Are you a healthcare professional wanting to improve shared decision making in your NHS Trust? 

Shared decision making (SDM) enables health professionals to comply with the post-Montgomery legal requirement to take “reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment and of any reasonable alternative or variant treatments”.

SDM is supported by NICE (NG197) and GMC guidance. It has an ethical imperative, inherent social value and is increasingly demanded by patients. 

Measuring SDM in NHS trusts is financially incentivised by The Commissioning for Quality and Innovation (CQUIN) which sets goals to achieve high-quality SDM conversations in specific specialised pathways to support recovery. 

The ALPACA study enables routine measurement of shared decision making in surgical clinical practice. We have tested the feasibility and usability of an electronic system which automatically monitors patients’ experiences of SDM in real-time. The system has been successfully rolled out to three NHS Trusts and a variety of surgical departments, ready for wider implementation. Ongoing work aims to co-develop an intervention which uses the system to realise sustained and large-scale improvements in SDM.