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To what extent should the public be involved in health disinvestment decision making: a mixed methods investigation into the views of health professionals in the English NHS

Daniels, Thomas Andrew (2016)
Ph.D. thesis, University of Birmingham.

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Demand for health services is growing, but funding is often failing to keep pace. To ensure that budgets are balanced and that delivered services continue to be high quality, decision makers are having to set priorities, removing funding from some services- this is disinvestment.

This thesis details research incorporating a literature review followed by a two stage empirical investigation into the way that disinvestment decisions are made and whether or not the public should be involved. The first stage is a Q-Methodology study, the second is in-depth interviews. The population for the study is NHS health professionals (including managers and clinicians). 55 participants took part in the Q-study, and of these, 20 took part in follow-up interviews.

The study highlighted three distinct perspectives, all of which supported public involvement. One was unequivocal in its support, another highlighted some potential disadvantages to involving the public and the third suggested that the public should have the freedom to choose whether they became involved. The follow up interviews re-iterated participants support for involvement but suggested that the public should become involved earlier and to a greater extent in those disinvestment decisions which affected more patients and/or resulted in a tangible loss of services.

Type of Work:Ph.D. thesis.
Supervisor(s):Williams, Iestyn and Robinson, Suzanne
School/Faculty:Colleges (2008 onwards) > College of Social Sciences
Department:Health Services Management Centre, School of Social Policy
Additional Information:

PhD jointly awarded with the University of British Columbia

Subjects:HD28 Management. Industrial Management
HJ Public Finance
HV Social pathology. Social and public welfare
Institution:University of Birmingham
ID Code:6439
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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