Shared Decision Making

Realistic Medicine is not about failing to offer treatments. It is about supporting people using healthcare services, and their families, to feel empowered to discuss their treatment. That’s why changing our style to sharing decisions with our patients is one of our priorities. A move away from the “Doctor knows best” approach to shared decision making between the professional and patient will require more meaningful discussions about the treatment options available as well as their risks and benefits.

There are a number of initiatives underway that aim to support shared decision making. For example:

In order to support patients to get the most out of their conversations with their healthcare professional, posters have been developed and displayed by various health boards across the country. The posters encourage patients to ask questions when consulting their healthcare professionals that aim to support more meaningful conversations and provide patients with informed choices about their treatment options.

The questions are:

We are encouraging all NHS Boards to consider adopting this person centred approach and evaluating their impact.

The Magic Programme


Changing the way we practise will take conviction from clinicians as well as skills to facilitate the change. The MAGIC programme, supported by the Health Foundation, demonstrated that “skills trump tools and attitudes trump skills.”

Health Literacy


We should also ensure that we share decisions about how we best deliver services and work creatively to improve the way we provide care. This is at the heart of health literacy and of the new action plan Making it Easier, a health literacy action plan for Scotland for 2017-2025.

In the Health Literacy Place, you can find some excellent examples of work, tools and techniques which can be helpful in improving health literacy. We encourage you to take a look and consider whether there are projects in the Health Literacy Place that might inspire you to start up your own health literacy project.



We advocate supporting people to make informed decisions about their treatment and care, by explaining the risks and benefits of each treatment option. People should be supported to give their healthcare professionals informed consent. It will help transform and strengthen the relationship between individuals and healthcare professionals. Giving informed consent is an important way of practising Realistic Medicine. That’s why we are committed to reviewing the consent process for patients in Scotland with the General Medical Council and Academy of Medical Royal Colleges. The GMC’s consultation on their revised guidance on consent is now open. The GMC are inviting people to comment on their draft guidance via their website, with a view to publishing their new guidance in late 2019.