Key points

Key points

  • In the context of medicines optimisation, shared decision making involves healthcare professionals and patients (patients should be understood to include all people who use NHS services), working together to make choices about medicines based on clinical evidence and the patient's informed preferences about what they hope to gain from the treatment.

  • When discussing the risks and benefits of treatment, the law now requires healthcare professionals to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment and of any reasonable alternatives.

  • The first principle in the Royal Pharmaceutical Society's good practice guidance on medicines optimisation, published in 2013 is 'Aim to understand the patient's experience'. Professional codes of practice recommend a shared decision-making approach to care, including those of the General Medical Council, General Pharmaceutical Council and Nursing and Midwifery Council.

  • All NICE guidance recommends shared decision making, and several NICE quality standards identify and define shared decision making as part of good quality care.

  • The NHS England document Universal personalised care: Implementing the comprehensive model, published in January 2019 has shared decision making as 1 of the 6┬ácore components of personalised care.

  • Options for local implementation:

    • Encourage and support a shared-decision making approach to care. Visible organisational buy-in and support are essential for this to succeed. Individual healthcare professionals need support and training to incorporate and develop shared decision making in their practice.

    • Consider patient empowerment, activation and preparation campaigns, such as the Ask 3 Questions or Choosing Wisely campaigns, to explain what shared decision making involves, why it might help, and provide interventions such as question prompt lists.