Shared Decision Making

Shared decision making

What is shared decision making?

• Shared decision making ensures that you are supported to make decisions about your care that are right for you.
• It involves a conversation between your doctor or nurse and you. 
• Tests and treatments are chosen based on the healthcare professionals knowledge and expertise and your individual preferences, beliefs and values. 
• The conversation should include a discussion about the risks and benefits of any treatment or test.

When is shared decision making used?

Shared decision making is suitable in any situation when there: 

• Is more than one reasonable course of action (e.g. more than one treatment option) and 
• Where no one option is best.

The National Institute for Health and Care Excellence (NICE)

NICE provides guidance on:

• How different conditions should be treated
• What treatments should be made available.
• Learn more about NICE and what they do by visiting their website.

Making informed choices about your treatment - Tony's top tips

Watch this short animation to learn some valuable tips on shared decision making.

A patient's experience of shared decison making

Listen to Frank, who has been treated for prostate cancer, talk to Colin from NHS England, about his experience of shared decision making.

• Frank also talks about his experience of being involved with a clinical trial called the STAMINA trial (Supported exercise training for men with prostate cancer on androgen deprivation therapy). This trial is now closed.
• Visit our page on clinical trials to learn more about clinical trials. 
• You can also use our clinical trial finder to look for a trial that is suitable for you.

Can I ask for a second opinion?

• If you want a second opinion, your consultant may be able to refer you to a different specialist within that hospital trust. 
• However, you may have to go back to your GP. This is so they can make an appointment with a consultant from another trust.
• There is also the option of getting an opinion from a private specialist. If you do decide to take this route. Make sure you do your research and look for recommendations. 
• The process of getting a second opinion may take time. This may delay your treatment. It is a good idea to discuss with your healthcare team any implications of delaying your care. 
• Macmillan Cancer Support have a webpage that tells you more about getting a second opinion. 
• Maggie’s cancer charity explain the advantages and disadvantages of asking for a second opinion. 

Ask 3 questions

The Ask 3 Questions campaign encourages shared decision making. It does this by reminding you to think about three simple questions when making decisions about your healthcare:

Question number 1: What are my choices?

• Your healthcare team should talk to you about the best treatment choices for you. 
• You can ask them why they have decided on those choices.
• You can also ask to speak to both an oncologist and a urological surgeon. This will make sure you get to hear about surgical and non-surgical options (where appropriate). Visit our mastering healthcare conversations page to watch a video about what healthcare professionals you will meet along your prostate cancer journey. 

Question number 2:  What is good and bad about each choice?

All of our treatment information pages describe: 

• The benefits of the treatment
• The risks of the treatment
• The possible impact the treatment may have on your everyday life. 
  • We asked real visitors to the infopool to share their experience of their treatment.
  • They told us how this treatment had impacted their everyday lives in a number of different areas
  • The numbers and images in the impact tab of each treatment page represent how many people said this treatment had impacted them 'a lot' in each of the different areas.

Visit our explore treatments page to find out more about each treatment type. 

Question number 3: How do I get support to help me make a decision that is right for me?

• Our infopool explore treatments tool allows you to explore treatment types or use the "compare" buttons to view methods side by side.
• Our infopool understanding treatment choices tool. This treatment tool aims to help you do four things:
  • Understand your possible treatment choices
  • Compare these treatments
  • Find out more about any treatment
  • Discover what might happen if the cancer keeps growing after treatment.

Please note:

• The treatments shown may not always apply to you. 
• Your choice may be limited because of the nature of your cancer. 
• This includes how likely it is that the cancer will grow quickly or spread, or whether it has spread already. 
• Your choice may also be affected by your fitness levels and other existing health problems.
• The treatments shown are also currently only those which have been approved for use on the NHS in England and Wales. 
• Treatments are mostly the same on the NHS in Scotland and Northern Ireland but there may be some small differences. Where a treatment is not available in all four countries we will say so.
• There may also be other treatments which are available privately or on clinical trials which are not listed here.

You can also visit our page called 'mastering healthcare conversations'. This page will give you tips and tricks that will help you have productive conversations with your healthcare team. 

Ask three questions is part of the NHS's National Shared Decision Making programme. To find out more  visit the AQuA website.  The Advancing Quality Alliance (AQuA) is an NHS health and care quality improvement organisation in the north-west of England. 

What's next?

Use the infopool tools to:

• Find clinical trials you may be suitable for near you
• Or download our interactive 'Treating Prostate Cancer Q&A' booklet using the link below

Listen to our Treating Prostate Cancer Q&A Booklet