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Involving citizens in disinvestment decisions: what do health professionals think? Findings from a multi-method study in the English NHS

Published online by Cambridge University Press:  29 December 2017

Tom Daniels Open the ORCID record for Tom Daniels [Opens in a new window] ,
Iestyn Williams ,
Stirling Bryan ,
Craig Mitton  and
Suzanne Robinson
Tom Daniels*
Affiliation:
Health Services Management Centre, University of Birmingham, Birmingham, UK
Iestyn Williams
Affiliation:
Health Services Management Centre, University of Birmingham, Birmingham, UK
Stirling Bryan
Affiliation:
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Craig Mitton
Affiliation:
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
Suzanne Robinson
Affiliation:
Department of Social Sciences and Security Studies, School of Public Health, Curtin University, Perth, WA, Australia
*
*Correspondence to: Tom Daniels, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Birmingham, B15 2RT, UK. Email: tomdaniels1984@yahoo.co.uk
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Abstract

Public involvement in disinvestment decision making in health care is widely advocated, and in some cases legally mandated. However, attempts to involve the public in other areas of health policy have been accused of tokenism and manipulation. This paper presents research into the views of local health care leaders in the English National Health Service (NHS) with regards to the involvement of citizens and local communities in disinvestment decision making. The research includes a Q study and follow-up interviews with a sample of health care clinicians and managers in senior roles in the English NHS. It finds that whilst initial responses suggest high levels of support for public involvement, further probing of attitudes and experiences shows higher levels of ambivalence and risk aversion and a far more cautious overall stance. This study has implications for the future of disinvestment activities and public involvement in health care systems faced with increased resource constraint. Recommendations are made for future research and practice.

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Articles
Information
Health Economics, Policy and Law , Volume 13 , Issue 2 , April 2018 , pp. 162 - 188
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Copyright
© Cambridge University Press 2017 

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