Disinvestment in health care

The principle objective of the overall project was to develop and refine the process by which NHS commissioners identify clinical procedures that are over-utilised in their area and establish a process for disinvestment.

Results show a high degree of geographical variation in many procedures that cannot be explained by proxies of clinical need. Commissioning group meeting agendas were dominated by investment rather than disinvestment topics. Interviews with stakeholders confirmed concerns about the reliability of routine NHS data for benchmarking and the lack of alternative methods for identifying opportunities for disinvestment. There is a need for increased central NHS support to encourage commissioners to disinvest, and provide the tools, accurate data and relevant evidence to facilitate this.

The study final report can be found here and the results published in The Lancet 2013 and The Lancet 2014.