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Effectiveness and efficiency of committee work: a rapid systematic review for NICE by its Research Support Unit

What do we want to know?

Making collective decisions faces new challenges in the 21st Century: a growing expectation for evidence-informed decisions for public policy; policy support for involving relevant stakeholders from different backgrounds; and economic pressures which limit time and resources. These changes raise specific questions about decision-making committees: What does the evidence tell us about the effectiveness and efficiency of committee work?

Specific questions are raised about:

  • The composition and working environment
  • The skills and competencies of a committee chair
  • Committee processes regarding timescales, support tools, media for communication, equity, and training

Who wants to know?

This review was commissioned by The National Institute for Health and Care Excellence (NICE) from its Research Support Unit (a multi-disciplinary academic unit based at the UCL Institute of Education (IOE)) to provide a rapid assessment of the evidence for the impact of the structure and management of committees on decision making and outputs.

What did we find?

Committee performance depends upon their members, whether they: are aware of their tasks, roles and responsibilities; understand the wider the context and culture; bring analytical and political competence, interest and willingness; offer time and commitment; actively participate; and behave appropriately over external relationships, confidentially and conflicts of interest.

Particularly important are the different perspectives and sets of knowledge brought by individual members or presented to them in papers or meetings. Time is required for a committee to explore their collective knowledge to make choices or solve problems.

Time and facilitation skills for sharing knowledge and developing mutual trust allows sharing of ideas and individual learning, better quality decisions, more commitment to decisions by group members and wider acceptability of decisions within the group’s wider networks.

What are the implications?

The findings of this review have a number of implications for the organisation and management of committees.

  • Committee composition and size: Having members representing the full range of stakeholders could bring the full range of relevant knowledge to discussions, although increasing the size of a committee above 12 members has diminishing returns.
  • Competencies of effective chairs: Effective chairs are more likely to be generalists with good facilitation skills to help members share their knowledge; manage hierarchy and conflict constructively; and develop an atmosphere of inclusiveness, openness and trust.
  • Timing of committee work: Time is required to allow knowledge brought to the meeting to be shared and evaluated before decisions are made.
  • Effective processes and structures for supporting group decision making: Formal consensus methods are recommended, with guideline groups given the relevant technical literature to inform their decisions.
  • Use of media for committee interaction and decision making: Distance working reduces the influence of individuals, but also opportunities for discussion. Computer-mediated communication (email and chat) may take longer and reduce member satisfaction.
  • Equity issues: Demographic diversity is valued for bringing different perspectives and a wider variety of alternatives for consideration. Educational and functional diversity has given teams greater strategic clarity. More time and effort may be required to explore issues requiring judgements where committee members vary in status.

How did we get these results?

We searched for research evidence about committees and small group decision making and found studies largely in the areas of health (specifically clinical guideline development and research ethics committees), business administration (mainly corporate boards, health boards or charity boards and audit committees), and social psychology (mainly ‘laboratory’ studies).

The synthesis was conducted in two stages. The first stage synthesised findings for each review sub-question that had been reported by earlier systematic reviews. These findings offered evidence of what works, and presented explanations of what works.

The second stage synthesised findings from systematic reviews that offered frameworks for clarifying the meanings of ‘effective’ and ‘efficient’ when applied to committees, or models or theories to enhance understanding of decision-making groups.

Please cite this report as: Oliver S, Hollingworth K, Briner R (2015) Effectiveness and efficiency of committee work: a rapid systematic review for NICE by its Research Support Unit. Report of the Research Support Unit for the National Institute for Health and Care Excellence. London: EPPI-Centre, Social Science Research Unit, UCL Institute of Education, University College London. ISBN: 978-1-907345-82-1 

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