Tools and resources

How NICE clinical guidelines are developed: an overview for stakeholders, the public and the NHS

The Guideline Development Group (GDG)

The Guideline Development Group (GDG)

The role of the GDG

The GDG is established by the NCC or the Internal Clinical Guidelines Programme, and is responsible for developing the clinical guideline.

During development of the clinical guideline, the GDG:

  • agrees the 'review questions' about treating and managing the condition that will guide the search for evidence

  • considers the evidence and reaches conclusions based on the evidence

  • uses expert consensus to make decisions if evidence is poor or lacking

  • formulates the guideline recommendations

  • considers comments made by stakeholders during consultation

  • agrees the necessary changes to the guideline after consultation.

Key point

GDG members do not comment during the stakeholder consultation on the draft guideline.

There is more information on the role of the GDG in chapter 3 of The guidelines manual.

GDG membership

All members of a GDG need to have:

  • an interest in and commitment to developing the clinical guideline

  • time to attend all meetings (usually 10–15 in total, held monthly)

  • time to do the background reading and help formulate the recommendations

  • good communication and team-working skills.

Each GDG is made up of healthcare professionals (and other professionals if relevant), technical experts and patients and/or carers. The membership reflects the range of stakeholders and groups whose professional activities or care will be covered by the guideline. Every GDG includes at least 2 members with direct personal experience or knowledge of patient and carer issues. As far as possible, the GDG will have an appropriate balance with regard to the principles of NICE's equality scheme. Expert advisers may also be invited to attend GDG meetings for specific discussions.

NICE is not represented on the GDG, but the Guidelines Commissioning Manager who is responsible for overseeing the clinical guideline attends meetings as an observer.

The healthcare industry is not represented on GDGs because of potential conflicts of interest. However, manufacturers have input into the clinical guideline development process as stakeholders.

All members of the GDG are expected to abide by the NICE code of conduct and NICE's equality scheme and to declare potential conflicts of interest. On appointment, all GDG members are required to sign a confidentiality form.

GDG members are reimbursed for travel and subsistence. In addition, patient and carer members are offered an attendance allowance, and GPs are offered an allowance to enable them to provide locum cover at their surgeries.

Becoming a GDG member

Adverts for all GDG vacancies are posted on our website. A brief job description and person specification are provided, together with additional information and details of how to apply. All applicants must complete a declaration of interests form and an equality monitoring form. For details of vacancies and application forms, visit the Join a NICE committee or working group page of the NICE website.

When selecting GDG members, both of the following are taken into account:

  • the suitability of individual applicants

  • the requirement for the best combination of people to maximise the range of skills and experience of the GDG.

Short clinical guidelines

We may select the GDG Chair and technical members of the GDG (for example, epidemiologists, statisticians and health economists) from a pool of suitable members. This pool will be recruited through a formal advertisement and recruitment process to act as standing members for each guideline.

GDG Chair

The GDG Chair is appointed before work starts on the scope of the guideline. We inform registered stakeholder organisations about the vacancy. Applicants are required to submit a CV and a covering letter.

The GDG Chair is selected after interview. The selection panel includes the Director of the NCC (or a senior colleague), the Director of the Centre for Clinical Practice at NICE (or their representative) and a non-executive director of NICE.

Clinical Adviser

Some GDGs have a Clinical Adviser who is an expert on the topic, and who provides extra support to the GDG. The Clinical Adviser is appointed in the same way as the GDG Chair, before work on the guideline scope begins.

Patient and carer members of the GDG

A key role of patient and carer members is to ensure that patient issues are considered in everything that the GDG does.

The PPIP team at NICE contacts patient and carer organisations that have registered an interest in the guideline topic to notify them of vacancies. Vacancies are also advertised on our website, and people who are not associated with a particular organisation are also welcome to apply.

Patients and carers do not need any formal qualifications to become GDG members, and they are not required to act as a representative of a patient organisation. However, they should meet the following criteria:

  • Be familiar with the condition being covered by the guideline and the issues that are important to people with it. For example, they might:

    • have (or have had) the condition themselves

    • be related to and/or care for someone with the condition

    • be a member of a patient organisation.

  • Understand the range of experiences of people with the condition. They should be willing to reflect these different experiences, rather than basing their views only on their own experience.

  • Have some familiarity with medical and research language. For example, it is helpful if they can understand an abstract from the 'British Medical Journal'. However, training and help will be available.

When considering whether to apply, anyone interested in becoming a patient and carer GDG member should bear the following in mind.

  • The clinical guideline will usually cover the entire 'patient journey', from the first time a person contacts a healthcare professional to treatments and long-term care. An understanding of the different stages of the condition is therefore useful. We encourage applications from people with a broad knowledge of the condition. GDG members need the confidence to consider and to discuss all findings from research studies.

  • The guideline will cover many aspects of treatment and care. Anyone who is interested only in 1 or 2 specific aspects of care should consider carefully whether they want to apply. The time spent discussing any one issue may be limited, and issues discussed will be restricted to those listed in the guideline's scope. Ideally, applicants should have an interest in, and a willingness to consider the evidence on, a wide range of possible treatments. It is useful for potential applicants to look at the scope (which will be available on our website) to get a clear idea of what the guideline will cover.

Appointing patient and carer members

Applicants should complete an application form describing how their skills and experience meet the specified requirements. The NCC and the GDG Chair shortlist applicants. Those on the shortlist are interviewed either in person or by phone. The GDG Chair, with help from the NCC, makes the final decision on which patient and carer members to appoint, and is responsible for notifying both successful and unsuccessful applicants.

Healthcare professional members of the GDG

There are usually between 6 and 8 'healthcare professional members' of the GDG. These are healthcare professionals (and other professionals where relevant) who either treat people with the condition directly or manage services. The NCC and NICE agree a list of professions that will be represented on the GDG to ensure the widest possible range of viewpoints on the topic.

Healthcare professional GDG members should:

  • have an interest in and experience of the guideline topic, but this need not be as an 'expert' – GDGs need to include clinicians who treat patients on a day-to-day basis in the NHS

  • be chosen on the basis of their individual skills and experience – they are not expected to act as a representative of their profession or a professional organisation.

Appointing healthcare professional members

The NCC informs stakeholder organisations about vacancies for healthcare professional GDG members. Applicants are required to submit a CV and a covering letter.

Healthcare professional members are selected by the Director of the NCC (or a delegated guideline lead) and the GDG Chair, subject to confirmation by the Centre for Clinical Practice lead for the guideline at NICE. Applicants may be interviewed.

Key point

All GDG members are recruited as individuals and not as representatives of particular organisations or professional groups.


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