Chapter 8: Final priority setting

Final priority setting principles

The final stage is to rank all the shortlisted indicative questions in priority order, with an emphasis on the Top 10. 

For JLA Priority Setting Partnerships (PSPs), final priority setting is ideally done in a face-to-face workshop, using small and whole group discussions.  With the Covid-19 restrictions introduced in 2020 and the need for social distancing, the JLA has developed and tested an online workshop method that will be explained later in this chapter. 

The priority setting 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’ opinions and experiences.  They are making decisions based on what they already know.  Bringing people together in a workshop enables them 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.  The JLA recognises that there is subjectivity here and that a different set of people on a different day could give a different result.  However, there is immense value in bringing people together to engage in careful consideration and quality discussion to make shared decisions and reach genuine consensus.

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 ranking 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.

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.