Shared Decision Making in the NHS Sue Kennedy National Shared Decision Making Programme Manager

The policy context

Shared Decision Making Shared decision-making is a process which involves patients: as active partners with their clinician; in clarifying acceptable medical options; and in choosing a preferred course of clinical care.

What are they sharing?

Why shared decision making? Benefits include : Improving patient satisfaction, experience, knowledge; Helping patients make healthcare choices aligned with their personal needs, values and circumstances; Improving clinical outcomes and safety; Achieving the right intervention rate and reducing unwarranted practice variation; Reducing litigation costs.

Shared Decision Making in the NHS Health and Social Care Bill: SofS, NHS Commissioning Board & CCGs have a duty “to promote the involvement of patients, and their carers and representatives (if any), in decisions about the provision of health services to the patients” NHS Operating Framework 2012/13: Quality “Tools such as patient decision aids, health investment packs, the atlas of variation should help shared decision making with patients about care options, as well as supporting commissioning for increased value to address unwarranted variation. “ SDM underpins the Government’s vision of a patient-centred NHS. “No Decision about me without me”

The policy context

Patient Decision Aids Patient Decision Aids (PDAs) are tools designed to help patients make difficult treatment or screening decisions when there is no clinical evidence that one option is better than another. PDAs aim to increase patients’ awareness of the expected risks, benefits and likely outcomes, empowering them to make informed choices about their care.

The National SDM Programme

NHS Direct Hosted Patient Decision Aids The Right Care SDM Programme: Phases 1-3 Phase Healthcare Decision Addressed by the Patient Decision Aid Current Status 1Osteoarthritis of the kneeAvailable since February BPHAvailable since February Localised prostate cancerAvailable since February Breast cancer surgery choicesAvailable since August Chorionic villus sampling/amniocentesisAvailable since August Prostate Specific Antigen (PSA) testingAvailable since August Osteoarthritis of the hipAvailable since August Cataract surgeryAvailable since August Advanced kidney disease (end of life care plan)Available since December 2011

Patient Comments "All the necessary information was there in simple illustrative manner" “Easy to follow and explained simply in plain English“ “I have an understanding of what I want to get across to the consultant” "Own time, own space, own pace"

The National SDM Programme Phase 4 3 contract lots running for months: Lot 1: Totally Plc: Developing Patient Decisions Aids and Patient Coaching Lot 2: Capita : Embedding SDM in NHS systems Lot 3 : AQuA: Creating a Receptive Culture for SDM

Phase 4 : Lot 1 Totally Plc February 2012 – January 2013 SDM tools and decision support 30 new Long Form PDAs 38 Short Form PDAs 38 Mobile Apps Migrate 9 Phase 1-3 PDAs SDM Patient Coaching Development CRM/Webinars Potential to propose a further 14 PDAs

Phase 4 : Lot 2 Capita “Embedding SDM in NHS systems “: Work with EMIS, Vision, System One Routine commissioning systems, frameworks and informed consent procedures Providing information, insight and advice to the NHSCB and CCGs to enable the delivery of their statutory duties Develop appropriate SDM KPIs and quality measures Produce a baseline of UK-based scientific evidence on the effects of SDM and ongoing research framework proposals

Phase 4 : Lot 3 AQuA: Advancing Quality Alliance “Creating a receptive culture” Engagement Campaign targeted at patients, clinicians, 3 rd sector and the wider public Communicate via variety of media including Patient Opinion and social media to raise the profile of shared decision making to patients, the public and the Service. Work with education providers, Royal Colleges and professional bodies to promote the inclusion of SDM in the training and education of clinical professionals. Produce a range of resources to support the introduction and embedding of SDM into the NHS: Deliver a programme of learning and development for clinical teams, to raise awareness and secure ongoing sustainability within clinical practice. Design and implement a training programme intended for clinical providers and commissioners using video and wiki technology

Give people the care the need and no less, the care they want and no more Thank Thank you