How to support patients to make decisions
Disregarding a patient’s individual circumstances and instead expressing a personal bias about the type of birth a patient should have isn’t in line with the professional standards.
Reading the signals Maternity and neonatal services in East Kent.
The Report of the Independent Investigation
‘In this context, the language used around ‘normal birth’ may have significant unintended consequences, raising expectations among women and maternity staff that this is an ideal to be aspired to by all. But it is far from ideal for all, and promoting it unselectively can leave women feeling unfairly that they have failed in some way; in some cases it can expose them to additional risk.’
Key Action Area 3: Flawed teamworking – pulling in different directions
Our Decision making and consent guidance sets out what you need to do to support patients to make decisions:
Listen to patients
This includes encouraging them to ask questions.
Find out what matters to them
This includes their concerns and preferences about the available options, as well as their expectations about what different options could achieve.
Explore risks with your patient
This includes exploring what risks your patient would and wouldn’t be prepared to take to achieve a desired outcome, as well as how the likelihood of a particular outcome might influence their choice.
Give your patients time
This includes giving your patient the opportunity to consider the information you’ve given them before and after making a decision and could include arranging a follow-up appointment.
Benefits and harms
When discussing benefits and harms, you need to set out a range of information:
- Expected harms, including common side effects and what to do if they occur.
- Recognised risks of harm that you believe anyone in the patient’s position would want to know.
- The effect of the patient’s individual clinical circumstances on the probability of a benefit or harm occurring. If you know the patient’s medical history, you’ll know some of what you need to share already, but the dialogue could reveal more.
- Risks of harm and potential benefits that the patient would consider significant for any reason. These will be revealed during your discussion with the patient about what matters to them.
- Any risk of serious harm, however unlikely it is to occur.
Our professional standards
11. You must try to make sure the information you share with patients about the options is objective. You should be aware of how your own preferences might influence the advice you give and the language you use. When recommending an option for treatment or care to a patient you must explain your reasons for doing so, and share information about reasonable alternatives, including the option to take no action. You must not put pressure on a patient to accept your advice.
