GPs need support to improve shared decision-making with patients

The government's drive to give patients a greater say in their care could fail unless patients and clinicians are given proper practical support, a King's Fund report warned.

The report said despite widespread support for involving patients in decisions about their care, shared-decision making is not yet the norm.

‘No decision about me, without me: making shared decision-making a reality’ said the challenge is to devise effective ways for supporting shared decision-making and ensuring it is embedded in clinical practice.

It said patients could be better supported through greater provision nationally of decisions aids. It also suggested that shared-decision making should be included in medical training.

The drive to embed shared-decision making will also require strong clinical leadership, proper incentives and 'patient push', the report said.

Angela Coulter, report author and senior research scientist at the University of Oxford, said the idea that clinicians make the decisions with the patient following this advice is ‘out of date’.

She warned that if patients aren’t involved in decisions about their care then dependency on clinicians is created. This has implications on the sustainability of the NHS, she said.

She said: ‘In the UK we have had lots of rhetoric around shared-decision making, but not much has happened in terms of practical support for patients and clinicians.

‘This not just about producing papers, there needs to be actual practical support, such as decision aids for patients which set out treatment options.

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