NICE releases latest guidance on shared decision making in healthcare settings

The National Institute for Health and Care Excellence (NICE) has published new guidance on shared decision making in everyday healthcare settings.

The guideline is for healthcare professionals and providers, public health commissioners and service users, to help people to work together on decisions about treatment and care, and ‘making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing’.

As well as advising on “how to embed shared decision making in organisational culture and practices”, the document offers recommendations on training and communicating risks and benefits, and promotes using decision aids.

On embedding shared decision making at an organisational level, NICE recommends making “a senior leader accountable and responsible” across all organisations, regardless of size, and also encourages the appointment of “a patient director” from a healthcare service user background – to act as the service user voice in planning and implementation.

Further advice includes appointing senior healthcare professionals to work as organisation-wide shared decision making “champions”, and also recruiting “service user champions” to work with these leaders.

Among NICE’s guidance on implementation, the framework advises an “organisation-wide improvement plan to put shared decision making into practice”, which will involve: identifying existing good practice within teams and utilising their experience, locating departments where shared decision making can be put into practice easily, and using key staff and service users as shared decision making trainers.

On supporting healthcare professionals’ skills and competencies, the document says: “organisations should ensure that knowledge, skills and confidence to support shared decision making are included in the induction, training and continuing professional development of all healthcare staff.”

Training and development in this area should be practical rather than theoretical and include: encouraging people to talk; making sure people understand the principles that support shared decision making; communicating clearly and avoiding jargon; making sure people understand the choices available to them; communicating with and involving family members and friends; and using patient decision aids.

Key to implementation, NICE says, is also promoting shared decision making to those who actually use the services, through media and training.

On putting shared decision making into practice, the document states that before discussions, service users should be offered access to resources in their preferred format, encouraged to think about what they want to get from the discussion, and offered support if they find participating difficult.

As well as guiding professionals through a template of how to provide support before, during and after discussions about treatment and care, the NICE guidelines advise on how to personalise communication about risks, benefits and consequences and also covers how best to talk about stats, data and other numerical information clearly and consistently with patients.

To read the full NICE guidance on how to implement shared decision making in healthcare settings, visit