Claire Fernie, SHTG Public Partner
How did you become a Public Partner in SHTG?
I became a Public Partner with Healthcare Improvement Scotland (HIS) in 2018. I’m a scientist by training but in my mid twenties I started to develop long term health issues which eventually forced me to take a break from laboratory work. I started to do some voluntary work with local charities, then in 2013 I saw an advertisement for a patient representative on the panel of our local Scottish Patient Safety Programme (SPSP) group for Primary Care. I thought it might be a good way to put my experiences from the patient side of the healthcare system to some positive use, so I applied, and was taken on. The group expanded over the next five years to also include work with Pharmacy and Medicines. As part of that, I was lucky enough to be able to attend national SPSP events and it was there that I heard about the Public Partner role.
What does SHTG do?
SHTG considers non-medicine treatments and devices. That can include anything from looking at the effectiveness of a new type of heart valve or a treatment for MS, to the usefulness of an app in monitoring health or the review of a service. We look at how well something works, if it’s affordable, whether it’s safe, what do patients think of it and other things such as equal access. We get information from health professionals in that field and hear the views of patient groups to help us come to a decision.
What do Public Partners do at SHTG?
I’ve been privileged to be one of the Public Partners on SHTG since 2019. Our job is to make sure that care decisions are person-centred, to challenge the professional thinking where necessary and to take a look from outside at the decision-making process. We think about how decisions might affect the general public. We are involved at the major stages of each topic. We are members of SHTG's Evidence Review Team, where we meet with clinicians, health technology experts and the members of the HIS Evidence staff to consider the draft documents, discuss the findings and decide on a wording for Council that best represents the evidence. We are also members of the SHTG Council, whose membership includes national NHS directors, health economists and industry representation. At Council, we hear views from both clinicians and the patient groups, consider the strength of the evidence and decide on the final recommendation. And we are actively involved in producing all of SHTG's Plain Language Summaries to help our advice to be understood by the general public. This is important because it makes it easier for everyone to learn about technologies that might be of use to them, but without all the complex and off-putting jargon.
What does the role involve?
The Council and the Evidence Review Team currently meet once a month on alternate months, each time for a couple of hours, though that can change depending on the number of technologies to be looked at. The role does involve reading and making sense of a large amount of information from summaries of scientific and economic data. It can take a bit of time to get a feel for that, but the information we’re given is not extremely difficult to understand and I’ve always found the SHTG Evidence staff very friendly and approachable and willing to answer any of my questions – no matter how daft! But then, to quote one of the other Partners, one of the reasons we’re there is to ask the “daft laddie” questions and occasionally to add a bit of common sense and a view from outside the care setting. We look at things differently and sometimes find ourselves challenging one another! For instance, a former Partner from the Western Isles taught me things about the challenges of accessing services that I’d only been vaguely aware of from my own, relatively privileged, central belt experience.
Why do you volunteer?
I enjoy SHTG because, as a scientist, I get to learn about all the new technological developments, which is fascinating. I really look forward to and value the views from the patient groups because I believe they greatly add to how we think about the possible effects of the work on real people. But I also like hearing the other side, the clinical reviews of the draft, because they’re great for highlighting that, even though the literature or the manufacturer says something is great, actually using it in practice can have challenges we’d not even considered. The role comes with responsibilities too. It can be difficult to hear how desperate patients are to get access to a particular technology, when that has to be balanced against a poor evidence base or extremely high costs. And we are very aware that, particularly in the current climate, we may recommend that a technology is suitable for use in Scotland but, due to budget restrictions, local health boards may struggle to be able to offer it. But ultimately I find the role rewarding and get a sense of satisfaction at being part of the process that ensures that the technologies that become available for general use are safe, effective, and value for money.