title: A qualitative study of the relationship between the Scottish Medicines Consortium and their clinical experts.
abstract: OBJECTIVE
  Internationally, health technology assessments (HTAs) are ubiquitous drivers to health policy. Within Scotland, the Scottish Medicines Consortium undertakes the medicine review process. Input from clinical experts, involved in frontline care, is an integral component of the assessment process. This paper explores the relationship between the clinical experts and the HTA agency within Scotland to better understand what motivates expert clinicians to devote their time to the medicine review process with no remuneration.
  
  
  METHODS
  Twenty-seven clinical experts from 16 different clinical specialties took part in one-to-one interviews at their place of work between October 2011 and March 2012. Data analysis was inductive and comprised the organization of data into a framework and a subsequent thematic analysis.
  
  
  RESULTS
  Three distinct themes were identified: (1) recruitment, which identified two types of explanations for the experts' appointment: external justification (nominated by another) and internal justification (being recognized as an expert); (2) flexibility of the procedures, with experts able to determine their own response style and negotiate timelines; (3) health care systems, demonstrating that their affiliation to the health system underpinned the relationship and their motivation to be clinical experts.
  
  
  CONCLUSIONS
  The findings of this study provide insight into the elements important to clinicians who voluntarily contribute to HTA processes. Examination of these elements in the context of the organizational citizenship behavior literature provides a foundation on which to improve understanding of this relationship and sustain and improve clinical expert participation in an increasingly intensified clinical environment and within cash-limited HTA systems.
authors: Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.
authors: Rosemary
authors: R
authors: Newham
authors: Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.
authors: Emma Dunlop
authors: ED
authors: Corcoran
authors: BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh University, Edinburgh, UK.
authors: James W
authors: JW
authors: Dear
authors: Public Health Intelligence, NHS National Services Scotland, Edinburgh, UK.
authors: Sharon
authors: S
authors: Hems
authors: Public Health Intelligence, NHS National Services Scotland, Edinburgh, UK.
authors: Stuart
authors: S
authors: McTaggart
authors: Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.|Public Health Intelligence, NHS National Services Scotland, Edinburgh, UK.
authors: Marion
authors: M
authors: Bennie
mesh_terms: D000328:Adult; D026683:Advisory Committees; D005104:Expert Testimony; D005260:Female; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012606:Scotland
keywords: clinical engagement; health technology assessment; organizational citizenship behavior; qualitative research