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Your choices in the NHS

Making choices about your treatment

It's important to be involved in decisions about your treatment and to be given information to help you choose the right treatment. When making treatment choices, you'll often discuss the options with your doctor or another healthcare professional.  

The more you know about your condition and treatments, the easier it willl be to make your views known and get the right care. Your personal needs and circumstances may make a big difference in deciding which treatment is best for you, so it's important to explain these to your doctor.  

When and what you can choose

Sometimes, scientific evidence may strongly suggest that one form of treatment is better than others. But even here there are choices and decisions to be made. You can choose not to have any treatment at all, for example.

In other cases, it may be less clear which treatments are best. Here, it's especially important to make sure you understand the options and make your views known.

For example, if you have depression, you may decide to see a counsellor rather than taking antidepressant medicines if you're worried about side effects. Or you may have a condition that can be treated with a single operation, which carries risks, or could also be treated with a series of physiotherapy sessions, which has fewer risks but will take longer. 

If in doubt, ask

Feel free to ask if there are other ways to treat a condition and what the doctor or other health professional would advise you to do. You can ask how well the treatment is likely to work (some treatments work better in some people than in others), what the common side effects are, how long the treatment will take and how you'll know if it's working.

NHS health professionals are trained to involve you in making important decisions. They can give you expert information and advice, and may recommend one treatment over another. But only you know what's most important to you. 

If you have questions that are worrying you, write them down and ask them at your next appointment, but remember that doctors are busy, so ask the most important questions first. Here is a list of questions you may want to know the answers to. 

Consider the evidence

Doctors recommend treatments based on evidence from research and their own experience with other patients. The evidence includes information on how well treatments work, what side effects or complications they have, and how they interact with other treatments.

Some of the evidence that health professionals rely on comes from treatment guidelines produced by the National Institute for Health and Care Excellence (NICE).

The NHS offers a choice of the most effective treatments. NICE is responsible for judging whether particular treatments are effective enough for the NHS to use. It balances the benefits of a particular treatment with its cost. It sometimes decides that the benefits are too small and the cost too large, and that the NHS can do more for patients by spending its limited resources elsewhere. This is why some treatments are not available to some NHS patients. 

Read the patient information on NICE

When searching for information about treatments, you may come across conflicting information and advice. This can be confusing and it can be difficult to know who to believe. If a source of information on treatments tries to sell you something or promises something that seems too good to be true, treat it with caution. If the information comes from one individual who had a particularly good or bad experience of a treatment, don't assume that you will have the same experience. Only the experience of hundreds or thousands of people in research studies can give a full and rounded picture of the effects of a treatment. The NICE patient information is published at the same time as its guidelines for health professionals.  

Read about the personal treatment choices Evelyn and Shiv have made and why.  

Knee pain: Evelyn's treatment choice

Evelyn's knee pain from osteoarthritis was getting worse even though she was taking paracetamol painkillers, so the 55-year-old booked an appointment with her GP. Some of her friends had had successful artificial knee replacements and she wanted to know whether this could be a good choice for her. In particular, she wanted to be able to enjoy her daughter's wedding in six months' time without pain.

Evelyn found that she had a number of treatment choices. These included switching from paracetamol to different anti-inflammatory painkillers, such as ibuprofen and naproxen. If that didn't work, there were other painkillers she could have tried. The GP also suggested that she could have a steroid injection into the knee shortly before the wedding to ensure that the symptoms were under control.

Evelyn realised that surgery was a treatment choice she could think about later and that the less risky treatments could be effective for a few years.

She decided to try some new painkillers and have a steroid injection before the wedding.

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Prostate cancer: Shiv’s treatment choice

Shiv was diagnosed with an early form of prostate cancer, where the cancer had not spread outside the prostate gland. He had a consultation with a cancer specialist, and at the end he was given an information leaflet about the treatment options.

Because no one treatment has been proven to be more effective than another, Shiv had a range of treatment options, including:

  • Surgery to remove the prostate completely.
  • Active monitoring, which involves regular blood tests to check for a rise in a chemical called prostate specific antigen (PSA). A rise may mean the cancer is getting worse and further treatment may be required.
  • Radiotherapy, where a beam of radiation is pointed at the cancer cells in the prostate to kill them off.
  • Brachytherapy, where radioactive "seeds" are put into the prostate under general anaesthetic to kill the cancer cells.

Shiv decided not to do anything straight away and to have regular PSA tests. Two years later, there was no rise in his PSA levels and his cancer doctor thinks he has a very slow-growing form of the disease.

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Comments

The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

jimbob2 said on 12 May 2011

I have read a lot about PRP (Platelet Rich Plasma injection therapy) becoming a succesfull alternative treatment that can be used be to speed up the bodys natural healing process of the tendons in tennis elbow and all other types of tendinopathys. I see you don't mention it in the list of treatments but in this article it mentions there are a few NHS hospitals that are performing it, and I wondered if you ever refer people to clinics that are performing it, as in the article the lady says she was refered. link:http://www.dailyexpress.co.uk/features/view/135016/I-was-cured-by-my-own-blood#

It seems a very good option to try for chronic cases before having to go for surgery and seems to have a lot of positive results. Far better than having a cortisone shot which from my reachearch of tendinopathys, seems to only provide temporyary pain reilef. Stated in this disciption on this site they are shown to be ineffective treatment, used to reduce immflamation. But in chronic tendonitis, which is actually called tendonosis ( the prefix "itis" meaning imflammation ) immflamation is not present and the problem is actual degeneration of the tendon. This is much more common and it actually tuns out tendonitis is rare compared to tendonosis. I have even read that cortisone shots can make things worse as they weaken the tissue.

I have been suffering with tennis elbow in both arms for around 4 months now, although the problem has been manifesting over about as far as I know 18 months ago. It all started due to leading an active life style and perticualary from doing heavy strength training over a long period of time. It has now completely disabled me and I can no longer do my Job.

I am due to see an NHS ortopedic specialist soon, and im hoping he has heard of PRP therapy. And I was wondering do they do any further diagnosis, so far all I have had is a GP press on my elbow and forearm. I read that an MRI scan would show the extent of damage to tendons.

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Page last reviewed: 07/03/2014

Next review due: 07/03/2016

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If, after finding out some information for yourself, you're still unsure about your treatment choices, talk to your doctor.

 

Questions to ask at your doctor's appointment

Professor Sir Muir Gray talks about the importance of clear, accurate and reliable information to help doctors and patients make decisions about their health and treatment. Sir Muir Gray has worked in public health for 35 years.

Media last reviewed: 02/10/2013

Next review due: 02/10/2015

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