The first evaluation of an NHS programme to spread joint decision making with patients has found nurses more open to the approach than doctors.
The Department of Health, working with NHS East of England, is trying to encourage clinicians to provide patients with more information about their condition and treatment options, and involve them more in decisions.
Findings from the first evaluation of support websites provided by NHS Direct, shown to Nursing Times, found many patients were “enthusiastic” about using the tools - which provide them with a personalised summary sheet about their condition - and keen for more discussion of options.
However, it found there are “many challenges to overcome before [the] approach can be mainstreamed”. These included resistance and lack of understanding among specialist doctors.
The report, by researchers at Cardiff University, says: “Many of the specialists stated that they would not be interested in the summary pages produced by the websites even if the patients presented them.”
Steve Laitner, a public health consultant and clinical lead for the programme, said: “Surgeons and medics are very biomedically trained and sometimes nurses and therapists and other professionals have a more holistic view of health. That can be helpful [in encouraging joing decision making and support].”
Findings from one large general hospital say: “The nurses and unit manager seemed very committed to the idea of involving patients in decision making. However, the specialist was less supportive of the idea that patients could become involved in decision making… The nurses and unit manager are committed to shared decision making but the specialist is less committed when asked directly.”
In reference to the summary sheets, it was reported: “The specialist was anxious to establish that he would not want to have to use them in his clinic. He did not want to make use of the patient’s knowledge, their knee score, the degree to which they were ready to make a decision and their personal preferences… The nurses seemed bemused by this as they thought this was a central objective of the project.”