National Institiue for Health and Clinical Excellence

Annual Review - 2012/2013
citizens council 2

Bringing the views of the public to NICE

NICE’s Citizens Council is a group made up of 30 members of the UK public that provides a public perspective on challenging social and moral issues that NICE has to take account of when producing guidance.

The Citizens Council is broadly representative in key demographics such as age, sex, ethnicity and socio-economic status and meets once a year for two days at a time to discuss a specific topic. During the meetings, members hear from topic experts and take part in exercises to examine the topic in detail and discuss their own views. An independent report writer captures the members’ views and conclusions and prepares a report of the meeting to present to NICE’s board.

The recommendations and conclusions that emerge from the Citizens Council meetings are incorporated into a document called “Social Value Judgements: Principles for the Development of NICE Guidance”. This document underpins a large proportion of NICE’s work as it describes the social and moral principles that NICE must consider when producing its guidance.

This year, NICE recruited thirty new Citizens Council members and the Council met to consider the question of which aspects of benefit, cost and need NICE should take into account when developing social care guidance.

NICE will start producing guidance and quality standards on social care in adults and children from April 2013, as the National Institute for Health and Care Excellence.

The Health and Social Care Act 2012 sets out NICE's new remit for social care states that it must take into account  the broad balance between the benefits and costs of care and people's degree of need for care.

“There are many important aspects that come under these terms,” said Dr Sarah Garner, Associate Director for Research and Development at NICE.

“For example benefits can include quality of care, dignity, personal cleanliness and comfort.

“NICE has produced guidance for nearly 14 years. Our experience was that the methods that we used for health needed adapting for when we started to produce public health guidance. We anticipate that they will also need adapting for social care as it is set up differently and trying to achieve different outcomes.”

The Council was asked to think about whether this would be the case and to consider the differing evidence bases for health and social care and whether NICE’s current processes could be applied to social care.

NICE's standard processes for judging the cost effectiveness of clinical and public health interventions use the quality-adjusted life year (QALY) to measure the benefits. This involves the use of standard questionnaires that ask about factors that impact on a person's health-related quality of life.

But social care interventions aim to increase capability and function, in addition to health-related quality of life. Therefore, a different approach may be needed. This includes the questionnaires that are used to ask people about their experience.

Over the two days of the meeting, held in January 2013,  the group began to appreciate that what makes good social care is very different from what makes good health care.

While a doctor might prescribe treatment that will cure an infection, social care does not provide cures but aims to help people live their lives as normally as possible. No two people’s needs are the same, was a key message that emerged from the meeting.

A report on the Council's views will be published on the NICE website in the summer of 2013.

This report will support the development of processes for producing NICE guidance in relation to social care. It will also be used in conjunction with reports from previous Citizens Council meetings to inform and update NICE’s Social Values Judgements document, which concerns all aspects of NICE guidance.

This year, NICE recruited 30 new members and the Council met to consider what NICE should take into account when developing social care guidance