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Table 4 Round one aggregated responses from 30 participants: best practice recommendations (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

1 Adopt a whole systems perspective from the beginning
2 Base decisions on evidence of what works
3 Be pro-active in engaging with the media
4 Clear and thorough project planning and governance
5 Collect and analyse relevant data before, during and after
6 Do not decommission until alternative services in place
7 Engage and involve clinical leaders from an early stage
8 Engage and involve service users from an early stage
9 Ensure a transparent decision-making process
10 Establish a clear rationale and narrative for change
11 Establish clear criteria by which to measure outcomes
12 Focus on improved patient experience and quality
13 Identify and establish a strong top leadership team
14 Pay attention to the human elements of change and the impact that decommissioning can have on those involved
15 Pay equal attention to implementation and decision-making phases
16 Place emphasis on public engagement and communication
17 Provide regular feedback on progress
18 Resource the process and retain a budget for contingencies
19 Secure high-level political support (national and local) at early stage