The first evaluation of an NHS programme to spread joint decision making with patients has highlighted “many challenges” to the aim, mainly because of resistant doctors.
However, it also found enthusiasm from patients and the lead for the project told HSJ work was now planned to overcome the resistance.
The project – led by the Department of Health and NHS East of England - is trying to encourage clinicians to provide patients with more information about their condition and treatment options, and involve them more in decisions. It is part of the quality, innovation, productivity and prevention work and has also been highlighted by the government as focusing services on patients.
Findings from the first evaluation of support websites provided by NHS Direct, shown to HSJ, say patients were “enthusiastic” about the tools and more discussion of options.
However, it found there are “many challenges… before [the] approach can be mainstreamed” – the most notable being lack of understanding among clinicians, particularly specialist doctors.
The Cardiff University report says: “Clinicians feel it acceptable for patients to become informed but not to expect shared decision making. [This] will need addressing if there is further investment in decision support interventions for patients.”
NHS East of England commissioning director and programme lead officer Robert Harris told HSJ it was now moving to “adoption, spread and roll out”. He said to address resistance there were plans to train clinicians and inform patients through representative groups and information in GP surgeries.
He said: “We can do all this work and show it works but it is no good unless people start to use it and patients start to make choices alongside their clinical advisers.”
GP and clinical lead for the programme Steve Laitner said: “This is a challenge that is acknowledged in the [government’s] reforms. To have a sustainable healthcare system we need patients to be much more in the driving seat.”