Commissioners need to understand what the drivers for change are and the motivations that lead to decommissioning. This will have an impact on the process of decommissioning and other factors such as timescales and levels of engagement with stakeholders.
Our research found a wide set of drivers for change including those in the table below.
Drivers for change
|Performance management||Where the underlying reason for decommissioning is the poor performance of a service provider. There can be various reasons why proper monitoring and management of the provider has not led to either remedial action being taken or the grant or contract terminated on performance grounds. It is debatable whether this is properly decommissioning.|
|Better and more consistent use of evidence based commissioning||Where improved commissioning processes better identify user needs, leading to a change in service provision and the need to decommission existing services and providers.|
|Changes in user needs||Where an assessment of need shows a change in user needs (e.g. changing demographics, changes in health needs such as HIV infection rates, etc) and current services no longer adequately support users.|
|Changes in service, organisation or national priorities||Where changes in service, organisation or national priorities and funding lead to reconsideration of the services provided.|
|Natural end of a contract/grant||Where a contract or a grant is coming to an end and commissioners use this as an opportunity to consider the service and whether it is needed.|
|Reduced funding||Where less funding and smaller budgets lead to a need to reduce costs. The review of services can lead reduced services or their complete cessation. Currently, an increasingly common driver.|
|Cost shunting||Where there is an imbalance between referrals to a service from a commissioning agency or department and their contribution to costs.
For example, social care referrals to a service commissioned by social care become less than referrals by health visitors. Social care decommissions the service on the basis that health should pay for it. There is no guarantee that health has the funds to re-commission the service.
|Rationalising of providers, services or pathways||Where commissioners seek to reduce the number of providers and/or services in a bid to simplify management of delivery and associated costs.|
|Service redesign||Where changes in services or their delivery lead to decommissioning of existing services or providers. This may be due to a move from more traditional methods of delivery because of innovation or initiatives such as personalisation.|
|Provider driven innovation||Where a provider produces innovative new services that lead to decommissioning of existing services.|
|Provider driven ending of service||Where a provider can no longer deliver the service commissioned due to changes in the provider’s circumstances e.g. bankruptcy, closure of a facility, or loss of other grants or contracts.|