Doing more with less in health care: findings from a multi-method study of decommissioning in the English National Health Service

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@article{66e78f4526da4712b1abcdf1e742d5e9,
title = "Doing more with less in health care: findings from a multi-method study of decommissioning in the English National Health Service",
abstract = "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 NHS 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 {\textquoteleft}successfully{\textquoteright} implement decommissioning decisions unless aspects of engagement, local context and outcomes are addressed, it remains unclear what {\textquoteleft}success{\textquoteright} looks like in terms of a decommissioning process.",
author = "Iestyn Williams and Russell Mannion and Kelly Hall",
year = "2017",
month = oct,
day = "30",
doi = "10.1017/S0047279417000721",
language = "English",
journal = "Journal of Social Policy",
issn = "0047-2794",
publisher = "Cambridge University Press",

}

RIS

TY - JOUR

T1 - Doing more with less in health care: findings from a multi-method study of decommissioning in the English National Health Service

AU - Williams, Iestyn

AU - Mannion, Russell

AU - Hall, Kelly

PY - 2017/10/30

Y1 - 2017/10/30

N2 - 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 NHS 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.

AB - 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 NHS 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.

U2 - 10.1017/S0047279417000721

DO - 10.1017/S0047279417000721

M3 - Article

JO - Journal of Social Policy

JF - Journal of Social Policy

SN - 0047-2794

ER -