Application of a novel disinvestment research design to the use of weekend allied health services on acute medical and surgical wards - randomised trial and economic evaluation protocol

Background Some currently provided health services have an absence of evidence for effectiveness, cost-effectiveness and/or safety. These are candidates for disinvestment. It is possible that such services would prove valuable if trials were to be conducted however, making disinvestment a clear risk. Provision of these services in the context of usual care is a considerable barrier to conducting a conventional trial of these interventions. Our team has recently developed a novel research approach to conduct a trial in this context [1]. In this paper, we describe the first application of this design. Allied health services include those provided by a range of health professional groups. Weekend allied health services on acute medical or surgical wards are widely provided internationally but are inconsistent in their composition and focus. There is no direct evidence of efficacy for these weekend services, and higher rates of pay on the weekend make their likely cost-effectiveness questionable. This research examines the efficacy, cost-effectiveness and safety of disinvesting from weekend allied health services on acute medical or surgical wards.