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Special Issue / Schwerpunkt| Volume 123, P99-103, June 2017

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Shared decision making in the UK: Moving towards wider uptake

      Abstract

      Shared decision making (SDM) is firmly on the policy agenda in the UK and a recent legal ruling has confirmed its importance. Policymakers, ethicists, professional regulators and societies, patient organisations and now the courts are committed to ensuring that SDM becomes the norm throughout the NHS, but an unfavourable economic climate makes this especially challenging. Considerable progress has been made over the last few years, with new learning from demonstration sites, various initiatives in capacity building and training, wider availability of patient decision aids, and important leadership initiatives. Enthusiasm for this way of working is growing among clinicians, patients and managers, but it could be undermined if SDM comes to be seen primarily as a means of cost control.

      Zusammenfassung

      Partizipative Entscheidungsfindung (PEF) hat in Großbritannien einen festen Platz auf der politischen Agenda gefunden, und eine kürzlich getroffene gerichtliche Entscheidung hat die Bedeutung von PEF bestätigt. Entscheidungsträger, Ethiker, Regulierungsbehörden und Fachgesellschaften, Patientenorganisationen und nun auch die Gerichte setzen sich dafür ein, dass PEF im gesamten National Health Service (NHS) zur Norm erhoben wird; allerdings macht ein ungünstiges ökonomisches Klima diese Aufgabe zu einer besonderen Herausforderung. Dabei konnten in den letzten paar Jahren beträchtliche Fortschritte erzielt werden; dazu zählen das Lernen von Vorzeigeeinrichtungen, verschiedene Initiativen zum Aufbau von Kompetenzen und Schulungsmaßnahmen, eine höhere Verfügbarkeit von Entscheidungshilfen für Patienten und wichtige Initiativen von Meinungsführern. Unter Ärzten, Patienten und Managern nimmt die Begeisterung für diese Art zu arbeiten zu, doch könnte sie auch schnell wieder nachlassen, wenn partizipative Entscheidungsfindung in erster Linie als Kostendämpfungsinstrument wahrgenommen würde.

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