Working together to put patients at the heart of decisions about their care

Professor David Haslam, Chair of NICE, talks about the benefits of clinicians and patients making decisions together.

According to the King’s Fund, 15 million people in England have long term health conditions, and this number will inevitably rise as medicine becomes ever more effective in preventing premature deaths.

As our health service faces this growing challenge, it’s more important than ever for clinicians and health care professionals to move away from ‘top-down’ medicine and connect with patients on decisions about their care, doing medicine with people rather than doing it to them.

There is a growing body of evidence about the benefits of shared decision making.  When clinicians and patients make decisions together, research has shown that this can lead to more appropriate decisions being made about care, which in turn can improve both patient safety and patient satisfaction. In some cases, it can even result in more cost-effective care.

The advantages are clear, but what is being done to embed this important practice within our health and social care services?

In 2015, the Shared Decision Making Collaborative was formed. This brought a wide range of individuals and organisations together, led by NICE, to serve a common goal – driving forward shared decision making. A commitment which will ensure that patients and clinicians work together to select tests, treatments and support packages, based on both clinical evidence and what really matters to the individual patient.

Today, the collaborative has set out a range of recommendations to encourage a shared decision making culture. An action plan has also been published which describes how these recommendations will be put into practice.

This is an important step forward that will help transform the way we deliver the best care to patients.

The leading organisations in our health service are joining forces and committing to a future that will see improved patient centred care for everyone. It’s not just about the words on a page, it’s about making it happen and ensuring that shared decision making becomes an essential part of medical practice.

NHS England has pledged to make sure that involving patients in the decisions about their care is rooted in to ongoing work programmes. And we will work with them to ensure that tools to support the clinician/patient conversation are up to standard and embedded within guidance and pathways.

Healthwatch England has committed to help advocate and support this initiative in local health and care systems, and the General Medical Council has agreed to incorporate shared decision making within its Generic professional capabilities framework, which sets out the knowledge, skills and behaviours which doctors need.

Personalising care for the individual is fundamental to our future. It is imperative that we actively seek and listen to our patients and involve them in the development of our NHS and social care services.

The plans put forward today by the Shared Decision Making Collaborative are proof that we’re up for the task. Let’s work together and change the future of healthcare for the better.

Blog comments

  • Dear Sir:

    It seems that your vision still views the patient as an object, not of a subject. The sentence "Personalising care for the individual is fundamental to our future" still is talking about, not with the patient. In my view, the notion of the subjective approach is crucial in creating a strong patient-doctor-dyad. Painfully, patients understand that their doctors do not always know best, because they know that often, doctors do not know their medical history, allergies, or medications. They daily they feel the paradox of lack of important information in view of billions of pounds poured into megalomanic IT projects.

    The title of this blog "Working together to put patients at the heart of decisions about their care" should have been "Let patients work together with their doctors by preparing their appointment, maintaining their health dossier, presenting their case in a comprehensible way". At MediPrepare we let patients work, we help them collect medical data and we help them present their medical history and important data. Patients feel the urgency of informing and making sure their doctors know all important information and context. This can be accomplished in a very inexpensive and effective way, solving a lot of problems patients as well as doctors experience on a daily basis.

    Yours truly,




  • Hello, thank you for your comment. Shared decision making is key to our guidance and we produce patient decision aids to assist patients in their treatment decisions. Please email us on nice@nice.org.uk to find out more.

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