Common considerations that both (a) should, and (b) do in practice inform decisions: | |
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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 |