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Social Values Related to the Development of Health and Care Guidance: Literature review for NICE by its Research Support Unit

What do we want to know?

The aim of this review is to identify and organise the variety of different viewpoints in the literature on social values in health and care guidance.  

Who wants to know?

The National Institute for Health and Care Excellence (NICE) is a Non Departmental Public Body (NDPB) that provides national guidance and advice to improve health and social care.

The role of NICE’s guidance is to improve outcomes for people using the NHS and other public health and social care services. NICE achieves this by producing evidence-based guidance and advice for health, public health and social care practitioners. NICE has published statements on the principles that NICE should follow in its work; in particular, in designing and implementing the processes it uses to develop its guidance and in developing individual pieces of guidance. The most recent version of these principles, Social Value Judgements: Principles for the Development of NICE Guidance (NICE 2008), is currently under revision. This literature review was commissioned to inform this revision.

What did we find?

The review identified twenty two issues within eight main forms of social values: SV1: Utility and efficiency (Effectiveness and cost effectiveness); SV2: Justice and Equity; SV3: Autonomy; SV4: Solidarity; SV5: Participation; SV6: Sustainability; SV7: Transparency and Accountability; and SV8: Appropriate Methods of Guidance Development

What are the implications?

The review identified nine main themes on:  

  1. Increased sophistication in guidance development 
  2. Boundaries of questions and boundaries of evidence
  3. Including all of society’s social values
  4. The balance between utility and equity
  5. Corporate or societal social values
  6. Guidance or rules
  7. Hidden social values
  8. Lack of research evidence
  9. Is social care different?

How did we get these results?

Inclusion criteria were developed which informed the search strategy to identify relevant papers which had four main components of: a systematic search of bibliographic databases; a follow search of references of papers identified from these databases; documents known to the reviewers by other means; and a rapid search for lists of social values more generally. All papers were entered into specialist review software EPPI-Reviewer 4. The papers were screened to determine whether they met the inclusion criteria. As the aim of the review was to identify and organise ideas (issues related to social values and guidance) rather than aggregate findings, it was not necessary to identify and report every paper that discussed a relevant issue. The priority was to identify all issues and then provide a reference to the paper in which it is referenced rather than listing every paper (or what might be considered the most important or famous paper) on the issue (a ‘saturation’ approach).
The initial search identified 1264 potentially relevant papers. The references sections of included papers were examined for possible relevant papers and this ‘follow on’ searching identified a further 655 papers (thus a total of 1919 potentially relevant studies), which were then themselves screened for inclusion. The included papers were coded for the social values they considered and the values issues that they considered and these were analysed using an adapted version of a framework developed by Weale (2012).

This report should be cited as:

Gough D, Kenny C, Vigurs C, Stansfield C, Rosen R, Taylor T (2014). Social Values Related to the Development of Health and Care Guidance: Literature 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, Institute of Education, University of London.
ISBN: 978-1-907345-71-5

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