Policy - Decommissioning

Decommissioning components of the existing service is an important part of the implementation process. It not only facilitates strong stakeholder engagement, but also allows the implementation team to focus on a robust justification for the change at both Trust and PCT level. Implementing this technology requires a shift in how the existing service model is delivered, and it is these changes that need to be reviewed and fully understood before embracing a new model of care. It was important for teams involved in the Technology Implementation Project to review 6 areas of the existing service and to understand what aspects needed to be decommissioned in order to successfully adopt the technology as part of routine clinical care. These included:

  1. Theatre Timetabling,
  2. Bed Capacity,
  3. Waiting Lists,
  4. Outpatient Department Capacity,
  5. Tariff Provision
  6. Pre and Post Operative Counselling.

The practicalities of decommissioning these areas are discussed in more detail in the Implementation Section of this How to Why to guide. However the service requirements document outlines the operational details surrounding the existing, commissioned service with a proposed model of care for the future in relation to the adoption of the technology.

Implementation teams going forward will also benefit from understanding what processes can be stripped out of the patient pathway. This will allow teams to begin discussions with senior management (at Trust and PCT level) regarding what the new, recommissioned service will look like.

Preparing for the Road Ahead

There are five areas that Trusts need to focus on in order to understand what lies ahead. These core principles stem from the lessons learnt from the NTAC implementation sites.

  1. Clinical algorithms: The processes by which clinical decisions are to be made by introducing the technology and what impact this will have on current commissioning protocols.
  2. Information flow processes: the processes by which information needs to be shared across the different persons involved in the decommissioning of existing practice.
  3. Patient flow processes: The processes by which patients will move through the new pathway as they seek and receive care - and the steps taken to replace old practice with the new model.
  4. Material flow processes: The processes by which materials (e.g. supplies, consumables) were previously passed through the system prior to the introduction of the technology.
  5. Multiple flow processes: Most processes are actually multiple flow processes, whereby patients, materials, information, and others are involved simultaneously in the same process of care.

Click here for a more detailed overview of all of the above principles.

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