Chapter 9: Final priority setting

Final priority setting principles

The final stage is to agree 10 prioritised uncertainties.

Generally final priority setting is conducted in a face-to-face workshop, using small and full group discussions.

The final workshop is an opportunity for different parties to express their views, hear different perspectives and to think more widely about treating or helping people with the health problem. While interim prioritisation involves more people, the responses gathered are based on individuals’ or groups’ particular opinions and experiences.  Bringing people together in a workshop enables people to exchange knowledge and information, and make decisions based on a wider set of experiences.  The workshop enables a group of people to agree on the Top 10 as they see it, on that day.   A different set of people on a different day could give a different result.  However, there is immense value in getting people together face to face to agree priorities.

The format is rigorous, but flexible enough to allow people to revise their opinions, raise concerns and correct through consensus any perceived imbalance emerging from the interim stage.  This is the stage at which any concerns about fairness or representation can be openly discussed and addressed.  The JLA actively encourages participants to take ownership of this debate.

There are challenges, such as:

  • ensuring the choice of participants is balanced
  • avoiding domination by any one person
  • cost
  • reaching consensus when there may have been disagreement.

The JLA's experience suggests that participants may want to debate or even dispute the shortlisted uncertainties, for example the wording, or whether or not any questions could be considered duplicates of each other.  It is essential that the Steering Group is confident that it can defend the shortlist which goes to the final workshop.  It is worth the Steering Group reflecting on the following questions:

  • How confident are we that the questions will be understood?
  • Is there scope for confusion?
  • Are any of the questions too similar?
  • Are there any which may be better combined into one question?

Reaching decisions with large groups of people can be challenging, but also exciting.  The JLA is pragmatic about these challenges, which are not insurmountable, and encourages open debate and transparency when resolving them.  Preparation and a well organised meeting are key to ensuring good outcomes.