This guideline covers how to make shared decision making part of everyday care in all healthcare settings. It promotes ways for healthcare professionals and people using services to work together to make decisions about treatment and care. It includes recommendations on training, communicating risks, benefits and consequences, using decision aids, and how to embed shared decision making in organisational culture and practices.

The guideline does not cover unexpected emergencies in which immediate life-saving care is needed. It also does not cover situations when, at the time a decision needs to be made, an adult does not have mental capacity to make a decision about their healthcare. For more information, see the NICE guideline on decision-making and mental capacity.


This guideline includes recommendations on:

Who is it for?

  • Everybody who delivers healthcare services
  • Commissioners of health and public health services
  • Adults (aged 18 and over) using healthcare services, their families, carers and advocates, and the public

It may also be relevant for:

  • Social care practitioners
  • Voluntary, community and social enterprise organisations
  • People who use social care services

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces recommendations on shared decision making in NICE's guideline on patient experience in adult NHS services: improving the experience of care for people using adult NHS services (CG138, February 2012).

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.