Health Serv Deliv Res 2015;3(13)
- There is large inter-PCT variability in procedure rates for common NHS procedures. Variation is highest where the diffusion or discontinuance is rapidly evolving and where substitute procedures were available, suggesting that variation may be a proxy for clinical uncertainty about appropriate use.
- Using data from two PCTs the researches examined opportunities and barriers for disinvestment.
- Evidence to support commissioning decisions was limited.
- Commissioning meetings were dominated by new funding requests and benchmarking did not appear to be routinely carried out because of capacity issues and concerns about data reliability.
- Perceived barriers to disinvestment included lack of collaboration, central support and tools for disinvestment.
- Clinicians felt threshold criteria had little impact on their practice and that prior approval systems would not be cost-effective.
