Tough choices and new opportunities in a cold fiscal climate

Posted on Monday 19th May 2014

Iestyn WilliamsDr Jenny Harlock, Research Fellow, HSMC

To coincide with the publication of the latest HSMC newsletter the editors Iestyn Williams and Jenny Harlock reflect on how the NHS is coping with the challenges brought by austerity.

"Some say that necessity is the mother of invention, others that being innovative requires resources. Whatever the validity of these competing claims, it seems clear that we are entering into a sustained period of public sector budget constraint brought about by both economic trends and political decisions. As a result, ‘austerity’ has cast a shadow over the planning, commissioning and delivery of services. This presents both challenges and opportunities to those working in the health and social care sector.

The challenge of resource scarcity has led to the resurgence of the rationing (or ‘priority setting’) debate in health and social care. The pursuit of reasonable approaches to rationing has long been a preoccupation of HSMC. However this debate has evolved as the health and social care landscape has evolved, and HSMC’s research and practice has changed accordingly. For example, the controversial topic of ‘decommissioning’ has long been overlooked by social science researchers. We have sought to address this gap through a three-year investigation of the removal and/or replacement of NHS interventions and services, funded by the National Institute for Health Research. The aim of this project is not to make the case for decommissioning but rather to understand what happens when it is attempted in practice, and what determines ‘success’ in its implementation....."

To read the full opinion and to leave a comment on this ViewPoint piece, please visit HSMC's ViewPointBlog