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Shared Decision Making

Andrew Lansley, former Secretary of State for Health, stated on 9th June 2010,

“Patients must be at the heart of everything we do, not just as beneficiaries of care, but as participants, in shared decision making.  As patients, there should be no decision about us, without us.”

Under the NHS Constitution, you have

“the right to be involved in discussions and decisions about your healthcare, and to be given information to enable you to do this."

NHS Shared Decision Making WebsiteWhat is Shared Decision Making? 

It is an approach where clinicians and patients communicate together using the best available evidence to make decisions on treatments, management options and support options of an illness. 

Research on this topic has shown that although the clinician has knowledge in respect of the diagnosis, disease causes, outcome of the disease and treatment options, it is the patient who has the actual experience of the illness and their social circumstances, attitude to risk, their values and preferences should play an important part in making a decision in regard to their health.

It has been shown that if clinician and patient share information in respect of all these things, then the outcome for the patient is better.

There are lots of things that patients want to know when they visit a doctor such as:

  • What’s the cause of my symptoms?
  • Is there more than one way to treat my condition?
  • Will treatment relieve the symptoms?
  • What are the risks?

Decision aids have been designed to help the patient answer these questions.  The decision aids provide facts about the condition, the options for treatment, the expected outcomes and probabilities.  They help patients clarify and communicate their thoughts about the outcomes that matter most to them, not those that matter most to the doctors.

There is a lot of evidence showing that decision aids have led to:

  • greater knowledge for the patient
  • more accurate risk perceptions
  • greater comfort with decisions
  • greater participation in decision making
  • fewer people undecided about their options
  • fewer patients choosing major surgery

Most people have to make healthcare decisions at some time in their lives and people want clinicians to listen to them, explain and answer their questions. Many people want more information than is given to them by their clinician and most, but not all, people want to be involved in treatment decisions. As we know, people with long-term conditions have to self-manage and making health decisions is part of that.


Where Can I Find Decision Aids?

NHS Rightcare logoThe NHS website for shared decision making has several decision aids written by the BMJ Group under the supervision of a medical Advisory Group.


The Advisory Groups are made up of:

  • Doctors
  • Allied healthcare professionals
  • Clinical specialists
  • Patients
  • Charities and patient representative groups
  • Department of Health policy leads

As well as the decision aids, the website has lots of information about shared decision making including a good FAQ page.

There is, at present, no decision aid for any type of thyroid problem but there are others that you may find useful including:

  • Osteoarthritis of the hip
  • Osteoarthritis of the knee
  • Cateracts

The decision aids themselves include written information, animations, videos, decision maps, an area for your own notes and questions as well as a decision support telephone service.

You don’t have to register but if you do, your progress will be saved so you can go back at any time to review the decisions you are interested in. You can also store your own notes and questions about the decision you are making and you can print out a personalised summary of the decision information.

For more information go to:  sdm.rightcare.nhs.uk/


The Shared Decision Making Programme

The Shared Decision Making Programme is hosted by NHS Midlands and East on behalf of the QIPP (Quality, Innovation, Productivity and Prevention) Right Care Programme.

Totally Health were appointed by NHS Midlands and East to provide services for the Shared Decision Making project to develop of a suite of 36 patient decision aids and associated telephone support.

These decision aids, which are due to be completed soon, include conditions such as acne, blood pressure and depression.

For more information on these go to: www.totallyhealth.com/case-studies/shared-decision-making/

Thyroid UK feels that shared decision making is a step in the right direction. However, since awareness of the NHS Constitution is so low in both patients and healthcare professionals, it may be some time before shared decision making becomes a reality.

For more information on shared decision making go to:

The Health Foundation logo



Healthtalkonline logowww.healthtalkonline.org/improving_health_care/shared_decision_making



Last updated 9/11/2012