Shared decision-making

Shared decision-making occurs when a service user and health professional make healthcare decisions together. It involves looking together at the service user's values and preferences as well as the scientific evidence for different options.

It is about working in partnership so that you have the confidence that you're getting the most suitable care and treatment available.

Shared decision making views a consulation as a "meeting between two experts. The clinician brings an understanding of the effectiveness, benefits and harms of specific actions and the service user brings an understanding of their preferences and their attitudes to illness and risk."
(Marshall & Bibby 2011 Supporting patients to make the best decisions)

A review of the research evidence around shared decision-making shows that service users involved in shared decision-making are better informed and less likely to be undecided about the best course of action. They are also more likely to continue with the agreed treatment.
(Stacey et al, 2014: Cochrane review of people using decision aids)

More information about shared decision making can be found online at https://www.health.org.uk/video/shared-decision-making

Examples of questions you may want to ask:

• What is your understanding of my illness?
• Why has this happened to me?
• Will I get better?
• Would talking treatments be helpful?
• Are they available in my area?
• What alternative/complementary treatments are available?
• What self-help strategies are recommended?
• What medication are you suggesting; are other choices available?
• What are the possible side effects?
• Are there any long term risks?
• How long will medication take to work?
• How long should I continue taking it?
• What should I do if I don’t wish to take it any more?
• Who will be involved in my care?
• What happens if I refuse suggested treatment?
• How can my family/carers be involved?
• Will I have a care plan?
• How long am I likely to receive your support?

The acronym SHARE can be used to remind clinicians to implement Shared Decision Making:
Supply information about treatment options
Help the service user explore and compare treatment options
Assess the service user's values and preferences
Reach a decision together
Evaluate the decision

Examples of things you may want to tell our staff:

• My aims for care and treatment are...
• My preferred type of treatment is...
• I would like more written information on…
• I would prefer to have information explained to me verbally.
• These are the people I’d like to be involved in my treatment...
• This is how I’d like them to be involved
• My feelings about medication are…
• I am likely/not likely to take prescribed medication
• Side effects I’ve had in the past are…
• Side effects I currently have are…
• Side effects I really want to avoid include... 
• Physical problems I have are...
• Physical problems in my family are...(please tell us about any problems with blood pressure, diabetes, heart disease)
• My thoughts about talking therapies are...
• Alternative/complementary treatments I’d like to explore are...