More results from the Citizen’s Panel revealed that “the public greatly values a doctor who listens”. Care Opinion results were also shown as a tag bubble and highlighted that communication is consistently the most negative theme. Good communication, health literacy and asking the right questions are some of the key factors involved in shared decision making. There is room for improvement and a variety of methods, tools and case studies are highlighted to help illustrate what is being done already. [The Scottish Government. Practising Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2016-17. Published 2018. https://www.gov.scot/publications/practising-realistic-medicine/]
Shared decision making is directly related to personalised care, developing one will result in improvement in the other. In 2018 the Scottish Government conducted a study investigating good practice in shared decision making and consent. “The report’s main recommendation was to ‘bring the conversation back to the room’ – to allow a rich and meaningful dialogue built on partnership and placed at the heart of every interaction between those giving and receiving care.” Several of the findings from this study matched closely with the Citizen’s Jury results. [The Scottish Government. Personalising Realistic Medicine: Chief Medical Officer for Scotland’s Annual Report 2017-18. Published 2019. https://www.gov.scot/publications/personalising-realistic-medicine-chief-medical-officer-scotland-annual-report-2017-2018/pages/7/]
“The updated GMC guidance Decision Making and Consent was launched in September 2020. It focuses on delivering personalised care and firmly aligns with the principles of Realistic Medicine, including:
- finding out what matters to people, so we can share relevant information in the most effective way;
- the importance of taking a proportionate approach – good decision making needn't always be formal, or time consuming; and,
- suggestions for how other members of the healthcare team can support decision-making.” [The Scottish Government. The Chief Medical Officer for Scotland’s Annual Report 2020-21: Recover, Restore, Renew. Published 2021. https://www.gov.scot/publications/cmo-annual-report-2020-21/ ]
NHS Education for Scotland (NES) has produced an online module to aid shared decision-making.
Health literacy has been vital during the pandemic to ensure that the people of Scotland understand the situation and what is being asked of them. Many people are living with complex health conditions are cared for remotely and need advice that’s easy to understand so that they can self-manage where appropriate. Anticipatory Care Plans and Treatment Escalation Plans were also discussed. [The Scottish Government. The Chief Medical Officer for Scotland’s Annual Report 2020-21: Recover, Restore, Renew. Published 2021. https://www.gov.scot/publications/cmo-annual-report-2020-21/ ]
The Person Centred Care CAB provides evidence updates on person-centred and personalised care and shared decision making. If you are looking to answer a specific question please submit a literature search request at the link above.