Exploring Barriers and Facilitators to Patients and Members of the Public Contributing to Rapid Health Technology Assessments for NICE: A Qualitative Study.

Background: Evidence and External Assessment Groups (EAGs) assist in the National Institute of Health and Care Excellence's Technology Appraisal programme by either critiquing evidence provided by companies on different health technologies, or by carrying out an independent search and evaluation of the published evidence. Historically, there has been little patient and public involvement within the work of EAGs.

Objective: To identify key barriers and facilitators to patient and public involvement in EAG Reports feeding into the National Institute for Health and Care Excellence's Health Technology Appraisal process.

Methods: A primary qualitative study consisting of one-to-one interviews with EAG researchers and focus groups with members of the public. From anonymised transcripts, data were deductively coded using a framework analysis against the Theoretical Domains Framework and translated to the COM-B model. Coding was triangulated through inductive thematic analysis, guided by the principles of Braun and Clarke.

Results: Ten researchers were interviewed and four focus groups with a total of 26 members of the public were undertaken. Both EAG researchers and the public felt they did not have enough knowledge, time and money to be able to embed patient and public involvement; researchers suggested that patient and public involvement might not be relevant to the scope of their Reports. Members of the public highlighted a lack of awareness of the Technology Appraisal process and that jargon may stop them being involved. Both researchers and members of the public said having specific guidance on how to embed patient and public involvement in EAG Reports would be helpful, including guidance on how to write plain language summaries.

Conclusion: The perspectives of both EAG researchers and members of the public suggest work needs to be conducted to produce frameworks for patient and public involvement and plain language summaries within EAG Reports specifically. Additionally, that further awareness-raising of Technology Appraisals and the role of EAGs would help members of the public to contribute effectively to EAG Reports.

Patient or public contribution: Two members of the public were part of the research team and governed all stages of the research in accordance with the UK Standards for Public Involvement.