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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

Research output: Contribution to journalArticle

Jenny Harlock, Iestyn Williams, Glenn Brian Robert, Kelly Hall, Russell Mannion, Sally Brearley

Original languageEnglish
Number of pages22
JournalJournal of Social Policy
E-pub ahead of print30 Oct 2017

King's Authors


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.

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