Guidance

UK NSC code of practice

Updated 3 April 2023

1. Purpose

The UK NSC was established in 1996 to provide advice to ministers and the NHS in all 4 countries about all aspects of screening and to support implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria.

The UK NSC is included on the list of Department of Health and Social Care (DHSC) scientific advisory committees.

2. Accountability

The UK NSC is accountable to the 4 Chief Medical Officers (CMOs), who agree work plans for the UK NSC on an annual basis. The DHSC in conjunction with the other UK health departments will review progress formally against work plans.

3. Terms of reference

Current terms of reference are set by the 4 UK health departments and signed off by the 4 CMOs. Terms of reference should be reviewed at least every 3 years.

4. Roles and responsibilities

4.1 The 4 UK health departments

The UK NSC is sponsored by the DHSC on behalf of the other UK countries. It is funded by all 4 UK health departments.

It is the responsibility of the sponsoring body to ensure that the UK NSC’s remit, accountability and appointments process are clear.

The 4 UK health departments work closely with the secretariat for the UK NSC, to shape UK NSC agendas and work plans, agree papers and minutes.

Each UK health department is responsible for setting its screening policy with the agreement of their respective ministers, taking into account advice from UK NSC.

4.2 Department of Health and Social Care

DHSC is responsible for providing the secretariat for the UK NSC. This includes:

• supporting the work of the UK NSC, including, horizon scanning, undertaking a rolling programme of evidence reviews, working with key stakeholders
• managing specific expert clinical advice, and interested stakeholder groups to feed into the UK NSC for recommendations
• providing national communication functions to UK NSC, including development and maintenance of the UK NSC’s website
• developing and maintaining a forward schedule of future developments likely to lead to ministerial decision on screening programmes

4.3 Chair of the UK NSC

The chair has responsibility for providing effective leadership. The chair will ensure that accurate, timely, clear information is provided to members and that the minutes of the meetings accurately record the discussions held and the advice agreed.

The chair is responsible for ensuring appropriate membership with the right balance of skills and that there is fair representation across the 4 UK countries. The chair must ensure that the committee has a culture of valuing different perspectives and encouraging full engagement in collective consideration and discussion of the issues.

The chair is responsible for taking action when members’ attendance is poor.

The chair is responsible for ensuring that the UK NSC does not exceed its terms of reference.

There may be times when urgent advice is required. On such occasions the chair may, on behalf of the UK NSC, provide such advice. The committee will be updated at the earliest opportunity of any advice provided.

4.4 Vice-chair

The vice-chair is nominated by the chair. The vice-chair will be responsible for chairing meetings and providing leadership if the chair is not able to chair the meeting for any reason. The vice-chair should have appropriate expertise in screening.

5. Membership

Membership of the UK NSC should enable the committee to fulfil its terms of reference and deliver its objectives. The secretariat of the UK NSC should maintain a membership template that sets out the core skills, expertise and experience required to help deliver the business of the committee. The committee should regularly review the membership template to satisfy themselves, insofar as they are able, that the balance of expertise is adequate to perform the role which they are entrusted. The names and roles of members are published on the UK NSC’s website.

The committee membership normally includes individuals from public life, academia and practising clinicians who have expertise in one or more of:

• public health (screening)
• general practice
• paediatrics and child health
• obstetrics
• cancer
• genetics
• ethics
• health economics
• laboratory services
• nursing and midwifery
• epidemiology
• medico-legal
• social science
• patient and public voice

In exceptional circumstances the chair may authorise co-option of additional member(s) onto the group where particular expertise on specific issues is needed. Co-opted members do not have voting rights.

Members should regard it as part of their committee role to:

• ensure the sponsoring body, the 4 UK Health departments and their ministers receive the highest quality, timely advice
• offer advice which is understandable by the public and other interested parties
• examine and challenge if necessary the assumptions on which scientific advice is formulated and ask for explanations of any scientific terms and concepts which are not clear
• ensure that the committee has the opportunity to consider contrary views and incorporates the concerns and values of stakeholders into their decisions

Members must at all times:

• observe the highest standards of impartiality, integrity and objectivity in relation to the advice they provide
• abide by the principle of collective responsibility, stand by the recommendations of the committee and not speak against them in public
• be accountable for their activities and for the standard of advice they provide to the 4 UK health departments and ministers in all 4 countries
• act in accordance with government policy on openness, and comply fully with the code of practice on access to government information and any relevant legislation on disclosure of information
• follow the Seven Principles of Public Life set out by the Committee on Standards in Public Life as they apply to service on the committee

Members and observers of the committee must declare their relevant personal and non-personal interests at the time of their appointment. This should be done on an annual basis. An interest is relevant if it has occurred in the last 12 months or if it is a current or planned involvement. Members must inform the secretariat before each meeting of any change in their relevant interests. See UK NSC register of interests.

All members are expected to abide by this code of practice and sign the declaration.

Members are expected to attend all meetings in person. However, when this is not possible digital communications will be made available. Attendance and contribution will be subjected to annual appraisal by the chair.

Members who may speak at conferences, seminars or have public speaking arrangements with the media should take care to make clear whether they are speaking in a personal capacity or as a member of the UK NSC.

6. Other attendees at UK NSC and expert group meetings

6.1 Officials

Officials are designated representatives from UK health departments and national health agencies who actively develop, support and deliver the UK NSC strategic plan to enable and ensure national policy alignment across the UK. Their role is also to provide additional information to the UK NSC. Officials cannot vote on committee decisions and at all times must respect and uphold the independence of the committee in formulating its advice.

Officials are designated representatives of:

• UK NSC Secretariat
• Department of Health and Social Care
• Scottish Government
• Welsh Government
• Department of Health, Social Services and Public Safety, Northern Ireland
• Department of Health in the Republic of Ireland
• Public Health Wales
• Public Health Agency, Northern Ireland

6.2 Observers

Observers are designated representatives who actively help identify and implement innovation in screening with a focus on feasibility and applicability. They are identified because of their expertise and the positions they hold within their organisations.

Observers provide a link between the UK NSC and their representative organisations regarding important areas of work. They cannot vote but have access to committee papers and can contribute to the discussions in the committee. This is not confined to issues directly affecting an observer’s parent organisation. They must at all times respect and uphold the independence of the committee when formulating its advice.

Observers are designated representatives of:

• National Institute for Health Research - Health Technology Assessment Programme (NIHR-HTA)
• Scottish Intercollegiate Guidelines Network (SIGN)
• NHS in all 4 UK countries
• National Institute for Health and Care Excellence (NICE)
• Genomics England
• Crown dependencies

6.3 Technical experts

At the Chair’s discretion, technical expert(s) may be invited to meetings if further input is required to help support the committee in its understanding of the complexity of a matter in order to reach a decision. A technical expert will have specific knowledge and first-hand experience to be able to advise and answer queries on topics from an impartial perspective. An invitation for a technical expert will not be required for all conditions but for topics where the Chair feels it is required. Technical experts must respect and uphold the independence of the committee when formulating its advice.

7. Secretariat

The primary role of the secretariat is to support the UK NSC by assembling and analysing information and recording conclusions of meetings. The secretariat is impartial and respects the UK NSC’s independent role.

The secretariat of the UK NSC should maintain a membership template that sets out the core skills, expertise and experience required to help the UK NSC deliver its business.

The secretariat is responsible for monitoring members’ attendance and alerting the chair to non-attendance.

The secretariat will maintain and review a register of members’ relevant interests annually, publishing details as part of an annual report or similar routine progress update.

The secretariat will provide induction and mentoring support for new members, and support the chair’s annual appraisal of members, and the annual appraisal of the chair by the senior responsible officer (SRO).

The secretariat will produce a formal record detailing the recruitment and selection process for any members co-opted on to the committee.

The secretariat will draw up appropriate procedures for handling sensitive information. These procedures should be communicated to potential providers of sensitive information, so that material is only withheld from public release where it would be exempt under provisions of freedom of information legislation.

The secretariat is responsible for disseminating UK NSC consultations to stakeholder organisations.

The secretariat will ensure that the proceedings of the committee are documented ensuring a clear audit trail showing how the committee reached its decision.

8. Working practices

8.1 Frequency of meetings

The UK NSC usually meets 3 times a year. Two of these are held in London. The third will usually be held in one of the other UK countries on a rolling basis by agreement. In addition, there are occasional UK NSC workshops on various topics. Members and observers may be asked to attend these meetings or contribute to other work undertaken by the various officers of the committee. A schedule of meetings can be found on the UK NSC’s website.

8.2 Meetings

UK NSC meetings are not open to the public. This allows members to have a free and open debate before coming to any conclusions, which will be fully explained in the minutes or statements when these are published.

The committee will publish its future work programme and aim to publish an annual report of its activities normally within 3 months of the end of the financial year. These documents will be published on the UK NSC’s website.

8.3 Process for reaching decision

Open and frank discussion should be encouraged. It is recognised that advice includes expert judgement in addition to objective or factual information, and wherever possible the degree of certainty and the rationale for judgements should also be recorded.

Where the committee is offering advice on ethical considerations bearing on its advice, it should make explicit what processes or expertise it has drawn on in reaching its conclusions.

The chair should seek to obtain a unanimous view for its recommendations.

Where there is disagreement the chair should explore and attempt to resolve reasons for disagreement. The chair can exercise the option to defer decision to a future meeting. Where consensus cannot be reached, and a vote is required a simple majority of the committee voting members (excluding the chair) is required. The chair casts their deciding vote only when the majority is not achieved by the other voting members.

8.4 Representatives/deputies

Members may not send representatives if they are unable to attend a meeting. Observers may send alternates.

8.5 Quorum

Quorum is reached when at least half of the members are present. Only members of the committee contribute to the quorum. In the event of the meeting being inquorate, discussion can take place but no committee decisions can be made.

8.6 Conflict of interest

It is the responsibility of each member to indicate if they have an interest in any item of business on the agenda of a meeting of the UK NSC. Where this happens, the chair will determine whether a member should take part in any discussion or decision on the issue. This will be documented in the meeting minutes.

The role of the chair necessitates that he/she cannot have any interests that may conflict with his or her responsibilities to the UK NSC. Therefore the UK NSC chair cannot have interests that could conflict with the issues under consideration by the UK NSC. If the UK NSC chair has an unresolved conflict of interest then he/she shall step aside until that is resolved. The vice chair will deputise for the chair in these circumstances.

8.7 Communication and transparency

The secretariat will make committee agendas available publicly at least one week before the meeting.

Papers will normally be placed on the UK NSC’s website 6 weeks after the meeting has taken place. The UK NSC aims to publish all papers considered and all those invited to provide papers for the committee should be made aware of this publication process. However, confidential papers will not necessarily be published. Under the Freedom of Information Act, 2000, except where an absolute exemption applied, material should be disclosed unless the public interest in maintaining the exception in question outweighs the public interest in disclosure.

Public consultations will normally accord with the government’s consultation principles. Consultations will assist the UK NSC to reach a view on its advice. The secretariat will ensure that UK NSC consultations will be disseminated to stakeholder organisations.

Draft UK NSC minutes will normally be placed on the UK NSC’s website 6 weeks after a UK NSC meeting, following clearance with meeting attendees. At the same time that the draft minutes are posted, a press release may be published highlighting the key recommendations of the committee. Members or observers must not discuss in public any proceedings of the meeting until this time unless they have obtained agreement from the chair.

Minutes will be agreed formally by the committee at its next meeting and published on the UK NSC’s website. The minutes will be written in terms that make it easy for members of the public to understand the process by which a decision has been reached.

The committee will hold an annual meeting with officers and members to meet with stakeholders, to discuss and take questions on the work of the committee.

8.8 Communication with the media

All enquiries from the press should be directed to the PHE press office so that the secretariat can respond on behalf of the committee. Members of the Committee may be asked, by the secretariat or chair to speak to the media on a matter pertaining to the UK NSC.

8.9 Dealing with confidential information

The UK NSC deals with confidential information. Procedures to provide strict confidentiality are required, although the UK NSC aims to publish as soon as practicable the information and evidence considered in the development of its advice and recommendations. Members must take particular care to avoid premature or selective disclosure of the committee’s deliberations.

Members must not, without authority, disclose any information which has been communicated in confidence to them in their capacity as a member of the UK NSC.

8.10 Appeals process

The UK NSC is an independent advisory body that provides advice to the 4 UK health departments and ministers in all 4 countries. There is no appeals process on the advice given.

9. Appointing new UK NSC members

9.1 Nominations

Appointments to the UK NSC are made in line with the principles of public appointment set out in the Office of the Commissioner for Public Appointments (OPCA) governance code for public appointments.

A person specification will be produced by the secretariat to ensure consistency with the UK NSC’s terms of reference. The chair and members are appointed as individuals to fulfil the terms of reference of the committee, not as representatives of their particular professions, or their employer or any interest group. The chair and members are not representing a particular country, but are taking an objective perspective based on their professional experience. Membership is based on suitability for the role but the appointment panels should consider the balance of representation across the 4 countries, to reflect the devolved nature of NHS functions.

9.2 Appointments process

The DHSC, on behalf of the 4 UK Health Departments, will manage the process of recruiting the chair and members to the committee in a way that is open and fair to all applicants, and appointments will be made on merit.

Once a reference has been obtained the DHSC SRO in consultation with senior officials in the 4 UK health departments, PHE and the DHSC appointments team should then be asked to approve the appointments.

Appointments may be suspended or terminated, in the event that a member fails to fulfil his or her obligations or for conduct which renders the member unfit to remain in office. Members may also resign from their office, if they wish.

9.3 Expenses

Members are not remunerated for their work for the committee. They are eligible to claim expenses in accordance with PHE rules for travel, subsistence and overnight accommodation. UK NSC members will not gain financial benefit from their membership.

9.4 Review of membership

The balance of skills, expertise and experience represented by and required of UK NSC members should be reviewed regularly by the committee and the 4 UK Health departments in the light of both current and anticipated future work programmes. Additionally, the chair and the 4 UK health departments should consider the diversity of membership, including gender, age and ethnicity.

The chair and secretariat should regularly review the phasing and lengths of appointments to ensure both continuity and fresh perspectives. Membership will be reviewed after 4 years. Members may be reappointed after this period but in line with the OPCA code membership “should not exceed 10 years serviced continuously in the same office on the same public body”. The chair and 4 UK health departments will actively plan for succession with membership input.

Arrangements will be developed by the secretariat for newer members to receive induction and mentoring support. Training and development opportunities will be offered to all members where appropriate as part of the annual appraisal process. In particular given the many different social, ethical, and legal issues associated with screening, training will be made available to committee members on these issues.

Members of the committee must be made aware of the principles of the Government Office for Science Universal Ethical Code: Rigour, Respect and Responsibility at appointment and are expected to adopt and promote these.

9.5 Liabilities and indemnity of members

Legal proceedings by a third party against individual board members of advisory bodies are very exceptional. A board member may be personally liable if he or she makes a fraudulent or negligent statement which results in a loss to a third party; or may commit a breach of confidence under common law or criminal offence under insider dealing legislation, if he or she misuses information gained through their position or breaches confidentiality.

However, the government has indicated that individual board members who have acted honestly, reasonably, in good faith and without negligence will not have to meet out of their own personal resources any personal civil liability which is incurred in execution or purported execution of their board functions. Board members who need further advice should consult the secretariat.

9.6 Early identification of issues/horizon scanning

In order to provide timely advice to the 4 UK health departments and ministers the committee should keep under review potential opportunities and key developments in screening that may lead to the need for new advice or the revision of previous advice, drawing on and contributing to available horizon scanning resources.

9.7 Development of advice and recommendations

The UK NSC formulates its advice and recommendations based on the best and most up to date evidence available. The process involves a robust, transparent, and comprehensive appraisal of the evidence available. Reviews provide an overview of the best quality and informative studies relevant to the internationally agreed criteria for assessing the viability, effectiveness and appropriateness of a screening programme. Guidance on how the UK NSC assesses the evidence base against its criteria can be found on the UK NSC’s website.