Implementation of SDM in the NHS / UK – The MAGIC Project

There is an increasingly strong evidence base for the effectiveness of engaging patients in decisions about their treatment and care – shared decision-making (SDM) – where there are valid alternative options that are sensitive to patient preferences. Despite this evidence, implementation in practice remains a major challenge. There is a growing understanding about the challenges of implementation of complex interventions in general, but limited understanding currently about the specifics of implementing SDM at a local level (individual organisation or clinical team). MAGIC (MAking Good decisions In Collaboration) is an implementation programme based in Newcastle and Cardiff, UK, and supported by the Health Foundation. We tested implementation in both primary and secondary care. The learning from the first 18 months of the programme will be presented, with relevant case studies. We employed a multi-faceted approach including decision support tools; clinical skills education and training; clinical team and organisational engagement; patient and public involvement; and rapid quality improvement methods. The presentation will reflect on the findings in phase 1, with illustrative examples, and explore how these findings are now being further tested in a second phase of implementation.