Realistic Medicine

For people to reach the right decision for them, they need to be able to weigh up the potential benefits, harms and limitations of the available options. We need to find out what is important to each person, such as their values, beliefs and how this decision fits into the wider context of their life. Once we know the person’s priorities and preferences, we can look at the options together based on what the person hopes to achieve and what is important to them.

NES has developed an interactive and reflective module on shared decision making which offers practical hints and tips on communication and how to talk about risks and statistics in ways that are meaningful to people.

Click on the image below for the Shared decision making module on Turas.

Having a structure for shared decision making conversations can be helpful. In Scotland, we recommend the DECIDE model.  DECIDE stands for Define, Explain, Consider, Invite, Decide, Evaluate, and you can use it when having a conversation with a person and their family to involve them fully in decision making about treatment and care.

Click on the DECIDE model below to find out more.

Future care planning is about having conversations with people about changes in their life, health and care and what matters to them now and in the future. It offers people opportunities to discuss realistic, value based options for treatment and care. Future care planning is for adults, children and young people and includes people important to an individual. It is particularly helpful when people are living with health conditions or disabilities that may get worse, and for older people whose health is changing. Future care plans can include information about the person and how they would like to be cared for as well as advice to guide future decisions from clinicians or other staff who know them. 

Healthcare Improvement Scotland (HIS) provides a Future Care Planning Toolkit for professionals that includes guidance on meaningful conversations based on the REDMAP framework. There are also Future Care Planning prompt cards for staff. NHS Inform has public information on future care planning to help people prepare for conversations about thinking and planning ahead, as well as a short public video.

Having a structure for future care planning conversations can be helpful. In Scotland, we recommend the REDMAP framework. REDMAP stands for Ready, Expect, Diagnosis, Matters, Actions, Plan, and you can use it when having a conversation with a person and their family about future care planning. It focuses the conversation on realistic options after exploring what matters to the person.

Click on the REDMAP framework below to find out more