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Doing more with less in health care: Findings from a multi-method study of decommissioning in the English National Health Service
Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Health Services Management Centre, University of Birmingham, Birmingham, UK.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.ORCID iD: 0000-0001-8781-6675
Department of Social Policy and Social Work, University of Birmingham, UK.
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2017 (English)In: Journal of Social Policy, ISSN 0047-2794, E-ISSN 1469-7823, p. 1-22Article in journal (Refereed) Epub ahead of print
Abstract [en]

In the context of an austere financial climate, local health care budget holders are increasingly expected to make and enact decisions to decommission (reduce or stop providing) services. However, little is currently known about the experiences of those seeking to decommission. This paper presents the first national study of decommissioning in the English National Health Service drawing on multiple methods, including: an interview-based review of the contemporary policy landscape of health care decommissioning; a national online survey of commissioners of health care services responsible for managing and enacting budget allocation decisions locally; and illustrative vignettes provided by those who have led decommissioning activities. Findings are presented and discussed in relation to four themes: national-local relationships; organisational capacity and resources for decommissioning; the extent and nature of decommissioning; and intended outcomes of decommissioning. Whilst it is unlikely that local commissioners will be able to ‘successfully’ implement decommissioning decisions unless aspects of engagement, local context and outcomes are addressed, it remains unclear what ‘success’ looks like in terms of a decommissioning process. 

Place, publisher, year, edition, pages
Cambridge University Press, 2017. p. 1-22
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
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URN: urn:nbn:se:hj:diva-38525DOI: 10.1017/S0047279417000721ISI: XYZScopus ID: 2-s2.0-85033381035Local ID: HHJIMPROVEISOAI: oai:DiVA.org:hj-38525DiVA: diva2:1174257
Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2018-01-15

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