Even in a single after-hours encounter the patient decides. Before an investigation, referral or treatment the clinician explains what it is for, how important it is, the expected benefits and the risks, including the option of waiting to see the regular GP, and checks understanding. Patients also receive information that supports their diagnosis, treatment and self-care until follow-up, in a form they can use. Significant discussions and the patient's decision are noted in the record and in the report to the regular practice.
The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.