Star – Socio-technical allocation of Resources

Engaging stakeholders in re-designing services

The NHS is under greater pressure than ever to secure high-quality, value-for-money health services. At the same time, commissioners and providers are expected to involve stakeholders – including patients and the public – in decisions.

Obtaining value for money has always been an important aim for the NHS, as has a commitment to transparent and rational priority setting. The NHS Constitution also establishes as a guiding principle that the NHS should work in partnership with other organisations.

The NHS has an explicit duty to ensure that patients and the public have a say in how services are planned. The Constitution also gives them the right ‘to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services.

As clinical commissioning groups in England begin to take on their new responsibilities, they will need tools that help them meet these demands – and which enable them to demonstrate that they have done so. This will be particularly the case where they have to take difficult decisions that may involve disinvestment.

These two Casebooks describe a new approach to priority setting called Star (Socio-technical allocation of resources). The approach combines value for money analysis with stakeholder engagement. This allows those planning services to determine how resources can be most effectively invested, while the engagement of stakeholders means the decisions are understood and supported by those most affected.

The first casebook explains the principles of the approach and the decision conferencing. The second casebook describes the implementation of the Star approach in Sheffield in re-organising Eating Disorder services.