Leading the way to shared decision making The critical steps for the NHS Commissioning Board to make 'no decision about me, without me' a reality

In December 2011, the Health Foundation hosted a summit to consider what must be done to make a reality of ‘no decision about me, without me’. The summit identified that, as champion of patient and carer involvement, the NHS Commissioning Board has a critical role to play in making shared decision making the norm. This report is a distillation of that summit.

The case for ‘no decision about me, without me’ is clear in ethics and in policy and is supported by a growing evidence base. However, to make it an everyday experience for patients requires a significant change in philosophy, in culture and in the roles of patients and professionals. This fundamental shift must be modelled and led by every part of the system to drive change in government and in the consulting room.

A consistent message at the summit was that, while the involvement and leadership of all players in the system is essential, there is a critical role for the NHS Commissioning Board in convening, facilitating and modelling change so that shared decision making is adopted across the NHS.

To make this happen, the Board must:

• engage in the development of a strong narrative for shared decision making
• inspire others to play their part
• invest in the development of robust and meaningful measures of patients’ involvement in their own care
• pro-actively encourage the changes in service provision necessary to meet different expectations.

In this report, we briefly introduce the concept of shared decision making and then look at each of these four areas of action for the NHS Commissioning Board.

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