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I’m preparing to participate next month in a seminar on shared decision making, and some homework led me to this government paper, published in July: Equity & Excellence: Liberating the NHS (PDF, 339k). I must not have been paying attention to my UK friends on Twitter this summer, because by US standards of “patient centeredness,” this is pretty mind-blowing. Consider item 2.3, page 13:

We want the principle of “shared decision-making” to become the norm: no decision about me without me. International evidence shows that involving patients in their care and treatment improves their health outcomes, boosts their satisfaction with services received, and increases not just their knowledge and understanding of their health status but also their adherence to a chosen treatment.

It can also bring significant reductions in cost, as highlighted in the Wanless Report, and in evidence from various programmes to improve the management of long-term conditions. This is equally true of the partnership between patients and clinicians in research, where those institutions with strong participation in clinical trials tend to have better outcomes.

(In the original PDF, each of those statements is linked to a footnote.)

In the UK as in the US, I imagine there are people who don’t entirely agree :–) with this idea. What debate did I miss out on?

Update 11/29:

  • Please see Ted Eytan’s August post about this, which he notes in the comment below. Good perspective (he knows more about the NHS) and excerpts.
  • I’m surprised that we’re hearing no hoots of derision from across the pond about this “patient-centered” idea. We sure hear those hoots in the US. Is there no flaw in this document?


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