Evaluation of the Health Foundation’s MAGIC programme
There is a growing body of research that highlights the benefits of shared decision making, including patients being more comfortable with decisions, having improved confidence and coping skills and making more appropriate use of services. But putting it into practice in the day-to-day reality of hard-pressed health services remains a challenge.
The MAGIC programme aims to take on this challenge by bringing together a small group of passionate frontline staff, managers and academics in NHS sites in Newcastle and Cardiff to implement and embed shared decision making at individual, team and organisation level.
The programme worked to embed SDM in a range of primary and secondary care settings and involved developing and testing practical solutions that support patients and healthcare professionals to work together to make decisions about treatment and care.
The programme combined a range of activities and forms of support to embed SDM. This included running skills development workshops for participating clinicians, working closely with a number of clinical teams to develop and implement decision support tools for use in consultations as well as social marketing campaigns to increase organisational and patient awareness of SDM. The programme also provided regular facilitation and peer support with the participating clinical teams and sought regular feedback and input from a patient public panel.
What we did
The aim of the evaluation was to assess how, and to what extent, the MAGIC programme was able to embed SDM within clinical settings. The primary focus was on understanding and exploring the ‘process’ through which SDM was implemented. It used largely qualitative methods to elicit insights about what worked well, what worked less well, and in what circumstances, rather than establishing the impact of the programme on measurable outcomes.
The evaluation findings are based on a range of data, including the development of a programme logic model, observations at MAGIC local design team (LDT) and core design team (CDT) meetings, in-depth interviews with participants and stakeholders, and interviews with patient representatives. In-depth interviews with key staff and a small sample of patients were carried out seven clinical settings across the two sites Finally, an online survey was conducted to capture the views and experiences of all staff in the clinical teams that took part in the programme.
The evaluation helps to fulfil the core of aim of the MAGIC programme which is to build practical and transferable knowledge about how SDM can become a core characteristic of routine clinical care, how this can be achieved and what the conditions for success are.
Insights and learning has been captured through:
- The production of seven improvement stories which were published in the Health Foundation learning report Implementing shared decision making. These improvement stories capture the journey of implementation in a range of primary and secondary care settings highlighting the key successes and challenges of implementation as well as practical lessons and tips;
- A final report which provides a detailed exploration of the implementation processes and learning and tracks the extent of change across the key activities of the MAGIC programme; and
- These resources aim to support individuals, teams and organisations put shared decision making into practice, enabling them to transform services to embed mutual responsibility.