New social practices are never entirely new. The ‘vestiges of order’ that we insert into apparently novel situations and the constraints that are thereby put in place serve to bring at least some familiar routines into play. Furthermore, the process that Karl Weick (1995) was later to call ‘sense making’ in organisations will be visible in the dialogues and debates through which new practices start to crystallise and become embedded. Exploring the unfolding of this in the meetings of the Citizens Council of NICE is a major theme of the chapters that follow. But sense making and creating constraints also had to be agreed and accomplished in NICE as members of the Institute first set, and then reset, parameters for the Council. To be sure, one constraint was already given. As we saw in Chapter One, from the point of the political announcement in the summer of 2001, there was to be a Citizens Council. It was to work alongside the mechanisms of consultation that the Institute already had in place. But the precise form it would take and its ways of working remained to be settled.

The central concern of this chapter is with the first imagined shape of the Council and the reasons why it took the form that it did. How was the thinking within the Institute about a Citizens Council filtered through its own understandings of itself and its ways of working? How as a result of this was the Citizens Council given operational shape? In answering these questions, we highlight the importance of, sometimes hostile, outsider narratives about NICE, and the way in which insiders engaged with these in constructing a place for the Council. We will stress how the Institute had already created what it regarded as important new processes for stakeholder participation. It hence fashioned a particular vision of the Council – and importantly of the kinds of questions that it would address – with this in mind.

This chapter is in three parts. The first paints a picture of NICE at the point where the Citizens Council idea began to develop, linking understandings of the organisation with the challenge of putting words on paper about the precise shape of the Council.