The guidelines manual

A4.1 Introduction

Before invitations to participate in a NICE technology appraisal are sent out, the Guidelines Commissioning Managers are contacted to establish whether a related clinical guideline is on the work programme, and if so, who should act as representative(s) of the guideline. Members of the GDG – usually the GDG Chair (or the expert with the most relevant experience) and one other member (usually the NCC Director, the Clinical Adviser or another senior clinician) – are invited to attend the appraisal consultation document (ACD) and final appraisal determination (FAD) meetings of the Appraisal Committee considering any appraisal that is relevant to the development of the guideline.

When the topic of the appraisal relates to a guideline on the work programme for which development has not yet begun (that is, there is no GDG in place), the NCC Director should be invited to attend on behalf of the future GDG.

Project managers from the appraisals and guidelines programmes at NICE will liaise at an early stage in each appraisal to determine appropriate links between the relevant committees and GDGs, and to provide operational support.

A4.2 Purpose of attendance and role

The attendance of GDG members at the Appraisal Committee meeting allows them to participate fully in discussions about the technology. They can remain for the concluding discussions of the Appraisal Committee after the patient experts and clinical specialists have left the meeting.

The GDG members attending the Appraisal Committee meeting will also, in conjunction with their GDG as a whole, act as commentators on the documents produced. They will receive the ACD and FAD, and the GDG comments fed back via the NCC will be included in the review of the documents by the technical lead and the Appraisal Committee Chair, and be brought to the attention of the Appraisal Committee.

As is the case for other commentators, GDG members do not have the right of appeal.

A4.3 Voting

In the event of a decision of the Appraisal Committee being taken by a vote, the GDG members attending the meeting will not have the right to vote.

A4.4 Conflicts of interest

GDG members who attend the Appraisal Committee meetings will be expected to declare conflicts of interest and to abide by the current rulings on these for full committee members if they wish to take part in all of the Committee's discussions.

GDG representatives who attend Appraisal Committee meetings do so as committee members (except for voting; see section A4.3). Therefore a GDG representative with a personal pecuniary interest will not be able to attend the Appraisal Committee discussion.

GDG members who have conflicts of interest that would have excluded Appraisal Committee members can be present at meetings only for the same period as the clinical specialists and patient experts, and must leave the room with them before the concluding discussions. This would require their nomination as clinical specialists by the Appraisals' consultees and commentators. Such specialists are only usually present at the first Appraisal Committee meeting (that is, the meeting to develop the ACD).

A4.5 GDG members as clinical specialists or patient experts

GDG members may occasionally also be nominated as clinical specialists or patient experts for an appraisal. They may then act in both capacities, but must leave the meeting with the other specialists and experts if they have a conflict of interest (see section A4.4). GDG members may wish to avoid this dual role in order to maximise their attendance at Appraisal Committee meetings. Exclusion from the second half of the meeting because of conflicts of interest does not preclude GDG members who have attended from providing written comments during consultation.

A4.6 GDG comments on the ACD and FAD

It is expected that the GDG comments on the ACD and FAD will represent a consensus view, expressed in a single document, preferably submitted via the GDG Chair and coordinated by the NCC.