Decision-making Resources

Wound care presents a substantial burden on the NHS, clinicians, and patients. Promoting supported self-management has emerged as a key strategy to empower patients in proactively managing their wounds. When implemented appropriately, it can improve treatment adherence, enhance patient wellbeing, reduce the need for clinical appointments, and lower healthcare costs. The Covid-19 pandemic accelerated this shift by limiting face-to-face care, highlighting the importance of equipping patients with the knowledge, skills, and confidence required for effective self-management. Clear terminology and standardised approaches are essential for enabling the successful implementation of patient selfcare. Products such as Flaminal® (an enzyme alginogel®), with its simplicity and versatility, offers a practical solution that supports patient-led wound care while promoting sustainable healthcare delivery.

Prostate cancer screening in asymptomatic men is contentious and there is currently no national screening programme in the UK. Routine asymptomatic prostate-specific antigen (PSA) testing is often considered ineffective due to its diagnostic limitations and risks of overdiagnosis and subsequent overtreatment. This project undertaken by the author’s trust utilised the Prostate Cancer UK toolkit to engage men in making informed, personalised decisions regarding PSA testing. Men identified as being at elevated risk were contacted by text message and offered information about the risks and benefits of PSA testing, access to a personalised risk checker from Prostate Cancer UK and a direct testing pathway. The approach aimed to support informed decision-making in prostate cancer screening using the PSA blood test.

Clinicians working within primary care services tend to do so in isolation and without direct access to investigative resources. This places emphasis on the clinician’s abilities to perform a focused clinical examination and employ sound clinical decision-making processes to reach a definitive diagnosis. This article looks at the case history of a patient presenting to a GP out-of-hours service with an acute, undifferentiated illness, and explores the decisionmaking processes used by the author, a trainee advanced nurse practitioner at the time, to support a working diagnosis and justify a clinically suitable management plan.

Diabetes care takes up around 10% of the total NHS budget (Diabetes UK, 2015), and as type 2 diabetes mellitus (T2DM) makes up around 90% of all diabetes, it could be argued that prescribing for this largely preventable condition is the main culprit responsible for these costs. However, most of the money spent on treating diabetes is for managing its complications (Kerr, 2011). The key to preventing these complications is through effective prescribing aimed at reducing them. Possibly as a result of more clinicians thinking this way, prescribing costs for diabetes have been rising steadily (Health and Social Care Information Centre [HSCIC], 2014). So, how can clinicians be sure that newer and more expensive therapies are both clinically and financially effective? And crucially, how do clinicians ensure that patients are kept at the centre of all consultations and are fully involved in the decision-making process?