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Dr Natalie Joseph-Williams
(she/her)
- Available for postgraduate supervision
Teams and roles for Natalie Joseph-Williams
Reader in Improving Patient Care
Overview
A Reader in Improving Patient Care, Associate Director of the Health and Care Research Wales Evidence Centre, and Director of Impact at Cardiff University's School of Medicine.
I lead internationally-recognised research in person centred care and shared decision making that informs policy, practice, NICE guidelines and frameworks, international standards, and professional training globally.
I work closely with research partners across the UK, Europe, North America, South America, Asia, and Australia to understand, promote and embed evidence-based person centred care. To ensure our research delivers meaingful benefits to patients, clinicians and healthcare organisations, I work in close collaboration with Welsh Government, Public Health Wales, NHS Wales, Health Education and Improvement Wales (HEIW), NHS Performance and Improvement Wales, NICE, Picker Europe, the International Shared Decision Making Society and the International Patient Decision Aids Standards (IPDAS) Collaboration.
As Associate Director and Primary Research Lead for the Health and Care Research Wales Evidence Centre, I work with policy and practice stakehodlers across Wales to identify key health and care evidence needs, provide evidence based information to answer these needs, and ensure this directlt informs policy and practice.
Current research themes
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- how we can reduce ambulance handover delays in the NHS to improve quality, safety and experiences
- what support men with mental health conditions need from primary care services
- the future implementation of a novel drain fluid biomarker that can detect anastomotic leaks after colorectal surgery sooner
- equitable person centred care improvements for people with endometriosis, coeliac disease, learning disabilities, colorectal cancer, and women going through menopause
- outcomes of providing care closer to the community
- how we can better improve patient and public involvement in rapid research environments
- informed consent procedures for aneasthesia
Key papers
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Joseph-Williams N, Abhyankar P, Boland L, Bravo P, Brenner A.T, Brodney S, et al. What works in implementing patient decision aids in routine clinical settings: a rapid realist review and update from the International Patient Decision Aids Standards Collaboration. MDM. 2021;41(7):907-937.
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Joseph-Williams N, Lloyd A, Edwards A, Stobart L, Tomson D, Macphail S, Dodd C, Brain K, Elwyn G, Thomson R. Implementing shared decision making in routine NHS settings - kessons from the MAGIC Programme. BMJ. 2017;357:j1744
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Joseph-Williams N, Elwyn G, Edwards A. Power imblance prevents shared decision making. BMJ. 2014;14(348):3178.
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Oxford Textbook of Shared Decision Making in Healthcare
 |
Glyn Elwyn, Natalie Joseph-Williams, and Adrian Edwards Written by a global team of experts, the Oxford Textbook of Shared Decision Making, fourth edition, examines from both theoretical and practical perspectives, what comprises an effective decision making process, looking at the benefits and potential difficulties that arise when patients and clinicians share healthcare decisions. Authoritative, evidence based, and grounded in clinical practice, the Oxford Textbook of Shared Decision Making explores a very important paradigm shift in the delivery of healthcare, providing thoughtful consideration and key strategies for its successful implementation. |
Publication
2026
- Ogbukagu, C. M. et al., 2026. Benefits of public engagement in research and barriers to participation: A UK-based survey of academic scientists and support staff including international respondents. Immunology & Cell Biology (10.1111/imcb.70079)
2025
- Mazzaschi, F. et al. 2025. What members of the public think NHS dental services should include: qualitative study. IJQHC Communications 5 (2) lyaf015. (10.1093/ijcoms/lyaf015)
- Owen, R. K. et al., 2025. Health and care service utilisation in the last year of life before non-sudden death in Wales, 2014–2023, by palliative care registration: a population-based retrospective cohort study. The Lancet Regional Health Europe 59 101479. (10.1016/j.lanepe.2025.101479)
- Hughes, D. et al., 2025. A communication toolkit for the most impactful symptoms of Fabry disease: co-creation with Fabry disease patients and their treating clinicians in the UK. Rare Disease and Orphan Drugs Journal 4 31. (10.20517/rdodj.2025.27)
- Sha’aban, A. et al. 2025. Patients’ views on a subsidy card model for gluten-free food access: a qualitative study. BMC Health Services Research 25 (1) 1418. (10.1186/s12913-025-13582-z)
- Sha'aban, A. et al. 2025. Coproducing data-driven organisational safety with patients: development and cognitive testing of a multi-setting patient-reported safety concern tool. International Journal for Quality in Health Care 37 (3) mzaf056. (10.1093/intqhc/mzaf056)
- Sha'aban, A. et al. 2025. Public awareness of care pathways and available skill mix in NHS dental teams: A qualitative study. British Dental Journal 239 , pp.39-45. (10.1038/s41415-025-8491-z)
- Williams, D. et al. 2025. Recommendations for a communication strategy to support informed decision-making about self or clinician sampling for cervical screening in the UK: qualitative study. Health Expectations 28 (2) e70191. (10.1111/hex.70191)
- Lewis, R. et al., 2025. A bespoke rapid evidence review process engaging stakeholders for supporting evolving and time-sensitive policy and clinical decision-making: reflection and lessons learned from the Wales COVID-19 Evidence Centre 2021-2023. Health Research Policy and Systems 23 (1) 36. (10.1186/s12961-025-01297-w)
- McFadzean, I. J. et al. 2025. The evolution of patient-reported safety concerns during the COVID-19 pandemic within a series of study questionnaires: a multi-method analysis. International Journal for Quality in Health Care 37 (2) mzaf040. (10.1093/intqhc/mzaf040)
- Edwards, A. et al. 2025. Development of a clinical decision support tool for Primary care Management of lower Urinary tract Symptoms in men: the PriMUS study. Health Technology Assessment 29 (1)(10.3310/RGTW5711)
- Leighton, C. et al., 2025. A theory-based analysis of the implementation of online asynchronous telemedicine platforms into primary care practices using Normalisation Process Theory. BMC Primary Care 26 (1) 27. (10.1186/s12875-025-02717-0)
2024
- Driscoll, T. et al., 2024. PP35 Does mean ambulance handover time at emergency departments correlate with number of handovers per month?. Emergency Medicine Journal 41 (3), pp.A15-A16. (10.1136/emermed-2024-999.35)
- Gal, M. et al. 2024. Knowledge mobilisation of rapid evidence reviews to inform health and social care policy and practice in a public health emergency: Appraisal of the Wales COVID-19 Evidence Centre processes and impact, 2021–23. PLoS ONE 19 (11) e0314461. (10.1371/journal.pone.0314461)
- Joseph-Williams, N. , Elwyn, G. and Edwards, A. 2024. Twenty-one years of the International Shared Decision Making Conference: lessons learnt and future priorities. BMJ Evidence-Based Medicine 29 (3), pp.151-155. (10.1136/bmjebm-2023-112374)
- Cooper, A. et al. 2024. Informing evidence-based policy during the COVID-19 pandemic and recovery period: learning from a national evidence centre. Global Health Research and Policy 9 (1) 18. (10.1186/s41256-024-00354-1)
- Nollett, C. et al. 2024. Public involvement and engagement in scientific research and higher education: The only way is ethics?. Research Involvement and Engagement 10 (1) 50. (10.1186/s40900-024-00587-x)
- Leighton, C. et al. 2024. Effectiveness and safety of asynchronous telemedicine consultations in general practice: systematic review. British Journal of General Practice Open 8 (1) 0177. (10.3399/BJGPO.2023.0177)
2023
- Purchase, T. et al. 2023. Analysis of applying a patient safety taxonomy to patient and clinician-reported incident reports during the COVID-19 pandemic: a mixed methods study. BMC Medical Research Methodology 23 (1) 234. (10.1186/s12874-023-02057-6)
- Eberl, M. et al. 2023. Overcoming the disconnect between scientific research and the public. Immunology and Cell Biology 101 (7), pp.590-597. (10.1111/imcb.12657)
- Lench, A. et al., 2023. Household Composition and Inequalities in COVID-19 Vaccination in Wales, UK.. Vaccines 11 (3), pp.1-9. 604. (10.3390/vaccines11030604)
2022
- Sparrow, J. M. et al., 2022. Developing decision support tools incorporating personalised predictions of likely visual benefit versus harm for cataract surgery: research programme. Programme Grants for Applied Research 10 (9)(10.3310/BAGA4188)
- Coulter, A. et al., 2022. Implementing shared decision-making in UK: Progress 2017-2022. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 171 , pp.139-143. (10.1016/j.zefq.2022.04.024)
- Parish, O. et al. 2022. Barriers and facilitators to shared decision-making in neonatal medicine: A systematic review and thematic synthesis of parental perceptions. Patient Education and Counseling 105 (5), pp.1101-1114. (10.1016/j.pec.2021.08.033)
- Scott, H. et al., 2022. A qualitative exploration of decisions about dental recall intervals. Part 2: perspectives of dentists and patients on the role of shared decision making in dental recall decisions. British Dental Journal (10.1038/s41415-022-4046-8)
- Scott, H. et al. 2022. A qualitative exploration of decisions about dental recall intervals. Part 1: attitudes of NHS general dental practitioners to NICE Guideline CG19 on the interval between oral health reviews. British Dental Journal 232 , pp.327-331. (10.1038/s41415-022-3998-z)
2021
- Phillips, R. et al., 2021. Cohort profile: The UK COVID-19 Public Experiences (COPE) prospective longitudinal mixed-methods study of health and well-being during the SARSCoV2 coronavirus pandemic. PLoS ONE 16 (10) e0258484. (10.1371/journal.pone.0258484)
- Joseph-Williams, N. et al. 2021. What works in implementing patient decision aids in routine clinical settings? A rapid realist review and update from the International Patient Decision Aid Standards Collaboration. Medical Decision Making 41 (7), pp.907-937. (10.1177/0272989X20978208)
- Milosevic, S. et al. 2021. Managing LUTS in primary care: qualitative study of GPs’ and patients’ experiences. British Journal of General Practice 71 (710), pp.e685-e692. (10.3399/BJGP.2020.1043)
- Edwards, D. et al. 2021. A rapid review of the effectiveness of alternative education delivery strategies for undergraduate and postgraduate medical, dental, nursing and pharmacy education during the COVID-19 pandemic. Project Report.[Online].Cardiff: Wales COVID-19 Evidence Centre. Available at: http://www.primecentre.wales/resources/RR/Clean/RR00004_Wales_COVID-19_Evidence_Centre_Rapid_Review_Healthcare_Education_August-2021.pdf.
- Milosevic, S. et al. 2021. Conducting invasive urodynamics in primary care: Qualitative interview study examining experiences of patients and healthcare professionals. Diagnostic and Prognostic Research 5 10. (10.1186/s41512-021-00100-y)
2020
- Pell, B. et al. 2020. PRImary care Management of lower Urinary tract Symptoms in men: protocol for development and validation of a diagnostic and clinical decision support tool (the PriMUS study). BMJ 10 (6) e037634. (10.1136/bmjopen-2020-037634)
2019
- Joseph-Williams, N. et al. 2019. A descriptive model of shared decision making derived from routine implementation in clinical practice ('Implement-SDM'): Qualitative study. Patient Education and Counseling 102 (10), pp.1774-1785. (10.1016/j.pec.2019.07.016)
- Phillips, G. et al. 2019. Do published patient decision aids for end-of-life care address patients' decision making needs? A systematic review and critical appraisal. Palliative Medicine 33 (8), pp.985-1002. (10.1177/0269216319854186)
- Williams, D. et al. 2019. The ability of observer and self-report measures to capture shared decision making in clinical practice in the United Kingdom: a mixed-methods study.. BMJ Open 9 (8) e029485. (10.1136/bmjopen-2019-029485)
- Jordan, A. et al. 2019. "I'd like to have more of a say because it's my body?: Adolescents' perceptions around barriers and facilitators to shared decision-making. Journal of Adolescent Health , pp.-. (10.1016/j.jadohealth.2019.05.024)
- Sherlock, R. et al. 2019. 'What would you recommend doctor?'- Discourse analysis of a moment of dissonance when sharing decisions in clinical consultations. Health Expectations 22 (3), pp.547-554. (10.1111/hex.12881)
2018
- Jordan, A. et al. 2018. What adolescents living with long-term conditions say about being involved in decision-making about their healthcare: A systematic review and narrative synthesis of preferences and experiences. Patient Education and Counseling 101 (10), pp.1725-1735. (10.1016/j.pec.2018.06.006)
2017
- Joseph-Williams, N. et al. 2017. Implementing shared decision making in the NHS: lessons from the MAGIC programme. British Medical Journal (BMJ) 357 j1744. (10.1136/bmj.j1744)
2015
- Joseph-Williams, N. et al. 2015. Choosing a specialist: will patients vote with their feet (and wallets) for person-centered care?. Medical Decision Making 35 (6), pp.688-690. (10.1177/0272989X15583267)
- Durand, M. et al. 2015. Minimum standards for the certification of patient decision support interventions. Patient Education and Counseling 98 (4), pp.462-486. (10.1016/j.pec.2014.12.009)
- Joseph-Williams, N. J. 2015. ‘Nobody knows me better than me’: the development and pilot-testing of a patient-targeted complex intervention to prepare patients to participate in shared decision-making. PhD Thesis , Cardiff University.
2014
- Joseph-Williams, N. et al. 2014. Toward minimum standards for certifying patient decision aids: a modified Delphi consensus process. Medical Decision Making 34 (6), pp.699-710. (10.1177/0272989X13501721)
- Sepucha, K. R. et al., 2014. "It's valid and reliable" is not enough: critical appraisal of reporting of measures in trials evaluating patient decision aids. Medical Decision Making 34 (5), pp.560-566. (10.1177/0272989X14528381)
- Joseph-Williams, N. , Edwards, A. and Elwyn, G. 2014. Power imbalance prevents shared decision making. BMJ 348 g3178. (10.1136/bmj.g3178)
- Joseph-Williams, N. , Elwyn, G. and Edwards, A. 2014. Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Education and Counseling 94 (3), pp.291-309. (10.1016/j.pec.2013.10.031)
2013
- Lloyd, A. et al. 2013. Patchy "coherence": using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC). Implementation Science : IS 8 (1) 102. (10.1186/1748-5908-8-102)
- Elwyn, G. et al. 2013. Option grids: shared decision making made easier. Patient Education and Counseling 90 (2), pp.207-212. (10.1016/j.pec.2012.06.036)
- Joseph-Williams, N. et al. 2013. The cost implications of informed decision-making: a mathematical simulation model of the potential financial effects of a web-based prostate specific antigen decision aid. European Journal for Person Centered Healthcare 1 (1), pp.193-201. (10.5750/ejpch.v1i1.651)
- Sepucha, K. R. et al., 2013. Establishing the effectiveness of patient decision aids: key constructs and measurement instruments. BMC Medical Informatics and Decision Making 13 (Suppl) S12. (10.1186/1472-6947-13-S2-S12)
2012
- Elwyn, G. et al. 2012. Shared decision making: a model for clinical practice. Journal of General Internal Medicine 27 (10), pp.1361-1367. (10.1007/s11606-012-2077-6)
2011
- Elwyn, G. et al. 2011. How to develop web-based decision support interventions for patients: a process map. Patient Education and Counseling 82 (2), pp.260-265. (10.1016/j.pec.2010.04.034)
- Joseph-Williams, N. J. , Edwards, A. G. and Elwyn, G. 2011. The importance and complexity of regret in the measurement of 'good' decisions: a systematic review and a content analysis of existing assessment instruments. Health Expectations 14 (1), pp.59-83. (10.1111/j.1369-7625.2010.00621.x)
2010
- Evans, R. et al. 2010. Supporting informed decision making for prostate specific antigen (PSA) testing on the web: an online randomized controlled trial. Journal of Medical Internet Research 12 (3) e27. (10.2196/jmir.1305)
- Joseph-Williams, N. J. et al. 2010. Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid. Journal of Medical Internet Research 12 (2) e15. (10.2196/jmir.1307)
2009
Articles
- Ogbukagu, C. M. et al., 2026. Benefits of public engagement in research and barriers to participation: A UK-based survey of academic scientists and support staff including international respondents. Immunology & Cell Biology (10.1111/imcb.70079)
- Mazzaschi, F. et al. 2025. What members of the public think NHS dental services should include: qualitative study. IJQHC Communications 5 (2) lyaf015. (10.1093/ijcoms/lyaf015)
- Owen, R. K. et al., 2025. Health and care service utilisation in the last year of life before non-sudden death in Wales, 2014–2023, by palliative care registration: a population-based retrospective cohort study. The Lancet Regional Health Europe 59 101479. (10.1016/j.lanepe.2025.101479)
- Hughes, D. et al., 2025. A communication toolkit for the most impactful symptoms of Fabry disease: co-creation with Fabry disease patients and their treating clinicians in the UK. Rare Disease and Orphan Drugs Journal 4 31. (10.20517/rdodj.2025.27)
- Sha’aban, A. et al. 2025. Patients’ views on a subsidy card model for gluten-free food access: a qualitative study. BMC Health Services Research 25 (1) 1418. (10.1186/s12913-025-13582-z)
- Sha'aban, A. et al. 2025. Coproducing data-driven organisational safety with patients: development and cognitive testing of a multi-setting patient-reported safety concern tool. International Journal for Quality in Health Care 37 (3) mzaf056. (10.1093/intqhc/mzaf056)
- Sha'aban, A. et al. 2025. Public awareness of care pathways and available skill mix in NHS dental teams: A qualitative study. British Dental Journal 239 , pp.39-45. (10.1038/s41415-025-8491-z)
- Williams, D. et al. 2025. Recommendations for a communication strategy to support informed decision-making about self or clinician sampling for cervical screening in the UK: qualitative study. Health Expectations 28 (2) e70191. (10.1111/hex.70191)
- Lewis, R. et al., 2025. A bespoke rapid evidence review process engaging stakeholders for supporting evolving and time-sensitive policy and clinical decision-making: reflection and lessons learned from the Wales COVID-19 Evidence Centre 2021-2023. Health Research Policy and Systems 23 (1) 36. (10.1186/s12961-025-01297-w)
- McFadzean, I. J. et al. 2025. The evolution of patient-reported safety concerns during the COVID-19 pandemic within a series of study questionnaires: a multi-method analysis. International Journal for Quality in Health Care 37 (2) mzaf040. (10.1093/intqhc/mzaf040)
- Edwards, A. et al. 2025. Development of a clinical decision support tool for Primary care Management of lower Urinary tract Symptoms in men: the PriMUS study. Health Technology Assessment 29 (1)(10.3310/RGTW5711)
- Leighton, C. et al., 2025. A theory-based analysis of the implementation of online asynchronous telemedicine platforms into primary care practices using Normalisation Process Theory. BMC Primary Care 26 (1) 27. (10.1186/s12875-025-02717-0)
- Driscoll, T. et al., 2024. PP35 Does mean ambulance handover time at emergency departments correlate with number of handovers per month?. Emergency Medicine Journal 41 (3), pp.A15-A16. (10.1136/emermed-2024-999.35)
- Gal, M. et al. 2024. Knowledge mobilisation of rapid evidence reviews to inform health and social care policy and practice in a public health emergency: Appraisal of the Wales COVID-19 Evidence Centre processes and impact, 2021–23. PLoS ONE 19 (11) e0314461. (10.1371/journal.pone.0314461)
- Joseph-Williams, N. , Elwyn, G. and Edwards, A. 2024. Twenty-one years of the International Shared Decision Making Conference: lessons learnt and future priorities. BMJ Evidence-Based Medicine 29 (3), pp.151-155. (10.1136/bmjebm-2023-112374)
- Cooper, A. et al. 2024. Informing evidence-based policy during the COVID-19 pandemic and recovery period: learning from a national evidence centre. Global Health Research and Policy 9 (1) 18. (10.1186/s41256-024-00354-1)
- Nollett, C. et al. 2024. Public involvement and engagement in scientific research and higher education: The only way is ethics?. Research Involvement and Engagement 10 (1) 50. (10.1186/s40900-024-00587-x)
- Leighton, C. et al. 2024. Effectiveness and safety of asynchronous telemedicine consultations in general practice: systematic review. British Journal of General Practice Open 8 (1) 0177. (10.3399/BJGPO.2023.0177)
- Purchase, T. et al. 2023. Analysis of applying a patient safety taxonomy to patient and clinician-reported incident reports during the COVID-19 pandemic: a mixed methods study. BMC Medical Research Methodology 23 (1) 234. (10.1186/s12874-023-02057-6)
- Eberl, M. et al. 2023. Overcoming the disconnect between scientific research and the public. Immunology and Cell Biology 101 (7), pp.590-597. (10.1111/imcb.12657)
- Lench, A. et al., 2023. Household Composition and Inequalities in COVID-19 Vaccination in Wales, UK.. Vaccines 11 (3), pp.1-9. 604. (10.3390/vaccines11030604)
- Sparrow, J. M. et al., 2022. Developing decision support tools incorporating personalised predictions of likely visual benefit versus harm for cataract surgery: research programme. Programme Grants for Applied Research 10 (9)(10.3310/BAGA4188)
- Coulter, A. et al., 2022. Implementing shared decision-making in UK: Progress 2017-2022. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 171 , pp.139-143. (10.1016/j.zefq.2022.04.024)
- Parish, O. et al. 2022. Barriers and facilitators to shared decision-making in neonatal medicine: A systematic review and thematic synthesis of parental perceptions. Patient Education and Counseling 105 (5), pp.1101-1114. (10.1016/j.pec.2021.08.033)
- Scott, H. et al., 2022. A qualitative exploration of decisions about dental recall intervals. Part 2: perspectives of dentists and patients on the role of shared decision making in dental recall decisions. British Dental Journal (10.1038/s41415-022-4046-8)
- Scott, H. et al. 2022. A qualitative exploration of decisions about dental recall intervals. Part 1: attitudes of NHS general dental practitioners to NICE Guideline CG19 on the interval between oral health reviews. British Dental Journal 232 , pp.327-331. (10.1038/s41415-022-3998-z)
- Phillips, R. et al., 2021. Cohort profile: The UK COVID-19 Public Experiences (COPE) prospective longitudinal mixed-methods study of health and well-being during the SARSCoV2 coronavirus pandemic. PLoS ONE 16 (10) e0258484. (10.1371/journal.pone.0258484)
- Joseph-Williams, N. et al. 2021. What works in implementing patient decision aids in routine clinical settings? A rapid realist review and update from the International Patient Decision Aid Standards Collaboration. Medical Decision Making 41 (7), pp.907-937. (10.1177/0272989X20978208)
- Milosevic, S. et al. 2021. Managing LUTS in primary care: qualitative study of GPs’ and patients’ experiences. British Journal of General Practice 71 (710), pp.e685-e692. (10.3399/BJGP.2020.1043)
- Milosevic, S. et al. 2021. Conducting invasive urodynamics in primary care: Qualitative interview study examining experiences of patients and healthcare professionals. Diagnostic and Prognostic Research 5 10. (10.1186/s41512-021-00100-y)
- Pell, B. et al. 2020. PRImary care Management of lower Urinary tract Symptoms in men: protocol for development and validation of a diagnostic and clinical decision support tool (the PriMUS study). BMJ 10 (6) e037634. (10.1136/bmjopen-2020-037634)
- Joseph-Williams, N. et al. 2019. A descriptive model of shared decision making derived from routine implementation in clinical practice ('Implement-SDM'): Qualitative study. Patient Education and Counseling 102 (10), pp.1774-1785. (10.1016/j.pec.2019.07.016)
- Phillips, G. et al. 2019. Do published patient decision aids for end-of-life care address patients' decision making needs? A systematic review and critical appraisal. Palliative Medicine 33 (8), pp.985-1002. (10.1177/0269216319854186)
- Williams, D. et al. 2019. The ability of observer and self-report measures to capture shared decision making in clinical practice in the United Kingdom: a mixed-methods study.. BMJ Open 9 (8) e029485. (10.1136/bmjopen-2019-029485)
- Jordan, A. et al. 2019. "I'd like to have more of a say because it's my body?: Adolescents' perceptions around barriers and facilitators to shared decision-making. Journal of Adolescent Health , pp.-. (10.1016/j.jadohealth.2019.05.024)
- Sherlock, R. et al. 2019. 'What would you recommend doctor?'- Discourse analysis of a moment of dissonance when sharing decisions in clinical consultations. Health Expectations 22 (3), pp.547-554. (10.1111/hex.12881)
- Jordan, A. et al. 2018. What adolescents living with long-term conditions say about being involved in decision-making about their healthcare: A systematic review and narrative synthesis of preferences and experiences. Patient Education and Counseling 101 (10), pp.1725-1735. (10.1016/j.pec.2018.06.006)
- Joseph-Williams, N. et al. 2017. Implementing shared decision making in the NHS: lessons from the MAGIC programme. British Medical Journal (BMJ) 357 j1744. (10.1136/bmj.j1744)
- Joseph-Williams, N. et al. 2015. Choosing a specialist: will patients vote with their feet (and wallets) for person-centered care?. Medical Decision Making 35 (6), pp.688-690. (10.1177/0272989X15583267)
- Durand, M. et al. 2015. Minimum standards for the certification of patient decision support interventions. Patient Education and Counseling 98 (4), pp.462-486. (10.1016/j.pec.2014.12.009)
- Joseph-Williams, N. et al. 2014. Toward minimum standards for certifying patient decision aids: a modified Delphi consensus process. Medical Decision Making 34 (6), pp.699-710. (10.1177/0272989X13501721)
- Sepucha, K. R. et al., 2014. "It's valid and reliable" is not enough: critical appraisal of reporting of measures in trials evaluating patient decision aids. Medical Decision Making 34 (5), pp.560-566. (10.1177/0272989X14528381)
- Joseph-Williams, N. , Edwards, A. and Elwyn, G. 2014. Power imbalance prevents shared decision making. BMJ 348 g3178. (10.1136/bmj.g3178)
- Joseph-Williams, N. , Elwyn, G. and Edwards, A. 2014. Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Education and Counseling 94 (3), pp.291-309. (10.1016/j.pec.2013.10.031)
- Lloyd, A. et al. 2013. Patchy "coherence": using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC). Implementation Science : IS 8 (1) 102. (10.1186/1748-5908-8-102)
- Elwyn, G. et al. 2013. Option grids: shared decision making made easier. Patient Education and Counseling 90 (2), pp.207-212. (10.1016/j.pec.2012.06.036)
- Joseph-Williams, N. et al. 2013. The cost implications of informed decision-making: a mathematical simulation model of the potential financial effects of a web-based prostate specific antigen decision aid. European Journal for Person Centered Healthcare 1 (1), pp.193-201. (10.5750/ejpch.v1i1.651)
- Sepucha, K. R. et al., 2013. Establishing the effectiveness of patient decision aids: key constructs and measurement instruments. BMC Medical Informatics and Decision Making 13 (Suppl) S12. (10.1186/1472-6947-13-S2-S12)
- Elwyn, G. et al. 2012. Shared decision making: a model for clinical practice. Journal of General Internal Medicine 27 (10), pp.1361-1367. (10.1007/s11606-012-2077-6)
- Elwyn, G. et al. 2011. How to develop web-based decision support interventions for patients: a process map. Patient Education and Counseling 82 (2), pp.260-265. (10.1016/j.pec.2010.04.034)
- Joseph-Williams, N. J. , Edwards, A. G. and Elwyn, G. 2011. The importance and complexity of regret in the measurement of 'good' decisions: a systematic review and a content analysis of existing assessment instruments. Health Expectations 14 (1), pp.59-83. (10.1111/j.1369-7625.2010.00621.x)
- Evans, R. et al. 2010. Supporting informed decision making for prostate specific antigen (PSA) testing on the web: an online randomized controlled trial. Journal of Medical Internet Research 12 (3) e27. (10.2196/jmir.1305)
- Joseph-Williams, N. J. et al. 2010. Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid. Journal of Medical Internet Research 12 (2) e15. (10.2196/jmir.1307)
- Elwyn, G. et al. 2009. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi). PLoS ONE 4 (3) e4705. (10.1371/journal.pone.0004705)
Monographs
- Edwards, D. et al. 2021. A rapid review of the effectiveness of alternative education delivery strategies for undergraduate and postgraduate medical, dental, nursing and pharmacy education during the COVID-19 pandemic. Project Report.[Online].Cardiff: Wales COVID-19 Evidence Centre. Available at: http://www.primecentre.wales/resources/RR/Clean/RR00004_Wales_COVID-19_Evidence_Centre_Rapid_Review_Healthcare_Education_August-2021.pdf.
Thesis
Research
| Research and Implementation interests | Methodological interests |
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Research Programmes
RAPID-Involve - Understanding best practices for enabling puposeful public invovlement and capturing public impact in rapid evidence research
Forthcoming
ALPACA - Anastomotic Leak Prediction After Colorectal Anastomosis
https://www.alpaca-study.org.uk/
Health and Care Research Wales Health Research Award
2024 - 2026
Treatment for bowel cancer usually involves surgery, where the cancer is removed and the two ends of bowel are joined back together to restore normal function. However, joining the bowel back together carries a risk of a leak.
Funded by Health and Care Research Wales, our research aims to validate a new diagnostic test that can detect a leak earlier and more accurately. If introduced in clinical practice, such a test would improve the management of patients after surgery, help improve outcomes and quality of life for patients, and ultimately save costs for the NHS.
STALLED - Safety, clinical, systems effects and costs of ambuLances queuing with delayed patient handovers at Emergency Departments
https://www.fundingawards.nihr.ac.uk/award/NIHR159967
NIHR HSDR Programme
2024 - 2027
There has been a problem in the UK and other countries for many years, that at busy times Emergency Departments (ED) become unable to manage the flow of patients. Patients remain in the ambulance, sometimes for several hours. In some areas this practice is rare, in others it is common. When ambulances are queuing, patients are not receiving full ED care and ambulances are unavailable, so there are ‘knock-on’ effects on patients and staff throughout the urgent and emergency care system.
We aim to provide evidence about what works to reduce harms related to ambulance queuing.
Teaching
Undergraduate Medical Education
I am involved in the planning and delivery of the C21 Medical Programme (MBBCh) at Cardiff University.
I am course lead for Year 3 MBBCh Evidence Based Medicine, and design and run various undergraduate sessions (lectures, tutorials, experience weeks) throughout the five year C21 Programme:
- Evidence Based Medicine (Year 3 medical students) - topics include research design, critical appraisal, evidence based practice, shared decision making and quality improvement
- Organising and delivering Student Selected Components (SSCs) for Year 3 and 4 medical students
I also support the Intercalated Medical Degree Programmes (Population Medicine, Medical Education and Emergency, Pre-hopsital and Immediate Care)
- Design and deliver various teaching sessions - writing for the medical literature, critical appraisal, literature searching
- Supervise and assess dissertation projects, supporting students to write a publication from their work
Postgraduate and Continuing Professional Education
I have designed or contributed to various Shared Decision Making continuing professional development training programmes, available to NHS staff in the UK.
- 'Shared Decision Making Train the Trainer' Programme for Public Health Wales
This work formed the basis of a REF 2021 Impact Case Study.
- Shared Decision Making programme for Health Education and Improvement Wales (HEIW)
This programme is due to be launched in Winter 2025, and will be hosted on the HEIW Y Ty Dysgu platform.
Other teaching, supervision and mentoring duties include:
- Supervision of PhD students
- Personal tutor for MBBCh students
- Chair / member of postgraduate research progress review panels
- External PhD Examiner
Biography
Biography
Academic positions
Research Leadership Roles
- Person Centred Care work package lead for the Wales Centre for Primary and Emergency Care Research
Cardiff University School of Medicine Leadership Roles
- Director of Impact at Cardiff University School of Medicine - January 2026 to current
International Advisory Roles
- International Shared Decision Making Society Executive Board Member and Scientific Lead
- Picker Institute Board of Trustees
Teaching Leadership
- Evidence Based Medicine co-lead for Cardiff University MBBCh (Year 3)
Supervisions
- Shared decision making in healthcare
- Person centred health and care delivery
- Implementation science focused research
Current supervision
Jenny Waterman
Contact Details
Research themes
Specialisms
- Patient safety
- Patient and Public Involvement
- health service delivery
- Health services and systems
- Patient information