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PROactive Management of Integrated
Services & Environments
Shared decision making (SDM) is the honest discussion that happens between a service user and health professional to make decisions about care and treatment together. We encourage carers to be involved in this decision making (where the service user consents). Decisions are based on both clinical evidence and the service user’s understanding and choices. SDM recognises that patients and clinicians bring different but equally important types of expertise to the discussion.
The following 7 elements provide a framework for implementing SDM:
1. The service user/carer are provided with good quality information about treatment options.
2. The clinician discusses this information with the service user/carer.
3. The service user/carer discusses their priorities and preferences with the clinician.
4. The service user/carer and clinician have an open discussion about the risks and uncertainties associated with the treatment options available.
5. The clinician distinguishes between strong recommendations and situations where there are alternative, but equally valid treatment options.
6. The service user is given time to consider their options
7. Where a consensus can’t be reached, a compromise is negotiated.
Download our leaflet about Shared Decision Making.
In January 2015 the Trust ratified a policy for Shared Decision Making which is available on the CPFT website.
Why should we practice Shared Decision Making?
We know that service users want to be involved in decisions about their care and treatment. Research indicates that service users are more likely to engage with their treatment plans when they have been involved in the initial decision.
Nationally, NHS policy is that Shared Decision Making should become the norm in the NHS.
From 2011 – 2014, CPFT was involved in the ShIMME project (jointly with service users and Anglia Ruskin University). ShIMME stands for Shared Involvement in Medicines Management. This research project involved consulting with staff and service users about the amount of SDM that currently takes place in CPFT and then running a series of training programmes for staff and service users in the process of SDM. The main finding of the research project was that this training led to a significant increase in service users’ levels of certainty around medication decisions.
The following links provide more information about SDM in general:
Leading the Way to Shared Decision Making (Health Foundation 2012)
The ShIMME project website contains articles and information about Shared Decision Making
The NHS Shared Decision Making programme has decision aids for people with a variety of conditions. The only mental health decision aid at present is for mild-moderate depression. It gives a useful overview of the Shared Decision Making process.
The MAGIC programme describes work that’s been done in the NHS to promote Shared Decision Making
The clinician’s expertise includes
The service user’s expertise includes
diagnosis & possible outcomes, possible causes of illness, treatment options, factors that affect mental health, understanding of mental health challenges.
their goals, choices & values, experience of illness, including what’s helped (or not helped) before, social circumstances, attitudes to risk.
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