HFMA: A framework for the ethical and effective decommissioning and disinvestment of clinical services (1 June 2026)

Summary

The Health Economics Unit (HEU) has developed A framework for the ethical and effective decommissioning and disinvestment in clinical services, in partnership with the HFMA.

The framework is designed to support health and care leaders to systematically evaluate, prioritise and implement decommissioning and disinvestment decisions, particularly in systems facing significant financial deficit.

In producing the framework, the HEU explored the following questions:

• Reasoning: How are services or providers identified for decommissioning, consolidation or other significant change?
• Process: What constitutes best practice in decommissioning, consolidation, service redesign and the reallocation of funds?
• Challenges: What gaps and limitations have been identified that affect or constrain the decommissioning process and associated decision-making.

Decommissioning framework - accompanying guide.pdf