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Independence, choice and risk: a guide to best practice in supported decision making

This best practice guide is for the use of everyone involved in supporting adults (18 and over) using health and social care within any setting, whether community or residential, in the public, independent or voluntary sectors. This includes all NHS staff working in multi-disciplinary or joint teams.

Sometimes people’s decisions might be perceived by professionals or family members as carrying some degree of risk, and this guide is intended to help those involved in helping individuals to retain greater control of their lives.

It aims to support the principle of empowerment through managing choice and risk transparently in order to enable fair appraisal of the decision process, should it become necessary. It can be used to promote choice, while managing risk proportionately and realistically. It should have a two-fold use - in multi-disciplinary teams to foster a common approach to risk and, in organisations as the basis for corporate policies, as well as in contractual and other agreements. The aim should be to have a common approach to risk among all parties concerned in delivering health and social care, which will promote the sharing of responsibility for risk in a transparent and constructive way.

The proposals suggested in this document do not replace any existing risk guidance, including those risk management processes contained within the Care Programme Approach, Multi-agency public protection arrangements (MAPPA) or on safeguarding vulnerable adults. Nor do they conflict with professional codes or clinical practice guidelines; rather, it provides a common approach to risk in for use across health and social care systems.

• Download Independence, choice and risk: a guide to best practice in supported decision making (PDF, 280K)
• Download executive summary (PDF, 124K)