Shared decision making in the NHS is a process where patients and clinicians collaborate to make healthcare decisions based on the best available evidence. This approach respects patient autonomy and promotes patient engagement. Despite growing interest, implementation has been slow due to the need for accessible evidence-based information, guidance on weighing treatment options, and a supportive clinical culture. The article outlines strategies for creating a sustainable decision support platform to facilitate wider adoption of shared decision making in clinical practice. Decision aids, tools designed to support patient decisions, have been developed to provide evidence-based information. These tools are particularly useful in situations where multiple treatment options are feasible and the best decision depends on the patient's preferences. Examples include decisions about breast cancer treatment, benign prostatic hypertrophy, and knee osteoarthritis management. Evidence suggests that decision aids improve patient knowledge, understanding of treatment options, and reduce the demand for elective procedures. They also help patients make more informed decisions, leading to better adherence to treatment regimens and potentially reducing healthcare costs. The Dartmouth-Hitchcock Medical Center in New Hampshire is a pioneer in implementing shared decision making, with a Shared Decision Making Center offering over 30 DVD-based patient decision support tools. The NHS has also shown interest in decision aids, with adaptations of DVDs and patient booklets distributed to urology departments in England. Initiatives such as the NHS Screening and Cancer Screening Programmes have developed web-based decision support tools for patients considering prostate-specific cancer antigen testing or decisions about mastectomy or breast-conserving surgery. The Health Foundation has funded a program to explore how to achieve wider implementation of shared decision making. The East of England Strategic Health Authority is working to accelerate the adoption of patient decision support as part of shared decision making. NHS Direct is piloting three web-based decision support tools for patients with osteoarthritis, benign prostatic hypertrophy, and prostate cancer. These tools are designed to be used before outpatient appointments to ensure patients are well-informed. Implementing shared decision making requires substantial investment and collaboration between agencies. Many of the necessary tools and resources are already in place, but a system for regular review and updating is needed. Success will require strong strategic leadership, high-quality content, and sustained funding to host these resources through computerized, online, or telephone-supported channels. Despite the benefits of shared decision making, challenges remain. Producing and updating decision support materials is expensive and requires careful attention to evidence accuracy and patient understanding. Ensuring that these materials are accessible to both patients and clinicians and fit into clinical workflows is a significant challenge. The availability of choice depends on the willingness of clinicians to offer it, and there is a need for effective means of engaging patients in healthcare decisions and monitoring outcomes. The evidence suggests a reluctance among general practitioners to play this supporting role, highlighting the need for change in practice styles.Shared decision making in the NHS is a process where patients and clinicians collaborate to make healthcare decisions based on the best available evidence. This approach respects patient autonomy and promotes patient engagement. Despite growing interest, implementation has been slow due to the need for accessible evidence-based information, guidance on weighing treatment options, and a supportive clinical culture. The article outlines strategies for creating a sustainable decision support platform to facilitate wider adoption of shared decision making in clinical practice. Decision aids, tools designed to support patient decisions, have been developed to provide evidence-based information. These tools are particularly useful in situations where multiple treatment options are feasible and the best decision depends on the patient's preferences. Examples include decisions about breast cancer treatment, benign prostatic hypertrophy, and knee osteoarthritis management. Evidence suggests that decision aids improve patient knowledge, understanding of treatment options, and reduce the demand for elective procedures. They also help patients make more informed decisions, leading to better adherence to treatment regimens and potentially reducing healthcare costs. The Dartmouth-Hitchcock Medical Center in New Hampshire is a pioneer in implementing shared decision making, with a Shared Decision Making Center offering over 30 DVD-based patient decision support tools. The NHS has also shown interest in decision aids, with adaptations of DVDs and patient booklets distributed to urology departments in England. Initiatives such as the NHS Screening and Cancer Screening Programmes have developed web-based decision support tools for patients considering prostate-specific cancer antigen testing or decisions about mastectomy or breast-conserving surgery. The Health Foundation has funded a program to explore how to achieve wider implementation of shared decision making. The East of England Strategic Health Authority is working to accelerate the adoption of patient decision support as part of shared decision making. NHS Direct is piloting three web-based decision support tools for patients with osteoarthritis, benign prostatic hypertrophy, and prostate cancer. These tools are designed to be used before outpatient appointments to ensure patients are well-informed. Implementing shared decision making requires substantial investment and collaboration between agencies. Many of the necessary tools and resources are already in place, but a system for regular review and updating is needed. Success will require strong strategic leadership, high-quality content, and sustained funding to host these resources through computerized, online, or telephone-supported channels. Despite the benefits of shared decision making, challenges remain. Producing and updating decision support materials is expensive and requires careful attention to evidence accuracy and patient understanding. Ensuring that these materials are accessible to both patients and clinicians and fit into clinical workflows is a significant challenge. The availability of choice depends on the willingness of clinicians to offer it, and there is a need for effective means of engaging patients in healthcare decisions and monitoring outcomes. The evidence suggests a reluctance among general practitioners to play this supporting role, highlighting the need for change in practice styles.