Toolkit

We have put together this toolkit or checklist for other commissioners to run their own citizens juries along similar lines, hopefully building on what we got right and learning from our mistakes.

General Principles

  1. Clear and agreed objectives and outcomes
  2. Get your LINk or other patient group on board if you can - don't go it alone
  3. Use the input from GPs and other clinicians thoughtfully

Recruiting Your Jury

Start well in advance. At the beginning of the exercise, a strict panel profile was drawn up. In order to recruit a panel that fits the panel profile, recruitment should ideally start at least 2 months before the start of the event. The following actions can support the selection process and help it run more smoothly

Prepare the initial participant information well

The times and dates of all sessions should be given, with any out of pocket or per session payments clearly identified. While interested patients don’t need a full participant pack, they need to know what they are signing up to, what is expected of them and what we are trying to achieve, especially as this model requires a fair commitment of time from participants.

Have stricter criteria for participants – “participant profiles”

We need to give very clear guidelines to potential participants as to who we wish to recruit. If we want people who have never been involved in decision-making about the area under debate, we need to specify this clearly. If we want people who have no connection with health services, we need to specify this clearly. This must be included in the participant information. We also need to be able and willing to say “no” to potential participants who do not fit our criteria. However, we also need to have back-up plan for engaging these willing volunteers at a later date in other work.

Comprehensive, timely brief for recruited participants

Potential participants should be clear that they are looking at a big picture, not at a solution to their own personal problems or grinding their personal axe. They should also be given full information on venues, background information on the context of the issues under debate and other relevant details. This information should be given to participants well in advance, to avoid no-shows or people who miss initial sessions.

Publicise the event better to give a wider pool of participants

Promote the event widely, maybe even put a press release out. Although this may result in having to say “no” to interested parties (see above)

During the event

Allow longer time slots for questions. Participants need to ask experts questions. Establish that experts finish their presentation before there are questions (some questions are answered later in the presentation).

Ensure that quieter participants have the opportunity to comment and ensure that questions to speakers go through the Chair. If participants ask through the chair, there is less likelihood that vocal participants will drown out quieter ones.

Restrict individual issues and experiences where they are not relevant to the big picture. Participants often refer to their own experience. This is fine as long as it can be related to the wider issues. However, when it becomes a single issue rather than an illustration it needs to be reined back. It is useful to refer to a member of staff present and say “X will talk about this privately with you” etc.

Allow participants more time for discussion, there is a lot of information and participants need time to formulate their thoughts on the implications of the “expert witness” statements for the areas under debate.

What worked well

  • Neutral, non-health venue (makes the process more approachable and accessible)
  • Early group exercises to break the ice and help participants start to think about the reasons for the commission and set their own ground rules – gives a degree of participant ownership of the commission.
  • Independent chair and facilitators – with NHS staff on hand for questions
  • Well-briefed experts who are able to communicate accessibly with participants
  • Full background information on which to base discussion.