SHARE (Sustainability in Health care by Allocating Resources Effectively) Framework
The SHARE Framework helps healthcare organisations make better decisions about how to use their resources by systematically stopping or reducing ineffective practices (disinvestment) and improving care. It focuses on making resource allocation fair, transparent, and effective across all levels of a health system.
At a glance
Use when
Healthcare organisations seek to improve efficiency by discontinuing low-value practices; there is a need for systematic, transparent, and sustainable approaches to resource allocation; disinvestment initiatives are stalled due to lack of structure or process
Avoid when
Organisations lack leadership commitment or capacity for change; there is no mechanism for stakeholder engagement; urgent, crisis-driven decisions are required without time for structured processes
Inputs
Local healthcare priorities, evidence on clinical and cost-effectiveness, stakeholder input, existing organisational structures and processes
Outputs
Prioritised disinvestment decisions, implemented changes in practice, evaluated outcomes, improved resource allocation processes
How it works
The SHARE Framework operationalises disinvestment within a broader resource allocation approach, integrating investment and disinvestment decisions. It comprises three components: a decision-making program grounded in ethical and practical principles with systematic triggers; implementation and evaluation projects following structured disinvestment steps; and embedded research to continuously improve processes. The framework is designed for use at multiple organisational levels and does not prescribe specific methods, allowing flexibility in applying tools and theories. It emphasizes transparency, consistency, and responsiveness to local priorities.
- HTA domains
- Costs & Economic Evaluation, Organisational aspects
- Assumptions
- Disinvestment is most effective when embedded in ongoing resource allocation processes; organisational commitment and stakeholder engagement are essential; local adaptation of methods is necessary for success
- Strengths
- Flexible and adaptable to different organisational levels and contexts; integrates disinvestment within broader resource allocation to reduce stigma; promotes transparency and accountability; supports continuous learning through embedded research
- Limitations
- Does not prescribe specific methods or tools, requiring organisations to select or develop their own; success depends on organisational culture and leadership support; may face resistance due to the sensitive nature of disinvestment
- Also known as
- SHARE Framework, Sustainability in Health care by Allocating Resources Effectively Framework
Questions this answers
- › How can healthcare organisations systematically disinvest from ineffective or low-value practices?
- › What principles should guide fair and transparent resource allocation decisions?
- › How can disinvestment be integrated into existing healthcare systems and processes?
- › What organisational structures support sustained disinvestment efforts?
- › How can the impact of disinvestment decisions be evaluated?
- › What are the barriers to implementing disinvestment and how can they be addressed?
References & sources
Similar by meaning
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