The government's vision is for patients and clinicians to reach decisions about treatment together, with a shared understanding of the condition, the options available, and the risks and benefits of each of those.
Here clinicians will find evidence for the benefits of shared decision-making and practical support in implementing it.
The government wants to place patients' needs, wishes and preferences at the heart of clinical decision-making, a vision articulated by the Secretary of State for Health, Andrew Lansley, in the phrase 'nothing about me, without me'. But what does this mean in practice?
Making shared decision-making a reality: No decision about me, without me aims to answer that question. It clarifies what is meant by the term shared decision-making and what skills and resources are required to implement it and it also outlines what action is needed to make this vision a reality.
The principle of shared decision-making in the context of a clinical consultation is that it should:
support patients to articulate their understanding of their condition and of what they hope treatment (or self-management support) will achieve
inform patients about their condition, about the treatment or support options available, and about the benefits and risks of each
ensure that patients and clinicians arrive at a decision based on mutual understanding of this information
record and implement the decision reached.
The paper outlines the importance of communication skills and sets out how clinicians might approach consultations to arrive at shared decisions. It also suggests that tools that help patients in making decisions are just as important as guidelines for clinicians.
Clinicians will find evidence for the benefits of shared decision-making and practical support in implementing it.
I hope that the role of the clinical nurse specialist in SDM can be recognised soon, particularly in cancer care. We do so much of this work already, have advanced communication skills, are already preforming holistic assessment and advocacy for our patients but seem utterly absent in most research and debate about SDM. We work as a team, with the patient being a central part of that team already....the clinician is most certainly not alone in this process...please recognise us and our value!
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I hope that the role of the clinical nurse specialist in SDM can be recognised soon, particularly in cancer care. We do so much of this work already, have advanced communication skills, are already preforming holistic assessment and advocacy for our patients but seem utterly absent in most research and debate about SDM. We work as a team, with the patient being a central part of that team already....the clinician is most certainly not alone in this process...please recognise us and our value!
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