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Table 7 Examples of activities and settings for disinvestment within decision-making infrastructure

From: Sustainability in Health care by Allocating Resources Effectively (SHARE) 10: operationalising disinvestment in a conceptual framework for resource allocation

Activity

Example

Routine

Reactive

Proactive

Priority Setting

Meeting external requirements

â–ª Addressing legislative, regulatory and accreditation requirements, national and professional standards, etc

✓

✓

  

â–ª Responding to product alerts and recalls

 

✓

  

Setting budgets

â–ª Determining sources of income and items of expenditure

✓

  

✓

Spending money

â–ª Introducing new items to funding lists. Examples include, but are not limited to, national health schemes, insurance benefits schedules, institutional lists of permitted TCPs, formularies.

✓

✓

✓

✓

â–ª Commissioning health services and programs

✓

✓

✓

✓

â–ª Procuring capital works, plant and equipment

✓

✓

✓

✓

â–ª Purchasing clinical consumables

✓

✓

✓

✓

â–ª Assessing grant and funding applications

✓

✓

  

Allocating non-monetary resources

â–ª Allocating people, time, access to facilities, etc

✓

✓

✓

✓

â–ª Developing guidance documents, promotional information or educational materials that indirectly allocate resources. Examples include, but are not limited to, peak body recommendations, clinical guidelines, protocols, standard operating procedures, decision support systems, posters, presentations.

✓

✓

✓

✓

Making strategic and operational decisions

â–ª Developing goals and strategies for Strategic Plans

✓

  

✓

â–ª Developing outcomes measures and targets for Business Plans

✓

  

✓

Using evidence to initiate and/or inform decisions

â–ª Updating existing evidence, undertaking Health Technology Reassessment, etc.

✓

✓

✓

 

â–ª Accessing and utilising research evidence, population health data, local health service data, consumer and staff feedback

✓

✓

✓

✓

Evaluating outcomes of previous decisions and projects

â–ª Monitoring, evaluating and reporting of all newly introduced TCPs to see if they perform as expected, post marketing surveillance

✓

   

â–ª Monitoring, evaluating and reporting of purposive or random samples of decisions

✓

✓

✓

 

â–ª Monitoring, evaluating and reporting of purposive or random samples of projects

✓

✓

✓