During a night shift, you realise that a patient has been receiving ten times the prescribed dose of methotrexate for three days due to a prescribing error by a colleague. The patient is currently asymptomatic but is at risk of serious bone marrow suppression. What do you do?

Tips to guide your answer

- This tests your understanding of the duty of candour, your approach to managing a prescribing error, your knowledge of clinical governance and incident reporting, and your ability to balance transparency with the patient against the practical steps needed to mitigate harm.

- Interviewers want to see that your first priority is the patient's safety (stopping the error and managing the clinical consequences), that you understand the statutory duty of candour, that you report the incident through the appropriate channels, and that you do not try to conceal or minimise the error.

Sign in to unlock speak mode

Create account Sign in

How to approach this Shared interview question

This quality improvement question is common in NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "During a night shift, you realise that a patient has been receiving ten times the..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.

What the panel is testing

A strong quality-improvement answer uses method as well as enthusiasm. Be clear about the problem, baseline measurement, intervention, re-measurement, and how the change was made sustainable. For shared NHS interview questions, keep the answer portable across roles. Use one relevant example, explain your reasoning, and make the link to safe patient care explicit.

Separate audit, QI, research, and clinical governance clearly so the panel can follow your reasoning.
Use a real cycle: baseline, intervention, re-measurement, learning, and sustainability.
Link the project back to patient safety, service reliability, or measurable outcomes.

How to structure your answer

For a quality improvement prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.

Open by naming the main issue in the question.
Give a structured response rather than a memorised script.
End with escalation, documentation, learning, or follow-up.

Common mistakes to avoid

The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.

This tests your understanding of the duty of candour, your approach to managing a prescribing error, your knowledge of clinical governance and incident reporting, and your ability to balance transparency with the patient against the practical steps needed to mitigate harm.
Interviewers want to see that your first priority is the patient's safety (stopping the error and managing the clinical consequences), that you understand the statutory duty of candour, that you report the incident through the appropriate channels, and that you do not try to conceal or minimise the error.