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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