Dr Steve Laitner, GP - East of England NHS

Steve has been working with the NHS Institute for Innovation and Improvement to develop a decision making aid which will empower people with arthritis of the knee, and could radically change patient choice across a wide range of services.

As  a GP in Parkbury House Surgery in St Albans, Hertfordshire, Steve is acutely aware of the need to help patients become more informed about their care.  He is also a public health consultant and an associate medical director at NHS East of England.

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Comments from Dr Steve Laitner

"Educating patients about their treatment options is important, not just for the patient, but for their clinicians and the NHS too.  Better informed patients make better decisions and are more satisfied, which is motivating for clinicians.  They also allow clinicians to become more efficient and more focused in the information they provide.

"Currently one in five arthritis patients who have a knee replacement are either dissatisfied or are unsure whether they are satisfied.  I came up with the idea of creating a tool which allows patients with arthritis of the knee to have a better idea of their predicted benefit and risks from surgery, as well as being more informed about the options open to them.  This also helps them ask the consultant the right questions.”

The Knee Arthritis Decision Aid is currently under development and will be launched in six pilot sites in autumn 2009.  It is a web-based tool which will allow patients to access information about their condition and treatment options at home, through the internet.

The aid is also likely to include a questionnaire which will allow tailored information to be provided.  When the patient visits the clinic or hospital there will be a further online application to go through which a member of staff, such a nurse practitioner, will explain and provide support if necessary. The two stages allow patients to ask more detailed and focused questions during their appointment with their surgeon.

"The NHS Institute has provided support, both in terms of resourcing and people.  We have made good progress.  We have set up a high level and enthusiastic steering group, commissioned evaluators and trainers for the product, and are now developing the content of the aid and the statistical risk and benefit prediction too. We are really excited about launching the tool at our pilot sites later this year.

"The decision aid will make a real difference for people with arthritis of the knee who are facing a complex set of treatment choices, and will help them understand what to realistically expect from those treatments.  Both patient and the clinician benefit from the patient being better informed and more focused, and ultimately both are more satisfied.

"Our vision is to eventually introduce this initiative for use in the treatment of many other conditions.”