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Table 3 Round one aggregated responses from 30 participants: factors that positively or negatively shape the process or outcomes of decommissioning (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

Change management and implementation strategy:
1 Attention throughout to human aspects of process of change
2 Availability of resources to support decision-making and implementation processes
3 Clarity of incentives and levers to support change
4 Clarity of specific aims and objectives at start
5 Extent of cultural and behavioural change
6 Pace of change
7 Quality of strategic planning
8 Quality of project management
9 Complexity of decommissioning programme
10 Quality of communication
11 Strength of clinical leadership
12 Strength of executive leadership
13 Training and preparedness of staff
Evidence and information:
14 Availability of alternative services
15 Clarity around new patient pathways
16 Clarity of evidence/data to support business case, ongoing monitoring and impact assessment
17 Demonstrable benefits
18 Extent of adoption elsewhere of new intervention/service
19 Review/evaluation of process
Relationships and political dimensions:
20 Clarity of rationale/case for change
21 Extent to which challenges vested interests
22 Level of political support
23 Meets community expectations
24 Nature and extent of clinician engagement/involvement
25 Nature and extent of media coverage
26 Nature and extent of patient/public involvement
27 Quality of partnership working with relevant agencies
28 Reputation of existing providers
29 Stability within the local health economy during transition
30 Transparency of decision-making process