Not being properly told about their illness and the options for treatment is the most common cause of patient dissatisfaction. Most patients want more information and a greater say in decisions about how they will be treated. Shared Decision Making (SDM) is a process in which patients are encouraged to participate in selecting appropriate treatments or management options.
In Shared Decision Making, patients are involved as active partners with their health professional in clarifying acceptable medical options and choosing a preferred course of clinical care. Shared Decision Making is appropriate in any situation when there is more than one reasonable course of action and no one option is self-evidently best for everyone. This situation is very common since there are often many ‘preference-sensitive’ decisions. In these cases, the patient’s attitude to the likely benefits and risks should be a key factor in the decision.
SDM relies on two sources of expertise:
The health professional is an expert on the effectiveness, probable benefits and potential harms of treatment options
The patient is an expert on herself, her social circumstances, attitudes to illness and risk, values and preferences
Both parties must be willing to share information and accept responsibility for joint decision-making. The clinician must provide patients with information about the diagnosis and treatment options and the patient must tell the clinician about their preferences.
The Shared Decision Making programme consists of three e-learning modules:
Guidance on Shared Decision Making is a course developed by Health Education England (HEE) e-Learning for Healthcare and the Advancing Quality Alliance (AQuA). It introduces what Shared Decision Making (SDM) is and how to implement it in practice. The two sessions in this course are designed to help health professionals learn SDM skills, using examples of consultations to illustrate good and bad practice. Prompts to aid consultations, along with resources to help implement shared decision making in practice, are also provided.
Dialogues in Shared Decision Making is a course for GPs created by HEE West Midlands in partnership with GPs, GP trainers and trainees, patients and others. The aim of the course is to enable both trainee and established GPs to improve their skills in involving patients in decisions made about their care. For shared decision-making to work, GPs need good consulting skills, which is what this course is about. This course focuses on consultations between a patient and a GP on 12 different concerns, such as missed periods, a tingling arm, headaches and an unexpected pregnancy. The consultations, which are based on real patient encounters, are films showing both good encounters and ones in which the GP does not succeed in sharing the decision-making with the patient. There is then a further film in which the patient says how they found the consultation and a document which raises some of the arising issues.
Thinking About What Matters is a course developed by HEE West Midlands intended to explore in greater depth the interactions between doctors and patients that help create a meaningful outcome to consultations. The course consists of a series of patient scenarios and is designed to be applicable across primary care, and not confined to medical professionals.