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This paper examines patient organisations’ participation in the technology appraisals process of the National Institute for Clinical Excellence (NICE). In particular, it considers two policy areas prominent in recent UK government health reforms – patient participation and evidence‐based medicine (EBM). Data have largely been obtained from unstructured interviews with patient/carer groups involved in NICE’s technology appraisals, patient/carer representatives from NICE’s committees, and NICE personnel, supplemented by observation of NICE’s Board and Partners’ Council meetings, and analysis of documentary evidence. The paper focuses on the nature of “evidence” in NICE’s appraisals process, in particular patient groups’ concerns about the relative “weights” attached to patient and scientific evidence. NICE has taken some steps to allay such concerns, but more clarity is needed about how evidence from disparate sources is handled, if patient groups are to feel that their submissions of evidence have had more than marginal impact.

Examines the interaction of patient organisations with the National Institute for Clinical Excellence (NICE) during the first two years of its existence. In particular, it considers the intersection of two policy areas prominent in the Labour Government’s health reforms – patient participation and evidence‐based medicine. Data has been obtained from unstructured interviews with patient/carer representatives from NICE’s committees and patient/carer groups with an interest in NICE’s technology appraisals, supplemented by observation of NICE’s Board and Partners’ Council meetings, and analysis of documentary evidence. The paper focuses on “formal” and “informal” involvement of patient groups in NICE’s structures and appraisals process. Most interviewees felt that the patient voice had been strengthened in these areas, though there was concern about the relative weights of patient and scientific evidence. Thus NICE illustrates two paradoxes in Labour’s policy objectives – centralisation/participation and evidence‐based medicine/patient perspective – which may become problematic.

THE new library building has been open for six months now. It is pleasantly situated in an area of new buildings, and occupies a prominent island site just on the edge of the shopping centre. The old library was in the middle of a shopping area, and it has been interesting to note that our removal from that site has had a more considerable effect on the traffic pattern than one would have thought.