Public input helps shape NICE's social care work

One of the Council's conclusions was that the concept of need in social care is different to need in healthcare

In preparation for NICE’s move into social care, our Citizens Council was asked to explore which aspects of benefit, cost and need NICE should take into account when developing social care guidance.

The 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.

In July 2013, the Citizens Council published their 16th report which concluded that NICE needs to develop innovative new ways of considering how the costs and benefits of informal care can be taken into account when developing social care guidance and quality standards.

In response to the Councils conclusions, NICE established a methodological advisory group to build on existing methods, but also to innovate, and advise on the development of new methodologies, such as those around economic evaulation for social care, including how costs and benefits from informal care can be taken into account in any economic calculations.

NICE pledged to ensure a continued commitment to co-production by strengthening the involvement of service users and carers in the development of our products.

Another of the Council's recommendations was for quality ratings, regulations and inspection frameworks developed by national regulators such as the Care Quality Commission and Ofsted should be underpinned by evidence-based guidance developed by NICE.

NICE will also look at ways of further promoting integration through its guidance programme, including a topic on transition between health and social care, and ways of reducing duplication of care provision and supporting better coordination of care by working across teams to ensure that guidance promotes a joined up approach between health and social care.

Professor David Haslam, Chair of NICE, said: “One of the Council's conclusions was that the concept of ‘need' in social care is different to need in healthcare, where need is often determined by a health professional. They noted that in social care ‘need' is determined and defined by the service user, and is much broader than the health context.

“The Council also highlighted that, given the wider remit of social care, enabling a personalised service is very likely to improve quality of life for disadvantaged people. Importantly, an overwhelming majority of the Council (nearly 70%) felt that NICE needs a new way of applying its methods when developing social care guidance and standards.

“In response to the Council's conclusions, our new Social Care programme has already started to consider how the costs and benefits from informal care are taken into account in economic calculations, as part of our work developing methodologies of economic assessment for social care. And a person-centred approach will be central to NICE's development of quality standards, as demonstrated through the two quality standards already produced as part of the social care pilot programme.

“The Citizens Council makes an important contribution to NICE's work by providing a snapshot of what the general public thinks. NICE's new remit for social care charges us with taking into account ‘the broad balance between the benefits and costs' of care and people's ‘degree of need' for care when producing guidance and standards. This Citizens Council report will help us deliver the new remit. I would like to thank the Council for its invaluable perspective and informative deliberations on this topic.”

Nicola Bent, Health and Social Care Programme Director at NICE, added: “The insights of the public on the issues debated are helpful in informing the social care work programme.

"There is a need to adapt our existing methods in order to be able to produce effective and meaningful social care recommendations, and the input from the Citizens Council will help us think through how to do that.”"What are the social values that need to be considered when making decisions about trade-offs between equity and efficiency?”

"What are the social values that need to be considered when making decisions about trade-offs between equity and efficiency?”

The Citizens Council will next turn their attention to discussing what influences how health and social care resources are shared-out. The group will consider what the balance should be between getting the most out of every pound available whilst ensuring that resources are distributed fairly among members of the community.

Professor David Haslam, Chair of NICE, said: “NICE is integrating how it develops health and social care guidance and standards, so we want the public’s views on what social values are similar for both areas, but also where those values may differ.

“So we look forward to hearing the Citizens Council’s views on the complex social issue of which values they take into consideration when thinking about how resources might be used in health care, public health and social care.  This will provide insights into the public’s viewpoint for our independent advisory committees to take into account when they develop guidance and standards in these areas.”

A report on the Council’s views will be available on the NICE website for public comment later in the year, before the Council submits a report to the Board of NICE setting out its findings.