Not everyone thinks like you: why values matter in healthcare – A Fellow Perspective: Ashok Handa

Professor of Vascular Surgery and St Catherine’s Fellow, Ashok Handa, talks about decision-making, shared care, and the College-based centre helping reshape the conversation.

What if one of the biggest challenges in healthcare isn’t a lack of evidence but a lack of understanding about what matters to the person in front of you? For Professor Ashok Handa, that’s exactly the issue. “In simple terms, values are the things that are important to us and that drive our decisions,” he says. “And the way we choose to live our lives.”

That might sound obvious, but in practice it’s often missed. “In healthcare, patients bring their own values, sometimes family values too. And clinicians? It’s more complex. You’ve got personal values, professional values, your team, your organisation, society. It’s like layers of an onion.”

Values-based practice starts with recognising that. “It begins with becoming values-aware and realising that not everyone thinks like you.” One exercise Ashok uses makes the point quickly. Groups are given the same clinical evidence and asked to choose between treatment options. Despite working from identical information, they often reach very different decisions. “For people, it’s a lightbulb moment,” he says. “You suddenly realise you can’t predict how someone else will decide, because what matters to them is different.”

That insight has real consequences. Too often, decisions are still shaped by a traditional model where the clinician is the expert and the patient follows their lead. Even now, many patients ask: what would you do, doctor? “Before I became values-aware, I would answer that,” Ashok admits. “I’d say, ‘If I were you, I’d do this.’ But that was based on what’s important to me.” The shift is simple, but powerful. “Now I say, tell me what’s important to you in this situation. Then we decide together.”

When that conversation doesn’t happen, the system feels it. “In England and Wales, a third of prescriptions are never cashed in,” he says. “And another third aren’t taken as directed.” That’s not just inefficiency, it’s a sign that decisions aren’t landing. “People leave a consultation without really buying into the decision. There hasn’t been that proper conversation.”

Ashok’s own journey into this work came through surgery, and a moment of realisation. “I thought we were already doing this,” he says. “But then I realised, we were doing it really badly.” A chance conversation at a Catz dinner with another Catz Fellow, philosopher and psychiatrist Professor Bill Fulford, changed everything. “It stayed with me. I couldn’t let it go.”

Within months, the Collaborating Centre for Values-based Practice was established at Catz, a distinctly collegiate story of ideas turning quickly into action. “It shows what colleges can do,” Ashok says. “Those conversations across disciplines are incredibly powerful.”

That spirit continues through the Centre’s seminar programme, running for over a decade and continuing through 2026. The sessions are small, discussion-led and open to a wide audience, from healthcare professionals to students and the public. “If you’re going to give up a whole day, you have to be really interested,” he says. “But that’s the point, you get into deep thinking.”

This year’s topics range from spirituality in medicine and language in psychotherapy to menopause, interprofessional working, and questions around living and dying well. “We don’t force outcomes,” Ashok adds. “But people come together, and they want to do things – write, collaborate, start projects.”

More broadly, he believes healthcare is at a crossroads. “We’re good at innovation. We’re good at evidence. But we’re not always good at looking after our people.” For Ashok, places like Catz offer part of the answer. “Oxford gives you opportunities,” he reflects. “But in colleges, especially here, you get conversations that lead to ideas, and ideas that turn into something real.” And at the centre of it all is a simple idea: Not everyone thinks like you, and in healthcare, that’s where better decisions begin.

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Find out more about the Centre and the seminar series, here.

Find out more about Ahsok’s research, here.