Shared decision making: time to act now!
All the right rhetoric but none of the right actions. That was my instant response to Secretary of State Andrew Lansley's speech today at Guy's Hospital.
Excellent to hear a Secretary of State speak knowledgeably and passionately about shared decision making. Good to hear him say that patient choice was just one part of the picture, that it should not be seen as an end in itself but as just one part of a broader aim. Providing patients with real options, empowering them to work together with clinicians, giving them information to make informed decisions. All the right language, all the right sentiment.
But what about the action? Well, to be frank, the list was a disappointment. Each of the announcements was about giving people more and better information. But we know from the international evidence that simply doing that is necessary but not sufficient. Patients need support and clinicians need training if shared decision making is to become an embedded reality across the NHS. There was nothing that gave me confidence that these would be provided.
And I did not miss the irony of getting an email, while I was waiting for Secretary of State to arrive, telling me that publication of the NICE quality standard on patient engagement was going to be delayed.
Words are important and leadership right from the top is essential. But action ultimately speaks louder than words. We need action on the ground to ensure Secretary of State's rhetoric becomes reality.
Stephen is Chief Executive at the Health Foundation.
The very fact that Andrew Lansley believes he can deliver better patient outcomes from turning the health service upside down at the same time as cutting £20bn from it's coffers, notwithstanding the huge cost of up to £7bn the tranformation will take from the NHS budget, tells me his vanity has taken over his reality. As far as I can see there's no plan for failure, and, believe me, there will be failure, failure that will cost lives, the most expensive failure of all.
There is little point in talking about shared decision making if patients who have been victims of clinical error or substandard care are being denied knowledge of the damage done and what it means for them.
We don't leave road traffic victims at the side of the road nor are they routinely denied knowledge of their injuries or treatment for same.If things go wrong and there is the usual denial and cover-up then victims of negligence suffer a 'double whammy' and patient safety for all is a meaningless concept.
We must bring to an end the 'culture of denial and cover-up' as demanded by patients worldwide and supported by WHO ,as indicated in the London Declaration of 2005 at an International conference of WHO WAPS and PFPSA.[QE11 Centre]