Shared, informed decision making is a key component to high quality care in the NHS. This can occasionally be challenging through lack of time, lack of high-quality trial evidence to support treatment choices and financial limitations to treatment. Informed decision making includes open discussion of the risks and potential adverser consequences of treatment and alternatives. People with endocrine disorders often have symptoms that encompass both their psychological and physical health, and as part of collaborative care it is important that these are explored during the consultation. Research suggests that patients with chronic endocrine conditions report not being listened to and this is a barrier to effective consultation. We know that patients come into healthcare consultations with their own expectations and agenda, which may or not match with the healthcare professionals provisional agenda. A dissonance between the patient and the HCP can be a significant barrier in informed decision making. An essential aspect of the consultation is for patients to be able to disclose their concerns, and seek information and support. If this need isnt met it is likely the consultation will be less helpful and may not meet the patients physical and psychological needs. This talk will explore the basis of informed decision making as well as reviewing some ideas relevant to complex consultation such as supporting patients who have unresolved symptoms.