When every voice in your practice matters – but decisions still need to move forward – consent-based decision-making offers a practical and inclusive alternative to traditional consensus
CREDIT: This is an edited version of an article that originally appeared in Monday 8am
Today’s GP practice managers are leading in environments that demand both compassion and clarity. From managing multidisciplinary teams to navigating NHS requirements, patient needs, and ever-evolving clinical priorities, it’s essential to foster a culture where all team members feel heard and respected.
While the intention to build inclusive teams is both admirable and necessary for patient-centred care, it can also lead to a familiar challenge: decision-making paralysis. Trying to gain full consensus from GPs, nurses, receptionists and administrative staff often slows down essential progress – especially when time and resources are already stretched.
Consensus aims to ensure that everyone agrees fully before moving forward, but the pursuit of unanimous agreement can become a barrier rather than a bridge. In contrast, consent-based decision-making offers a compelling alternative – one that encourages alignment without paralysis and collaboration without gridlock.
The Benefits and Limitations of Consensus
There’s no denying that consensus brings several positive outcomes. Team members who feel involved in decisions are more likely to be committed and engaged. However, consensus can also dilute impact. When decisions are shaped to satisfy all viewpoints equally, the result is often a “safe” solution – one that is unlikely to offend but also unlikely to inspire.
Another significant drawback is decision abandonment. When multiple stakeholders with varied perspectives struggle to find common ground, decisions can be delayed indefinitely. Teams get stuck in endless loops of discussion, aiming for the elusive “perfect solution,” which sometimes leads to no decision at all.
Decision gridlock becomes a real threat. Debates stretch over days or even weeks. Momentum slows, and what was once a proactive team becomes reactive, caught in a cycle of hesitancy and over-analysis.
Understanding Consent-Based Decision-Making
Consent-based decision-making takes a different approach. Rather than asking whether everyone agrees completely, it asks whether anyone strongly objects to moving forward. The central question becomes: “Can we all live with this decision for now?” It is not about achieving perfect harmony but about removing significant barriers to action.
This method encourages clarity without the requirement of unanimity. Leaders can still invite input and feedback from the team, but the goal is to address concerns. Key objections are explored and evaluated, and if they reveal legitimate risks or flaws, they are addressed. If not, the team proceeds, knowing that progress is more valuable than perfection.
Laying the Groundwork for Consent
Before jumping into a solution, leaders must ensure there is alignment around the problem itself. This means establishing a shared understanding of the issue at hand, its importance and who the primary decision-maker is. Without this clarity, even consent-based approaches can falter, as teams may not be debating the same thing.
Communication must be reframed. Rather than asking, “Do we all agree?”, leaders should ask, “Are there any objections to moving forward?” This shift in language creates space for concerns to be raised in a constructive manner. And importantly, objections must be reasoned. In a consent framework, a simple “no” is not enough – it must come with explanation.
A Mindset Shift That Drives Progress
In busy healthcare environments, where change is constant and patient needs are pressing, adopting a consent-based approach allows GP practices to maintain inclusivity and agility. It encourages contribution without letting indecision take over.
For GP practice managers, mastering this mindset can unlock better team collaboration, faster decisions and smoother implementation of initiatives – from changes in appointment systems to rolling out new digital tools or improving patient triage. Consent-based decision-making isn’t about skipping collaboration – it’s about making collaboration more effective.
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