Embedding Shared Decision Making – Lot 2 work programme

The challenge The key message is that we could do better and we need to do better. Effective shared decision-making is not yet the norm and many patients want more information and involvement in decisions about treatment, care or support than they currently experience. The biggest challenge now is to devise effective ways for supporting shared decision-making and ensuring it is embedded in mainstream clinical practice. Angela Coulter, Alf Collins, Making Shared Decision Making a Reality, No Decision About Me Without Me, Kings Fund 2011

Lot 2: embedding Shared Decision Making  Embed Shared Decision Making and related interventions in NHS provider systems  Embed Shared Decision Making in routine commissioning systems, frameworks, and informed consent procedures  Provide information, insight and advice that would enable the NHS Commissioning board and CCGs to deliver on their duties  Develop and implement appropriate measures of Shared Decision Making and use of interventions designed  Produce UK based scientific evidence on the effect of shared decision making and related interventions on health outcomes, intervention rates, patient experience, litigation costs and other validated measures of Shared Decision Making

Principles underpinning our delivery plan …  Ensuring it is as easy as possible for clinicians and patients to access Patient Decision Aids  Building on progress to date and existing behaviours  Developing knowledge working with specific localities and pathways, that can be replicated elsewhere  What we can realistically achieve within a short timeframe  Providing a strong foundation for the programme after year 1

Key deliverables and milestones: embedding SDM within provider systems WhatWhen Inventory of information system suppliers – both patient and clinician facing – identifying key targets February Plan in place to engage with national bodies to promote information system provider uptake March Technical documentation in place to support information providers integration April Business case/propositions for information system suppliers – why integrate PDAs and SDM April Engagement and support systems in place for information system suppliers April

Key deliverables and milestones: embedding SDM in routine commissioning systems WhatWhen Implementation plans with local health economiesMarch Draft strategic framework for commissioners – where does SDM fit within the wider context? April Draft of model of excellence for commissioners - what does ‘good look like’ and how do you measure it April Interim reports and updates to guidanceRegularly Final report – progress locally, recommendations and final guidance January

Key deliverables and milestones: guidance for CCGs and the Commissioning Board WhatWhen Develop framework for guidance and approachApril Draft frameworkJune Final draft to Commissioning BoardOctober

Key deliverables and milestones: KPIs and evaluation WhatWhen Develop a set of KPIs to support the measurement and regular reporting of SDM April Quarterly and biannual reports on KPIsRegularly Evaluation approach agreedMarch Local evaluation approach and measures agreedApril Literature review completed – focusing on identifying measures of decision quality April Evidence baseline – measures supporting future evaluation of SDM September Final local reportJanuary

What we’re looking for …  An innovative, forward thinking health economy (CCG and possibly provider organisations) interested in Shared Decision Making  Some understanding of local priorities, commissioning processes and any relevant process improvement initiatives – so we can design a programme that meets local demands as well as what we’ve been commissioned to do nationally  Real, practical engagement with local commissioning processes and systems  Potential opportunities for collaboration on research and evaluation at a local level

What are the possible benefits for local health economies?  improved knowledge and understanding  more accurate risk perceptions  greater comfort with decisions  more participation by patients  fewer patients choosing major surgery  better treatment adherence  improved confidence and coping skills  improved health behaviours  more appropriate service use Angela Coulter, Alf Collins, Making Shared Decision Making a Reality, No Decision About Me Without Me, Kings Fund 2011