Shared governance and professional decision-making brings together teams in collaborative ways to discuss and coproduce work that is influenced by what matters to them and the communities they serve.

In this section you will find a range of evidence-based resources to support the implementation of shared governance and professional decision-making approaches as well as key steps you may wish to consider in practice.

Be clear about the benefits; both for teams and for those receiving care – When successfully implemented, the approach is considered to have a wide range of benefits for staff, patients and communities. However, it is advised that communication and agreement of what these can be is key to ensuring effective buy-in and engagement. Benefits have been identified in areas such as improved outcomes for those using services, staff satisfaction, a reduction in unwarranted variation in practice, improved increased engagement in quality improvement activity and practice development; or an increased sense of accomplishment within the workplace.

Consider what are the enablers – Establish early who might be key sponsors, supporters and stakeholders as well as identifying who will be the relevant senior support within an organisation. Consider also how shared professional decision-making aligns with an organisation’s values and behaviours and how each may influence the other.

Consider opportunities and barriers – Collective leadership is about everyone taking responsibility not just for their own job or role and empowering leadership at all levels by ensuring that everyone’s voice is heard and equally valued. Considering early how a non-hierarchical shared professional decision-making approach can be facilitated with opportunities maximised and barriers overcome is key to ensuring teams reach their full leadership potential.

Engage and consult: There is compelling evidence the more engaged people can be, the more effective and productive they are, and most importantly, the higher the quality of care they deliver. For meaningful engagement it is important to ensure there is a clear understanding of the value and impact the professions have in decision-making. A well represented steering group, with a range of staff from different backgrounds, levels and expertise can support this.

Identify your goals – Decide what constitutes success within an organisation, timescales and the ambitions. Having a vision for shared professional decision-making will shape the approach for implementation, help to support motivation as well as steering the direction.

Getting started – it can be helpful to consider:

• good practice already in place and where opportunities are to build upon this
• whether setting up a pilot may be a good option to test a model and relevant membership
• terms of reference; what is within the gift of members and what will require support or advice
• a facilitator role, coaching or training is helpful to support those involved on their way
• the responsibilities of shared professional decision-making councils or groups and individuals within them and how they fit within existing governance structures

Tools and resources

Further tools and resources are available to all health and care staff on the CNO Shared Professional Decision-Making Community platform here (FutureNHS login required).