Priority-setting and rationing in healthcare: evidence from the English experience

Article


Robinson, S., Williams, I., Dickinson, H., Freeman, T. and Rumbold, B. 2012. Priority-setting and rationing in healthcare: evidence from the English experience. Social Science & Medicine. 75 (12), pp. 2386-2393. https://doi.org/10.1016/j.socscimed.2012.09.014
TypeArticle
TitlePriority-setting and rationing in healthcare: evidence from the English experience
AuthorsRobinson, S., Williams, I., Dickinson, H., Freeman, T. and Rumbold, B.
Abstract

In a context of ever increasing demand, the recent economic downturn has placed further pressure on decision-makers to effectively target healthcare resources. Over recent years there has been a push to develop more explicit evidence-based priority-setting processes, which aim to be transparent and inclusive in their approach and a number of analytical tools and sources of evidence have been developed and utilised at national and local levels. This paper reports findings from a qualitative research study which investigated local priority-setting activity across five English Primary Care Trusts, between March and November 2012. Findings demonstrate the dual aims of local decision-making processes: to improve the overall effectiveness of priority-setting (i.e. reaching ‘correct’ resource allocation decisions); and to increase the acceptability of priority-setting processes for those involved in both decision-making and implementation. Respondents considered priority-setting processes to be compartmentalised and peripheral to resource planning and allocation. Further progress was required with regard to disinvestment and service redesign with respondents noting difficulty in implementing decisions. While local priority-setters had begun to develop more explicit processes, public awareness and input remained limited. The leadership behaviours required to navigate the political complexities of working within and across organisations with differing incentives systems and cultures remained similarly underdeveloped.

KeywordsPriority setting; Decision making; Resource allocation; Rationing; Primary care; Healthcare; England; Disinvestment
Research GroupDiversity and Gender group
LanguageEnglish
PublisherElsevier
JournalSocial Science & Medicine
ISSN0277-9536
Publication dates
Online20 Sep 2012
PrintDec 2012
Publication process dates
Deposited22 Nov 2013
Output statusPublished
Digital Object Identifier (DOI)https://doi.org/10.1016/j.socscimed.2012.09.014
Web of Science identifierWOS:000312757800041
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