Background and aims: There is an acknowledged tension between population-level recommendations within clinical practice guidelines and a person-centred approach to decision making for individuals (1). The National Institute for Health and Care Excellence (NICE) recommends the most clinically and cost–effective care for people using the healthcare system in England. We also support the rights of people to make informed decisions about their care within a range of clinical and cost–effective options. We wished to explore how we might support both these aims.
Methods: In 2015 NICE convened the Shared Decision Making Collaborative: A network of people with knowledge of, interest in and commitment to shared decision making (SDM). The collaborative includes academics, policy makers, practitioners and professional and patient organisations. The collaborative has developed a consensus statement(2) and an action plan(3) with specific short-term intentions and long-term ambitions. The collaborative will meet again in the summer of 2017 to discuss progress against the action plan and identify further areas for action.
Results: NICE’s activities to support this work include the following:
• changes to the NICE methods and process manual (4) to better support inclusion of SDM in guidelines;
• building on our existing collection of decision support tools (5);
• a proposed approach for quality assuring decision-support tools;
• advocacy for funding for SDM research;
• considering how to record SDM in clinical encounters; and,
• negotiation to develop a clinical guideline on best practice in SDM.
Conclusion: The SDM Collaborative has catalysed endeavors to promote high-quality SDM, supporting the wider cultural change needed to embed it in routine healthcare delivery and identifying practical actions to make this possible. Led by NICE, the collaborative demonstrates the need for a collective approach to seeing SDM as the norm for how healthcare is delivered. NICE has responded to the collaborative’s work by enhancing its own role in promoting evidence-based good practice while supporting SDM.
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