In recent years, the notion of patients as partners in their healthcare decisions has gained renewed momentum across the UK. The traditional model of a paternalistic clinician issuing instructions is evolving into one where informed patients and healthcare professionals collaborate to find the best path forward. This shift is not just an ethical aspiration but a practical necessity given the complexities of modern medicine, the availability of digital health tools, and patient expectations for greater agency.
This blog explores what "partner in decisions" means in actual clinical practice. We delve into key examples of shared decision making, consider the changing dynamics of the patient–doctor relationship, and clarify how informed consent works in the contemporary UK context. To ground this discussion, we use medical cannabis — a regulated but relatively new treatment option — as a case study. We highlight how remote specialist consultations and specialist-led assessment and prescription issuance provide concrete examples of expanding patient choice and involvement.
Expanding Patient Choice in the UK
Patient choice in NHS care has steadily expanded over the last two decades, driven partly by policy reforms and partly by digital health innovations. No longer are patients expected to passively accept whatever treatments their doctors prescribe. Instead, health systems increasingly recognise that patients bring valuable knowledge about their own preferences, lifestyles, and priorities.
Examples of expanded choice include:
- Choice of hospital or clinic for elective procedures Access to second opinions and specialist consultations Greater transparency of treatment options and risks Remote consultations which overcome geographical or mobility barriers Patient-centred care plans developed jointly between patients and clinicians
This transformation sets the stage for genuine shared decision making, where the patient is not merely informed but actively engaged in weighing treatment options.
The Informed Patient and Online Research
Go to the websiteThe rise of online health information has further empowered patients to be active partners in decisions. Many approach consultations with prior knowledge gained from reputable websites, patient forums, and research studies. While this can improve engagement, it also comes with challenges:
- Information overload: Large volumes of data can be overwhelming and sometimes contradictory. Quality concerns: Patients may struggle to discern evidence-based advice from marketing or anecdote. Misinterpretation: Without clinical context, some information may be misunderstood or lead to unrealistic expectations.
Healthcare professionals must therefore facilitate informed consent by clarifying uncertainties, contextualising evidence, and addressing misconceptions. This dialogue builds trust and supports balanced decisions.
Waiting Times Nudging People to Explore Alternatives
One practical reality that affects patient decision making in the NHS is waiting times. Although NHS England aims to deliver care within standard timeframes (such as the 18-week referral to treatment pathway), demand pressures mean delays are common in many specialties. For some patients, extended waits lead them to explore alternative pathways, including:
- Private health services Remote or telehealth specialist consultations Regulated private prescription routes for specific treatments Complementary therapies (though with caution around evidence)
These alternatives can offer speedier access or specialist expertise, but patients and clinicians must carefully weigh risks, costs, and regulatory safeguards.
Medical Cannabis: A Regulated Case Study in Shared Decision Making
Medical cannabis is a compelling example to illustrate how the UK’s evolving healthcare landscape empowers patients in decisions. Since November 2018, specialist doctors on the General Medical Council (GMC) register can prescribe cannabis-based products for medicinal use in humans (CBPMs) under strict conditions. However, there are important nuances:
- CBPMs are licensed for a limited number of conditions (e.g., rare epilepsy syndromes), but off-label use for other indications is possible with specialist oversight. The treatment journey often involves a specialist-led assessment to determine suitability and monitor outcomes. Remote specialist consultations have emerged as a convenient pathway, particularly for patients in regions without local expertise. Patient preference, prior experience, and research play an important role during shared decision making.
This scenario exemplifies how patients can engage with an informed clinician to choose innovative treatments within a regulated framework.
Stepwise Patient Journey in Medical Cannabis Shared Decision Making
Information Gathering: The patient researches medical cannabis using reputable sources and identifies potential benefits and risks in line with their condition. Initial GP Discussion: The patient's GP reviews overall health and may refer to a specialist since prescriptions must come from specialist doctors. Specialist Consultation: This can occur face-to-face or via remote telehealth platforms. The specialist assesses medical history, prior treatments, and patient goals. Shared Decision Making: The specialist outlines options including cannabis products, other conventional therapies, or no change. The patient’s preferences and values shape the plan. Prescription and Monitoring: If agreed, the specialist issues the prescription and organises follow-up assessments to monitor efficacy and side effects. Feedback and Adjustments: Based on outcomes, treatment may be modified or discontinued collaboratively.Shared Decision Making: Examples from Practice
Shared decision making (SDM) is often described conceptually, but what does it actually look like between a patient and doctor?
Scenario Shared Decision Making Example Choosing a treatment for chronic pain The clinician explains evidence for various options including medicines, physiotherapy, and medical cannabis. The patient voices preferences, previous experiences, and concerns. Together, they agree on a trial of medical cannabis with close monitoring. Managing epilepsy with drug-resistant seizures The specialist details clinical trial data on cannabis-based medicines, potential side effects, and alternative approaches. The patient's values regarding seizure control versus side effects inform a joint decision on initiating treatment. Deciding on remote vs face-to-face consultations The patient prefers remote consultations due to mobility issues. The clinician agrees, ensuring patient comfort while safeguarding clinical standards through telehealth platforms.Understanding Informed Consent in the UK
Informed consent is a legal and ethical cornerstone of shared decision making. Under UK law and GMC guidelines, patients must receive comprehensible information about:
- The diagnosis and prognosis All reasonable treatment options including no treatment The risks, benefits, and uncertainties associated with each option The likelihood of benefits versus harms
Consent must be voluntary and documented. The process is dynamic, meaning patients can change their mind at any point. Importantly, clinicians must tailor communication to the patient’s needs, avoiding jargon and checking understanding.
Reality Check: What Partnership in Decisions Is—and Isn’t
While the trend towards patient partnership is positive, it is important to be realistic about current challenges:
- Time constraints: NHS consultations are often brief, limiting in-depth discussions about complex treatments. Varied patient preferences: Not all patients want to be heavily involved or prefer to defer to clinician judgement. Disparities in digital literacy: Not everyone has equal access or confidence using online health information or telehealth platforms. Clinical uncertainty: Some novel treatments like medical cannabis have limited robust evidence, making shared decisions reliant on preliminary findings and patient values.
Meaningful partnership requires ongoing investment in clinician training, patient education, and system supports. It also demands transparency about uncertainties and respect for differing decision-making styles.
Conclusion
Being a "partner in decisions" in healthcare is no longer a vague ideal — it is increasingly reflected in everyday practice through shared decision making examples like specialist-led assessments, remote https://smoothdecorator.com/how-do-i-check-if-a-clinic-is-using-a-proper-regulated-pathway/ consultations, and jointly chosen treatment plans. The evolving patient–doctor relationship is characterised by open communication, mutual respect, and tailored informed consent. Medical cannabis serves as a useful case study of how regulated pathways can empower patients seeking innovative therapies while maintaining clinical rigour.
As patient choice expands across the UK, both healthcare professionals and patients must embrace the steps of gathering information, discussing options, making shared decisions, and monitoring outcomes collaboratively. Only then can partnership move from slogan to lived experience, ultimately improving care quality and satisfaction.