ABSTRACT
In recent years, the Welsh National Health System (NHS) has been the subject of bitter partisan wrangling in the United Kingdom, with Tory Prime Minister David Cameron claiming that problems in the Welsh system—in particular, longer waiting times for treatment—were due to the Welsh Labour government's mismanagement. Health spending in Wales has fallen over the last decade, and seems set to continue to fall: according to recent projections made by the Nuffield Trust, the 2015–2016 Welsh NHS budget will be 3.6" lower than in 2010–2011. This chapter addresses the challenges of improving patient-centered care, a particularly fraught area—through the process of shared decision-making. Shared decision-making is a process in which clinicians and patients work together to select tests, treatments, management, or support packages, based on clinical evidence and the patient's informed preferences. When decision-making is shared between healthcare professionals and patients, decision quality and patient satisfaction are improved and, in some cases, result in more cost-effective care.
