The concept of living guidelines is a recent change in the field of guideline development and has been quickly adopted since the COVID-19 pandemic (Cheyne et al. 2023). Living guidelines use all the main steps of conventional guideline development, including involving patient and public members. But so far, the experiences of people involved in developing living guidelines suggests they are different enough to experiences with conventional guideline development for them to have implications for PPI.

In this chapter we aim to:

• explain what is meant by living guidelines and when they are used

• describe current models for PPI in developing living guidelines

• explain the differences between developing living guidelines and conventional guidelines, highlighting what these differences mean for PPI

• provide practical examples of recruitment; managing and supporting patient and public panel members over time; setting priorities with patient and panel members; training and co-learning; and feedback, evaluation and improvement.

We have drawn from the limited research literature in this field, and the practical experiences of the author team, which includes patient and public members and guideline developers involved in living guidelines internationally.