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Table 2 Round one aggregated responses from 30 participants: considerations that (a) should and (b) do in practice inform decommissioning decisions (listed in alphabetical order)

From: Disentangling rhetoric and reality: an international Delphi study of factors and processes that facilitate the successful implementation of decisions to decommission healthcare services

Common considerations that both (a) should, and (b) do in practice inform decisions:
1 Addressing inequalities
2 Alignment with strategic priorities
3 Availability of alternative services/interventions
4 Capital costs/condition (buildings, maintenance)
5 Clinical effectiveness
6 Cost/budgetary pressures
7 Cost-effectiveness/efficient use of resources
8 Cost of implementation of decommissioning
9 Duplication of services
10 Equitable resource allocation
11 Evidence-base
12 Maximizing population health
13 New service developments/innovations
14 Patient and public views
15 Quality and patient safety
16 Responding to changing demographics/population needs
Additional considerations in practice:
1 Complexity of implementation of decommissioning
2 Government intervention, e.g., legislation
3 Impact on workforce
4 Marginal groups not heard (e.g., homeless)
5 Prejudice against public sector provision
6 Support from clinicians
7 Support from elected politicians
8 Support from industry and other interest groups