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What is shared decision-making in healthcare in the UK?

A care professional and a patient discussing healthcare decisions

An overview of shared healthcare decision-making in the UK

Do you believe that patients should have the right to be involved in decision-making about their healthcare in the UK? Everyone will have to make healthcare decisions at some point in their lives, either for themselves, their family members, or both. While these decisions will be difficult at times, they will have an impact on everything from your overall health to the quality of care you or your family receive. Your decisions even have an impact on the cost of care, so it is crucial to take your time and make the best choice possible. 

Gone is the era wherein physicians alone could make the most important care decisions for patients in the UK. Today, healthcare professionals should not use their expertise to drag patients towards a particular conclusion; instead, patients and experts should partner up in creating a treatment plan, wherein both contribute to the crucial discussion. 

It would be fundamentally right if patients were also involved in the decision-making, as it would help them to be more cooperative towards the treatment. Patients who are involved in their healthcare decision-making process have better health outcomes and a higher quality of life. 

In this article, we will discuss what shared healthcare decision-making is in the UK and how it can benefit a patient. 

What is "shared healthcare decision-making"?

Shared decision-making (SDM) in healthcare in the UK is a collaborative process in which a person and their healthcare professional collaborate to make the best healthcare decision for the person. It entails selecting tests and treatments based on evidence as well as the individual's preferences, beliefs, and values. It ensures that the person understands the risks, benefits, and potential consequences of various options through discussion and information sharing. 

SDM requires three components: 

1. Clear, accurate, and unbiased medical evidence about the reasonable options, as well as the risks, benefits, and burdens of each option, including no intervention 
2. Clinician communication expertise and the ability to tailor that evidence to individual patients 
3. Patient goals, informed preferences, and concerns, including treatment burden 

Shared healthcare decision-making is the key component of universal, personalised care. 

Why is shared healthcare decision-making so important in the UK? 

There are several factors for shared healthcare decision-making that are relevant for improved healthcare service, such as healthcare professionals encouraging their team to make improvements or commissioners working for better care across their area. 

According to the NHS Long Term Plan in the UK, personalised care will become the norm across the healthcare system, based on 'what matters' to people and their unique strengths and needs. The concept of universal personalised care confirms how we will achieve this. It outlines a comprehensive model of personalised care, with shared decision-making as one of its six key components. Here's why shared healthcare decision-making is so important: 

1. Shared healthcare decision-making can reduce the gap in treatment and help to create a positive relationship between individuals and professionals based on partnership. 
2. People want to be involved more in their healthcare plans than now. 
3. Both individuals and healthcare professionals tend to consistently overestimate the benefits of treatments and underestimate the harms. 
4. Shared healthcare decision-making has the potential to improve allocative efficiency while reducing unnecessary clinical variation. 
5. It is intrinsic to professional codes of conduct/standards. 
6. It is now a legal requirement in the UK, and healthcare providers must take "reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, as well as any reasonable alternative or variant treatments." 
7. As the preferences and goals of each patient differ, medical treatment might require the patient to take stock of their entire life to create the right care plan.  

Why do we need shared healthcare decision-making?

1. Shared healthcare decision-making is ethically the right thing to do when creating a care plan or treatment. 
2. It is "perfected" informed consent and addresses shortcomings in the current informed consent process. 
3. It helps bridge healthcare disparities. 
4. It can impact the quality, cost, and safety of healthcare delivery. 

What are the benefits and drawbacks of shared healthcare decision-making in the UK?

There are several advantages to shared healthcare decision-making, and they include: 
1. Enhancing patients' commitment to treatment and care plans. 
2. Helping care providers communicate evidence for healthcare decisions. 
3. Creating a positive connection between the patient and the healthcare professional
4. Perfecting informed consent: after a deep conversation, patients are well-informed and can consent more honestly than by simply signing a piece of paper. 
5. Setting realistic expectations for treatment and recovery. 
6. It gives people the option of determining how much involvement they want in decision-making. Some people may choose not to participate in healthcare decision-making with their healthcare providers. 
7. Through the communication of information, patients will have a good understanding of the benefits, harms, and possible outcomes of different options. 

However, even after having so many benefits, there are a few potential disadvantages to the method, which include: 
1. Time-consuming, as in some healthcare settings patients feel that they don't have enough time to ask questions during their visits, but in reality, most healthcare professionals value patient engagement. 
2. Burdening patients with decision-making, as some patients might be struggling with symptoms or in pain. It will be difficult to make healthcare decisions. They may prefer an expert's guidance regarding their treatment and care plan. 
3. Addressing communication barriers, as it is not necessary for patients and healthcare providers to speak the same language. In such cases, patients may be concerned about expressing themselves and being understood. 

What tools are available in the UK to facilitate shared decision-making?

The following are the tools that support shared healthcare decision-making: 

1. Patient decision aids 

Decision aids can be used to facilitate a shared healthcare decision-making conversation between the patient and provider. These tools can assist patients in comprehending the clinical evidence and identifying their preferences. Decision aids do not provide advice or advocate for one option over another. Instead, they educate patients so that they can make informed, value-based decisions with their providers. 

2. Shared decision-making skills training

Shared decision-making requires healthcare professionals in the UK to have guidance and practice using the six steps for the same. The training also gives the health experts opportunities to receive feedback on their communication skills with their patients about important medical decisions. 

3. Measurement and feedback

The goal of shared decision-making in the UK is for patients to make informed treatment decisions based on what is most important to them. Having practical and reliable measures of shared decision-making can provide clinicians and practices with feedback on their performance and whether they are assisting their patients in achieving meaningful outcomes. 

Nurses Group is the leading nursing staffing agency in the UK, with offices in Yeovil, Salisbury, Taunton, Bournemouth, and other cities. Our staff understands the importance of shared healthcare decision-making and thus includes patients in their care and treatment. As the highest-paid nursing agency in the UK, we understand that even staff members must be trained in shared healthcare decision-making in order to provide the best care experience to our clients. 

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