Disinvestment

Resources used to support investment/disinvestments/decommissioning decisions.

Kings Fund
Search the library database for service closures or hospital closures.

NICE ‘do not do’ recommendations database
All the ‘do not do’ recommendations that have been made since 2007, abstracted from NICE cancer service guidance, clinical guidelines, interventional procedures and technology appraisals guidance.

Decommissioning health care: identifying best practice through primary and secondary research a prospective mixed-methods study
Health Serv Deliv Res 2017;5(22) – this study led by Health Services Management Centre, University of Birmingham, uses expert interviews, a survey of CCGs, and four case studies of attempts to decommission services. It outlines good-practice principles for leading decommissioning processes and engaging service users and citizens, but suggests that no simple formula exists for doing decommissioning well.

Decommissioning Evidence Review 
Midlands & Lancashire CSU Strategy Unit – Evidence Analysis Team, Dec 2014
Evidence to support the decommissioning process and covers decommissioning activity within the NHS, priority setting, tools used to inform decommissioning activity such as the PBMA. Includes case studies and examples of toolkits to support decommissioning. Also download  here.

The Art of Exit: Tackling the challenge of decommissioning in public services – See more at: http://www.nesta.org.uk/blog/art-exit-tackling-challenge-decommissioning-public-services#sthash.AfkhKkNm.dpuf
This report explores how public services approach decommissioning as part of their efforts to innovate. Not a technical guide to how to decommission or managing cuts.
“In writing this report, we have been struck by how rarely decommissioning is discussed in the context of service improvement and innovation, and how little guidance there is on how to overcome the real barriers to decommissioning in the public sector.”

Decommissioning – Some tools and resources compiled by NAVCA (National Association for Voluntary and Community Action) currently available to assist support and development organisations faced with decommissioning of local services.

Decommissioning : How to decommission public services delivered by third sector organisations and maintain value for money
An NAO guide which goes through what is meant by decommissioning, the principles underlying this guidance and some pre-conditions for successful decommissioning; and looks at the issues that arise and good practice that should be applied at different stages of decommissioning.

Decommissioning Checklist and Guidance  – DH Care networks Care Services Efficiency Delivery
An example of a Decommissioning Checklist and Guidance from care services. This simple tool is a six-page checklist of questions, useful advice and further sources of information for those considering decommissioning specific services.

Health England Leading Prioritisation online tool
Information on the cost-effectiveness, impact on health inequalities, and reach of interventions to support the prioritisation of investments in preventative health care.

Tackling disinvestment in health care services by Tom Daniels, Iestyn Williams and Suzanne Robinson In Journal of Health Organisation and Management  Vol. 27 Iss: 6, pp.762 – 780.
An exploration of the experiences of budget holders within the EnglishNHS in their attempts to implement programmes of disinvestment, and to consider factors which influence the success (or otherwise) of this activity. (see draft here.)

A selection of 25 items selected by Sir Muir Gray on disinvestment.

A report from October 2009 based on reading the Implications for practice section in all new and updated Cochrane reviews in Issue 1 2009 of The Cochrane Library.

Looking for value in hard times, Health Foundation 2012
How a new approach to priority setting can help improve patient care while making savings using new approach to priority setting called Star (socio-technical allocation of resources). It works by producing simple visual models, developed interactively with stakeholders, so that everyone involved can understand the nature of the choices to be made, and the disadvantages of not changing current practices.

How can we improve disinvestment in health care services? The views of resource allocators in the English NHS 
A presentation at International Society on Priorities in Healthcare: Priorities 2012 Conference by Tom Daniels, Iestyn Williams and Suzanne Robinson of Health Services Management Centre, University of Birmingham.

Commissioning with the Community
A Health Foundation report exporing how the Isle of Wight used a value for money (VfM) approach to set local priorities.

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Reducing spending on low clinical value treatments Health briefing, Audit Commission, April 2011.
This briefing looks at primary care trusts’ (PCTs) spending on low clinical value treatments (ie treatments that are either clinically ineffective or not cost-effective) and how some PCTs have successfully reduced their spending in this area.

Decommissioning and reconfiguring services: A good practice guide for commissioners of adult social care (Nov 2010)
Developing Intelligent Commissioning Programme” from Yorkshire & Humber Joint Improvement Partnership.

Decommissioning Toolkit: A best practice approach to meeting changing needs and delivering value for money, Croydon Local Authority (no date)

Developed to supportcommissioners across the Council with planningand managing the decommissioning of services, provision or systems.
NHS South East Essex Decommissioning & Disinvestment toolkit, 2010
Sets out agreed prinicples for decommissioning.
Decommissioning – part of the Commissioning Support Programme’s suite of training materials ‘A-Z of Commissioning. An introduction to the issues thrown up by decommissioning – particularly in response to financial challenges.

Guide to Decommissioning and Service Reconfiguration in Adult Social Care
This guide from the Institute of Public Care describes the four key stages of service reconfiguration, and offers a checklist on the key activities needed to ensure the process is carried out as effectively as possible.

Short-notice care home closures: a guide for local authority commissioners, SCIE 2011. This guide helps commissioners, particularly local authority staff, to manage care home closures at short notice in situations that may be unexpected and therefore unplanned.

Getting out of Hospital? – Health Foundation 2011
A rapid review found that moving care from hospitals into the community improves patient satisfaction, but little  evidence of the necessary systematic decommissioning of hospital care.

Save to Invest – Exec Summary
A 2007 case study  from the London Health Observatory looking at adopting common service access criteria across the whole of London.

Ongoing research

Decommissioning health care: identifying best practice through primary and secondary research a research project (2013-2016) based at Health Services Management Centre, University of Birmingham

Implementation of NICE Disinvestment tools – PenCLAHRC –  this project will use NICE’s ‘disinvestment tools’ to develop a single evidence-based approach towards disinvestment which will be piloted across the Peninsula before national rollout.
Read the protocol here

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