Workshop process on the day
This section describes what happens in a standard JLA final priority setting meeting. The literature suggests that a nominal group meeting be facilitated either by an expert on the topic or a credible non-expert, and that the meeting should be structured as sequential steps of consensus building. The meeting is held in person, although the JLA has experience of including participants who have only been able to take part via Skype – this needs to be considered on a case by case basis.
The JLA offers transparency and fairness as guiding principles for PSPs. JLA Advisers have an important role in managing differences in values and perspectives at the workshop.
It is common practice for group discussions to follow ‘ground rules’ that participants have chosen together. These often include listening to and respecting other people’s ideas, and sharing news of the event with other people but not ascribing individual names to specific statements. This last principle is known as the ‘Chatham House Rule'.
Workshop phase 1: small group discussions
- In small groups (3 groups of up to 10 people – equal mix of patients, carers and clinicians), each participant, in turn, contributes their views on the treatment uncertainties they feel most and least strongly about. These are noted down by the facilitator. This continues until all ideas/views have been expressed.
- There the discussion is reviewed by the group to clarify any aspects of the uncertainties.
Workshop phase 2: first round of small group ranking
- The same small groups move the discussion to ranking the list of uncertainties.
- The facilitator will lay out the cards in rough groups: those which were thought to be most important, those thought to be least important and those not mentioned or where there was divergence of view.
- Participants are then invited to start discussing the ordering of the cards, with a view to ranking all of them in order. It is important that all small groups achieve a ranked order of all the uncertainties.
- Participants are also encouraged to take account of the contextual information on the back of the uncertainty cards – such as examples of original survey submissions and interim voting results.
Workshop phase 3: whole group review
- Each group’s ranking is entered into an Excel spreadsheet, and a first combined (aggregate) ranked list is achieved at this point.
- The JLA Adviser chairing the meeting will present an overview of the results, usually after a lunch break. Questions, comments and concerns are discussed with the whole group present.
- Participants will then break into three new groups – with an equal balance of patients, carers and clinicians – to discuss and revise the combined ranked list.
Workshop phase 4: second round of small group ranking
- In the new groups, the facilitator should lay all the cards out in the aggregate order, although the discussion should focus more on the top 15 and any ‘outliers’ that participants feel strongly about. A full ranking must be done and recorded.
Workshop phase 5: final whole group review
- The small group scores are again entered into the Excel spreadsheet, and an aggregate ranking is presented to the whole group.
- The ranking is discussed in the large group, with the aim of agreeing the top 10 by the end of the discussion session. Some PSPs have also decided on more than 10 for the final list.
- This discussion is chaired by the JLA Adviser to ensure no one group or individual dominates the decision making. If consensus cannot be reached by discussion, decisions may be put to a vote.
- The top 10 questions are agreed.