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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
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Harlock, Jenny, Williams, Iestyn, Robert, Glenn, Hall, Kelly, Mannion, Russell and Brearley, Sally (2018) Doing more with less in health care : findings from a multi-method study of decommissioning in the English National Health Service. Journal of Social Policy, 47 (3). pp. 543-564. doi:10.1017/S0047279417000721 ISSN 0047-2794.
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Official URL: http://dx.doi.org/10.1017/S0047279417000721
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 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.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Journal of Social Policy | ||||||
Publisher: | Cambridge University Press | ||||||
ISSN: | 0047-2794 | ||||||
Official Date: | July 2018 | ||||||
Dates: |
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Volume: | 47 | ||||||
Number: | 3 | ||||||
Page Range: | pp. 543-564 | ||||||
DOI: | 10.1017/S0047279417000721 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access |
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