for shared decisions in health and social care Supporting people to take the next steps
for shared decisions in health and social care 2 People may know what steps they can take with the information you have given them. However, some enquiries may need more information than you can give. It is important to know your boundaries - most information support will be to provide information only. Unless it is your role to give advice, you should not do this. It is very important to make this clear to people, so that they will not expect you to do more than you should.
for shared decisions in health and social care 3.1 Understanding when and how to signpost Sometimes it is essential to tell the person that they need more help than you can give. An example of this could be where a carer s wife has been given anti-histamines but is already getting warfarin on prescription. Having read about the possible side effects, the carer is very worried about how taking the two drugs might affect his wife. In this case, unless you have the appropriate qualifications, you need to signpost the person on to a pharmacist or a doctor for advice about taking the two drugs together. Activity A You have been approached for help by the carer we ve just mentioned. You know you must signpost him on to someone better qualified to give him this advice but he is very upset. What information and support could you give him to help him take the next steps? Discussion points You might have considered: Acknowledging his anxiety Listening calmly and sympathetically to his concerns Explaining the importance of getting accurate medical advice (which you can t safely give) Checking that he can access a GP or pharmacist Helping him write down what he wants to ask, so that he is more confident of getting his concerns answered
for shared decisions in health and social care 4.2 Signposting people to ongoing support As well as signposting clients to other people/organisations you should think about how you can help them develop their own skills in finding and using information. These are important skills for your client for the future, especially for those who have a long term condition. Therefore, as well as helping them with their immediate enquiry it is a good idea to establish what their ongoing information needs may be and how you can help them to be proactive in seeking out information for themselves. This process in itself will help to develop confidence and wellbeing. Signposting may involve suggesting a range of national and local information sources which may be relevant. These may include, for example: websites, local libraries, learning centres, patient information centres, advice agencies and support groups. Remember to be aware of literacy issues when you are signposting. Please see Appendix for additional sources of information..3 Understanding the limits of your role Be clear about the limits of what you can and cannot do, and how you can safely help. Knowing when to signpost the enquirer to a professional is very important. An enquirer will often ask for your advice, what do you think I should do?. You should not give personal advice or opinion, even if you are doing this with the best intentions. Activity B Someone complains to you about feeling low or depressed and tells you they need some help. You have some information on local support groups. What things might be helpful for this enquirer and what might be unhelpful to do?
for shared decisions in health and social care 5 Discussion points Helpful things may be: Using your active listening skills - listening with care and concern Being able to suggest options to suit different people s needs, for example: someone may like to go to a support group someone else may prefer a website someone else may just need to chat with you Be clear in telling someone what you can help them with and why you need to signpost them to someone better able to help. Understanding when your role is to signpost people rather than giving advice. If the person decides to seek more advice, check they know where to go, and help them plan their questions. Remember your Teach Back technique to make sure they understand. See Appendix 3. Reassure them they can come back and see you any time for more information. Unhelpful things may be: Not listening to the whole story Selecting what you think is the best option Giving them information they may not understand Offering to go with them to the GP or other service Telling them they must do something specific e.g. You must see the doctor You must speak to your family. They should decide the next step.
for shared decisions in health and social care.3 Reflections on your situation Add here any additional points you may have thought of, or points raised in your discussions with managers, colleagues, and partners, not already highlighted which may be useful for your own situation..4 Key Learning Points Know when to signpost people on, and explain why you are doing this. Know the boundaries of your role and how to maintain them. Help people to be prepared and confident to take next steps. Respect the enquirer s choice of next step. Remember an informed choice may be not to act on the information they have been given.
for shared decisions in health and social care 7 Activity C Signposting You know that there is someone else you work with who could be of more help to your enquirer. Discuss the best way to signpost them to this person. Can you think of anything you wouldn t do, and why? Activity D Read the following two scenarios and discuss how you would deal with these if you were the worker being asked for advice. Scenario 1 You are a volunteer working with older people. You have just had a session talking about the benefits of the flu vaccination to your group and everyone is now having coffee. Someone comes up to speak to you, saying they feel quite worried as they have been having dizzy turns recently. They don t want to bother the GP but they want to do something. What would you suggest they should do? Scenario 2 You are a district nurse visiting an older patient to dress a leg wound. This has been an on-going problem so you now know the patient quite well. His daughter is with him and she asks quietly if she could speak to you in private. She is very concerned about her father s forgetfulness but she does not want to upset him by suggesting he sees his GP about it. However, he is very happy talking to you as he feels he knows you. His daughter wonders what help and suggestions you might have.
for shared decisions in health and social care 8 Quick quiz: 1 Read the following scenario and look at the suggestions which follow. Which of these would you do/not do if you were helping someone to decide on their next steps? Write DO or DON T beside each one. Someone complains to you about feeling low or depressed and tells you they need some help. You have some information on local support groups. What things might be helpful for this enquirer and what might be unhelpful to do? Ask questions to clarify their story. Select what you think is the best option for the client. Reassure them they can come back and see you any time for more information. Offer to go with them to a support group. Check they have understood any information you have given them. Tell them they must tell a member of their family how they are feeling. Listen to their story showing care and concern. Discuss different options with the client. Acknowledge their anxiety Tell them what you would do in the same situation 2 Signposting Please complete the following advice for someone giving information. enquiries boundaries information advice signpost Some may need more information than you can give. It is important to know your support will be to provide only. most information Unless it is your role to give, you should not do this. Sometimes it is essential to tell the person that they need more help than you can give and you need to person on to someone better able to help. the For further information and advice please contact: Knowledge Services Group, NHS Education for Scotland, 1 Clifton Place, Glasgow G3 7 LD Tel: 0141 352 2800 email: knowledge@nes.scot.nhs.uk www.knowledge.scot.nhs.uk/home/portals-and-topics/information-partnership.aspx