It is clear that over the first two and a half years of the Citizens Council initiative, the Institute put a great deal of time into shaping just how the Council should work and into modifying its decisions in the light of experience. We have argued that the changes served to create more of an expertise space for citizens and that there was a perceptible rise in the amount of deliberation; we have also shown that important challenges remained. This chapter, the final one in the series presenting empirical data, will explore the thinking that accompanied change within the host organisation. The discursive turn in the study of organisations is particularly helpful here, in its insistence that talk in organisations is not a mere prelude or preliminary to action; instead it much more actively creates and constructs action (Weick, 2004). Chapter Three has already demonstrated how, in setting up the Citizens Council, key players within NICE rehearsed and reframed what were potentially hostile stakeholder constructions of the Institute, placing this latest innovation within their own emerging narratives of the significance of the organisation and its mode of operation. This meaning making continued and intensified as the dynamics of the development of the Council began to unfold. A council fit for citizens had also to be a council fit for purpose within the Institute, and it had to be seen to be so among the different stakeholders to whom NICE related. This chapter traces the discursive work of reframing, and sometimes work of repair, in the face of real and imagined forms of stakeholder interrogation and challenge.

The analysis proceeds via an examination of three particular moments in the overall period under study, each a moment of intense dialogic exchange about the emergent practice that was the Citizens Council. The first section focuses on the aftermath of the first meeting, as the steering committee received the Council's first report and heard the ways in which the facilitators, the project manager and others themselves reconstructed their experiences of the meeting.