12. In an economic appraisal or risk analysis, it is not always possible to measure all relevant decision-making variables in monetary terms. For example, an option may make it possible to improve the delivery of care, but this is difficult to quantify in financial terms. The same would be true for some risks (e.g. adverse public relations or changes in medical technology).
13. In such situations, weighting and scoring approaches should be adopted. In an economic appraisal, this would require the following steps (i) identifying relevant benefit criteria (e.g. quality of physical environment, accessibility to services and flexibility of accommodation for alternative use); (ii) setting weights for each criterion depending on their relative importance (e.g. weights could be ascribed in such a way that they sum to 100%. A criterion with 50% would be twice as important as one with 25%); and devising a simple scoring system for each option (e.g. marks out of 10, with zero as a possibility). The weight multiplied by the score would give the weighted score for each criterion in each of the options considered. The sum of the weighted scores produces the total weighted score for each option.
14. In the case of an assessment of non-financial benefits, the option which attracts the highest total weighted score is the most attractive. For a risk analysis, the option with the highest total weighted score is the most risky.
15. Given the inherent subjectivity in this approach, it is important for the process and reasoning behind the scores and weights to be clearly recorded to demonstrate that a plausible and even-handed analysis has been undertaken. It is the number of people involved in the process, their expertise and the way the decision is made (e.g. by negotiation and compromise) that lends credibility to this analysis.