How do you take a complex committee meeting and make it work online? Scottish Medicines Consortium’s Public Involvement Advisor Lindsay Lockhart explains how they successfully took one of Healthcare Improvement Scotland’s biggest and most vital meetings virtual.

So you think you’re pretty good at managing virtual gatherings – team meetings, drinks with friends, quiz nights with the family.  But then you’re asked to get involved in setting up a really complex, really important committee meeting.  Cue a sharp intake of breath.

Meeting the need

The Scottish Medicines Consortium (SMC) monthly committee meetings are the centrepiece of our work – and one of the largest, most complex and vital meetings in Healthcare Improvement Scotland. They’re the moment when everything comes together, in one large room, with lots of different stakeholders present, and complex decisions are made by committee members on whether medicines should be accepted for use in NHSScotland.

Well, that’s the way it used to be.  Then COVID-19 happened.  In March 2020, with agreement from Scottish Government, some of the work Healthcare Improvement Scotland does was put on pause. For SMC, that meant all our meetings, including the New Drugs Committee (NDC), Patient and Clinician Engagement (PACE) meetings and SMC Committee meetings, were suspended. Many of the SMC team were redeployed to working on frontline NHS services.  By May, while many of SMC’s pharmacists and clinical staff were still needed elsewhere in NHSScotland, we started to plan our business recovery, something that was vitally important to ensure any further delay on decision-making and patient access to new medicines was minimised.

It quickly became obvious that we couldn’t meet in person for the foreseeable future.  Urgent work had to be done to reinstate SMC’s meetings securely and professionally, avoiding reputational risk.  We had to get this right for all stakeholders – committee members, patient groups, public partners, industry representatives, and members of the public.

A new role to help roll out a solution

Stepping out of my day job (and comfort zone) as SMC’s Public Involvement Advisor, where my role is to ensure the voices of patients and carers are heard as part of the assessment of new medicines, I became part of a small team with Ailsa Brown, our Lead Health Economist, and Rosie Murray, our Admin Manager. We undertook a rapid review of the options and quickly established that NDC and PACE meetings could be held virtually with Microsoft Teams.

To make this work, the staff who organise and assist at these meetings and liaise with external stakeholders had to become ‘technical hosts’ almost overnight. The speed with which we all learned how to manage meetings in this way was impressive.  After a ‘mock’ NDC was held to iron out any technical issues, a virtual meetings protocol and etiquette document was produced. Thanks to the commitment of everyone involved, we were able to successfully reinstate NDC and PACE meetings  in June and July respectively.

NICE to (virtually) meet you…

Then came the real challenge. The SMC Committee with its various complexities – confidentiality of information, public gallery, closed sessions with no public or external attendees, private voting by ballot – demanded more research … and quickly.  Working with NHS National Services Scotland (NSS), it was established that the current roll out of MS Teams across Healthcare Improvement Scotland did not, at the time, provide sufficient functionality.  While this is likely to change in future, for the short term, another solution was needed.

Through other COVID-19 related work, we knew colleagues in NICE were using the Zoom platform for their health technology assessment committee meetings. They had chosen to take this route long before COVID, following a full option appraisal and two years’ work to introduce virtual meetings for sustainability, cost and environmental reasons.  With agreement from the Healthcare Improvement Scotland Executive Team, it was agreed that Zoom was the best option, in the short term, to allow its committee meetings to be reinstated quickly and efficiently.  This included support contracted from NICE and their virtual meetings team, which provided us with the benefit of their experience and excellent knowledge.

Early discussions identified key requirements for SMC including licences, dedicated technical/digital support, testing and training for committee members and staff, production of guidelines, slides, corporate visual backdrops and branded meeting communications.

The complexities of committee

We also had to consider amending some processes to match the technology, for example, how committee members could vote in private.  With six medicines on average discussed at each meeting, committee members used to cast their vote at the end of discussion for each medicine.  With Zoom, this couldn’t be done without moving committee members in and out of a break out room for each individual private vote. The answer was to ask voting members to note their vote for each medicine and then cast their votes for all medicines privately once the public part of the meeting was over.

Slides to complement presentations were introduced.  Non-committee members could follow the discussion using the slides instead of receiving a set of redacted Detailed Advice Documents (DADs) for each medicine.  More staff were required to manage waiting rooms and break out rooms, and to keep an eye on technological hiccups so they could be quickly resolved. And then…we were ready.

Opening night nerves – and the importance of audience feedback

Our first SMC Committee meeting using this new method took place on Tuesday 4 August.  SMC’s reputation  – and indeed, that of Healthcare Improvement Scotland – was at the forefront of everyone’s minds so there was an element of ‘opening night nerves’ for all of us.  Everyone had their own roles and responsibilities to ensure the meeting went well, and it did.

A debrief highlighted things which the team felt they would do differently for future meetings.  Feedback from attendees also helped identify anything else which may have to be reviewed, so it was important to follow up all virtual meetings – NDC, PACE and SMC Committee – with an online survey for all attendees.

Feedback from the first meetings has been very positive, with all participants rating the overall experience of attending virtual meetings as being ‘very good’ or ‘good’.  The majority of attendees found the technology ‘very easy’ or ‘easy’ to use and there has been a positive response to slide presentations.  Clarity of communication from presenters/speakers has been commented on, with some attendees preferring virtual meetings.

Becoming experts

It’s early days, but they say practice makes perfect.  Fortunately our virtual meetings team are fast becoming experts in the technology which will need to be a feature of all our work for some time to come. And with Rosie, Ailsa and I back in our “day” jobs, plans for future meetings are now in the very capable hands of SMC’s Operations Manager, Donna Leith, who has recently returned from maternity leave.

Still, it’s been said that everyone should acquire some new skills during lockdown.  I’d like to think I know more now about virtual meeting technology than I did a few months ago … that and how to cut my husband’s hair!

Lindsay Lockhart is a Public Involvement Advisor in Healthcare Improvement Scotland’s Scottish Medicines Consortium (SMC).

More information

Find out more about the SMC

Find out more about SMC’s role in our Evidence Directorate