Shared decision making in realistic medicine: what works

Synthesis of recent evidence on the current use of shared decision-making in Scotland, and international evidence of what works in encouraging greater use of shared decision-making in clinical consultations.


1. Shared decision making is also fundamental to the delivery of social care which uses self-directed support to allow people to choose how their care is delivered.

2. A Citizens Jury brings together a diverse group of 12-25 members of the public (usually randomly selected). Their task is to work through an issue, share ideas, explore options and create recommendations. The jury was the first of its kind in Scottish health and social care.

3. A summary of the Realistic Medicine survey results will be included in the Chief Medical Officer's Annual report 2018-19, with a fuller version to be provided on the Realistic Medicine website

4. National suite of surveys covering: Health and Social Care Experience; Inpatient Experience; Maternity Care; and, Cancer Patient Experience. They provide local and national information on the quality of health and care services from the user perspective.

5. The Our Voice Citizen's Panel is a large demographically representative group of citizens used to assess public opinions on specific issues, including in 2016, SDM. 44% of panel members (541) responded to this particular survey.

6. Research conducted with 100 people across UK to gather views to update the current consent and SDM guidelines (published 2008). Qualitative research was undertaken with samples from particular groups (e.g. gypsy-travellers, people with limited mental capacity)

7. The new draft GMC consent guidelines are currently under review. New guidelines are due to be published in 2019.

8. This column is based on the author's assessment of the availability and strength of the evidence in terms of numbers of studies that mention the condition and scales of studies, and if the studies were conceptual or based on primary data.

9. MAGIC was conducted over three years across ten clinical teams from different Health boards across Cardiff and Northumbria. The Health Foundation conducted an independent evaluation of the MAGIC programme investigating the motivations of uptake of SDM, the barriers to further implementation and the role of systems in implementing SDM.

10. Subject matter experts included: the Realistic Medicine policy team; Person-centred and Participation policy team; Scottish Clinical Leadership Fellow; National Clinical Advisor for Realistic Medicine; Deputy Chief Medical Officer; other clinicians of varying specialities



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