, and the RCGP feedback statement it matches
Data gathering and diagnosis	Asks the cauda equina, cancer and infection red flags; asks about asthma and previous NSAID use; finds the father's story and the work worry; reaches "mechanical low back pain"	"Rules in / out a serious disease"; "Discovers patient's psycho-social context"; "Discovers patient's ICE"	No red-flag questions: "Data gathering was insufficient to enable safe assessment of the condition/situation"
Clinical management and medical complexity	No routine imaging (NICE NG59); stays active; an NSAID at the lowest effective dose for the shortest time, after checking his asthma has not reacted to NSAIDs before; work plan and fit note if needed; safety-net for cauda equina symptoms; review in 2 weeks	"Offers a safe patient-centred management plan"; "Manages co-morbidity appropriately"; "Provides follow-up / safety net"	Orders an MRI to please him, or gives an NSAID without asking about asthma: "The management plan relating to investigations was inappropriate or not reflective of current practice" / "The implications of co-morbidity were insufficiently considered"
Relating to others	Picks up the dad cue the first time, explains the "no scan" decision in plain words linked to his fear, agrees the plan with him	"Clarifies and explores cues offered"; "Shares and uses ICE in plan"; "Supports in decision-making"	Says "you don't need a scan" and moves on: "The person's agenda, health beliefs and/or preferences were insufficiently explored"

The point of the example: the clinical answer (no scan, keep moving, NSAID with care, safety-net) is the same for every candidate. What separates a pass from a clear pass is whether the plan answers his fear about his father and his job.

How to practice SCA cases

Read like the exam. Give yourself exactly 3 minutes with the case notes and write hypotheses, red flags and one question about why they came today.
Time every case. 12 minutes, with a check at about 6 minutes; the toolkit's global skills include "Finishes data gathering by 6-7 minutes".
Practice with someone who has a hidden agenda. A study partner who reads the patient brief and only gives the concern when you ask well is closer to the exam than reading a case alone.
Mark against the RCGP's words. After each case, go through the three toolkit domains and the 26 feedback statements and pick the two that fit your performance.
Mix the groups. Don't practice ten chest pain cases in a row; rotate through all 12 blueprint groups, including audio-only cases, as the RCGP says to prepare equally for all of them.

More on a full plan: how to prepare for the SCA.