OBJECTIVES: To meet the needs of an evolving health and care system, the National Institute for Health and Care Excellence (NICE) in England is changing its approach to topic prioritisation so it can focus on what matters most. To support this, NICE ran a public dialogue with the aim of gathering informed opinion on how NICE should select topics for guidance, including for some technology evaluation programmes.

METHODS: general public participants from across England took part in 2 face-to-face and 3 online deliberative workshops, held over 4 weeks in 2023. Participants considered six proposed criteria in the context of prioritisation: health and care need, evidence availability, system impact, budget impact, health inequalities, and environmental sustainability. The workshops used deliberative engagement methods and included trade-off exercises, role-play, group discussion, ranking tasks, and interactions with specialists.

RESULTS: Participants agreed that NICE should consider all of the proposed criteria when prioritising topics for guidance. Eight key principles were derived from participants’ deliberations. To give three examples: (1) NICE should focus on guidance that can have a direct impact on the outcomes of people with health and care needs; (2) while system and budget impacts are important, NICE should ensure that people’s care and experience are not compromised when pursuing opportunities to relieve system and budget pressures; (3) when assessing the availability of evidence, NICE should consider a broad range of evidence types and sources, including real world evidence and evidence from other countries.

CONCLUSIONS: Deliberative engagement is a meaningful way to involve the public in complex policy decisions with a social value element. Broad public agreement was found with the criteria NICE has proposed to consider when prioritising topics for guidance. The findings have informed NICE’s new approach to topic prioritisation and will continue to inform the deliberations of NICE’s new Prioritisation Board going forward.