Shared decision making leads to a better patient experience: With policy documents promoting patient-centred healthcare, Steven Laitner explores how the shared decision making programme is providing tools to help make them reality
Shared decision making is the belief that patients and their clinicians bring equally valuable input to the table when patients reach a decisions crossroads in their healthcare.
Clinicians know about the options available, while patients know what they want from their treatment. With current clinical information, relevant to their particular condition, patients can be helped to work through any questions they may have, explore the options available, and take a treatment route which best suits their needs and expectations.
Shared decision making can reduce treatment disagreements, lead to more realistic expectations, reduce clinically unwarranted treatments, and potentially reduce litigation. Importantly, patients are more likely to stick with a course of action or treatment when they have chosen it, rather than had it foisted upon them. It leads to a better patient experience.
It is also becoming embedded in national policy, with considerable nod in the information strategy and 'Liberating the NHS', so why – now there's push from the top – is it not yet part of our everyday healthcare experience?
Recent research from the US shows that close to 70% of patients questioned preferred making medical decisions with their doctors. However, only one in seven would disagree with their doctor over treatment, some saying it would not be socially acceptable or would damage their relationship with the doctor.
To help redress the power imbalance, the Department of Health has funded a national shared decision making programme to support 'patient pull'.
In one strand of the programme, information posters, leaflets, film clips and animation are being made available to encourage patients to get clear and straight answers from their clinicians to three core questions: what are my options, what are the pros and cons of each option, and how do I get support to help me make a decision that is right for me?
There is also a series of 36 online patient decision aids so patients can delve into the facts, figures and options relating to their particular health care need. These resources will span a range of conditions, from rheumatoid arthritis and breast cancer, to multiple sclerosis and depression.
Patients can work through the decision aids in their own time, alone or supported by family and friends, or by a team of specially trained telephone advisers.
Alongside mobile apps, soon patients and clinicians will have a wealth of information at their finger tips, whatever their preferred way of sourcing it.
The third element of the programme is to embed shared decision making into everyday NHS business. So when a GP consults their information system, a patient decision aid pops up and when the clinicians of tomorrow undergo their training, shared decision making skills are part of their curricula.
Commissioners too are being targeted with advice on how they can deliver their statutory duties to involve patients in their care, and pointers on what good commissioning of shared decision making should look like.
Early indicators are promising. Following a recent event in Manchester, attended by over 200 delegates including clinicians and commissioners, 80% said that they felt more receptive and more likely to implement shared decision making with their patients.
As the Health Foundation said last month, patients "need to be able to choose which dance they want, know the steps needed and be able to hear the music". As the shared decision making programme continues to deliver, it is hoped that all parties concerned will soon be dancing to the same tune.
Dr Steven Laitner is a practising GP and the national clinical lead for the right care shared decision making Programme. Guardian Professional.
Shared decision making is the belief that patients and their clinicians bring equally valuable input to the table when patients reach a decisions crossroads in their healthcare.
Clinicians know about the options available, while patients know what they want from their treatment. With current clinical information, relevant to their particular condition, patients can be helped to work through any questions they may have, explore the options available, and take a treatment route which best suits their needs and expectations.
Shared decision making can reduce treatment disagreements, lead to more realistic expectations, reduce clinically unwarranted treatments, and potentially reduce litigation. Importantly, patients are more likely to stick with a course of action or treatment when they have chosen it, rather than had it foisted upon them. It leads to a better patient experience.
It is also becoming embedded in national policy, with considerable nod in the information strategy and 'Liberating the NHS', so why – now there's push from the top – is it not yet part of our everyday healthcare experience?
Recent research from the US shows that close to 70% of patients questioned preferred making medical decisions with their doctors. However, only one in seven would disagree with their doctor over treatment, some saying it would not be socially acceptable or would damage their relationship with the doctor.
To help redress the power imbalance, the Department of Health has funded a national shared decision making programme to support 'patient pull'.
In one strand of the programme, information posters, leaflets, film clips and animation are being made available to encourage patients to get clear and straight answers from their clinicians to three core questions: what are my options, what are the pros and cons of each option, and how do I get support to help me make a decision that is right for me?
There is also a series of 36 online patient decision aids so patients can delve into the facts, figures and options relating to their particular health care need. These resources will span a range of conditions, from rheumatoid arthritis and breast cancer, to multiple sclerosis and depression.
Patients can work through the decision aids in their own time, alone or supported by family and friends, or by a team of specially trained telephone advisers.
Alongside mobile apps, soon patients and clinicians will have a wealth of information at their finger tips, whatever their preferred way of sourcing it.
The third element of the programme is to embed shared decision making into everyday NHS business. So when a GP consults their information system, a patient decision aid pops up and when the clinicians of tomorrow undergo their training, shared decision making skills are part of their curricula.
Commissioners too are being targeted with advice on how they can deliver their statutory duties to involve patients in their care, and pointers on what good commissioning of shared decision making should look like.
Early indicators are promising. Following a recent event in Manchester, attended by over 200 delegates including clinicians and commissioners, 80% said that they felt more receptive and more likely to implement shared decision making with their patients.
As the Health Foundation said last month, patients "need to be able to choose which dance they want, know the steps needed and be able to hear the music". As the shared decision making programme continues to deliver, it is hoped that all parties concerned will soon be dancing to the same tune.
Dr Steven Laitner is a practising GP and the national clinical lead for the right care shared decision making Programme. Guardian Professional.
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