22 June 2021

Shared Decision Making Underpins Good Healthcare

Shared decision making between service users and healthcare professionals is an integral part of healthcare, says NICE, in new guideline recommendations published today.

The new recommendations advise that shared decision making should be part of everyday practice across all healthcare settings. The guideline sets out ways for healthcare professionals to work with people using services to make decisions about their treatment and care, and to ensure this is best practice at an organisational level.

Shared decision making is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care.

Prof Gillian Leng, NICE chief executive, said: “We’re delighted to see this shared decision making guideline published and we hope it will help people using healthcare services feel more confident in discussing care and treatment options with their healthcare teams. These recommendations should help healthcare professionals to embed good practice in all their interactions with the people they are caring for and at an organisational level.

“We view these recommendations as underpinning the implementation of all NICE’s work, and it’s important that these recommendations are put into practice at all levels across the system to support patient care.”

The new guideline offers advice on how to engage people accessing care in the shared decision-making process through honest conversation and by providing information resources before, during, and after appointments. The use of posters and patient decision aid leaflets are recommended to help the process.

The guideline suggests that, where possible, organisations should consider appointing a patient director to support the embedding of shared decision making at the most senior levels of the organisation and to help ensure the voice of service users is heard.

The guideline also includes recommendations on organisational planning, training and healthcare delivery to help organisations improve staff awareness of the importance of patient involvement, and ensure they are willing and able to embed shared decision making in organisational culture and practices.

Alongside the shared decision making guideline, NICE has collaborated with NHS England and NHS Improvement to develop a standards framework to determine whether the quality of shared decision-making support tools, including patient decision aids, is sufficient. The framework is designed for people who use patient decision aids, whether they are patients or clinicians. It also includes a simple self-assessment tool for people who produce patient decision aids so that they can quality check their processes and products.

James Sanderson, Director of Personalised Care at NHS England and NHS Improvement, said: “We very much welcome the new shared decision making guidelines and framework published today by NICE, which encourages this very important conversation between clinicians and the people they are supporting, so the patients we look after get the most appropriate and effective care.

“This is critical in giving people choice and control over their mental and physical health, as we have committed to in the Long Term Plan, ensuring better experiences for people using health services based on partnership, and is particularly important as we recover from the COVID-19 pandemic.”

In addition to this, as part of a package of resources to accompany the shared decision making guideline, NICE has collaborated with Keele University to develop a learning package, aimed at healthcare professionals, to help with implementing these recommendations.

Prof Katie Maddock, Head of Keele University's School of Pharmacy and Bioengineering, said: "The School of Pharmacy and Bioengineering is delighted to have been able to share our expertise in both shared decision making and the delivery of online education with the specialists at NICE to develop this new learning package. This new resource will enable practitioners from all healthcare professions to develop and put into practise the skills required for shared decision making which is a fundamental component of person-centred care. We are very much looking forward to the release of the education package alongside the new NICE guideline and also to evaluating its use within healthcare."

Prof Leng added: “We’ve been delighted to collaborate with our partners to develop this guideline, the patient decision aid framework, and the learning package to fully support bringing these recommendations to the healthcare system.”

The guideline and accompanying tools and resources can be read here.

A blog by Siân Phipps, lay member of the NICE shared decision making guideline committee, can be read here.