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In order to account for the fact that different kinds of decisions may give rise to different perceptions on what is necessary to achieve fairness and legitimacy, we will use the DMAT to assess both the mission statements, or equivalent, of our CCG sample��that is, how CCGs aspire to make decisions, as well as to assess specific types of decisions��that is, how criteria and values are used in practice. This approach reflects the complexity of CCG decision-making and ensures that a distinction is made between different types of decisions and the required legitimation processes. For example, a decision on whether to decommission a service is different from a decision on where to build a new hospital in that it may give rise to a different set of concerns by stakeholders, which in turn affects the way the legitimacy of the decision outcome is perceived. We will therefore test the usefulness of the DMAT in assessing a range of decisions that CCGs have made. When triangulating the results of this exercise with the results of the interviews, we may find that the fulfilment of A4R conditions is enough to achieve the status of legitimacy for some decisions, but not for others, for example, when decisions involve making moral judgements on funding healthcare such as those explored by Gkeredakis et al.18 The profiles of CCG decision-making will enable us to evaluate whether A4R and other criteria of fair and legitimate priority setting are met. This is a necessary step in operationalising hypotheses H1 and H2 because the current criteria for decision-making need to be identified in order to analyse whether they reflect A4R and other theories of fair priority setting. This will help us establish which CCGs perform well with regard to the principles contained in the previously outlined Selleck MK0683 frameworks. The goal is to develop a comparative overview of the CCGs that have performed well in our audit exercise and those that have performed less well. We will then carry out semistructured interviews with stakeholders within the CCG sample, asking them about their general perceptions of the legitimacy of ��their�� CCGs�� decisions and about their perceptions in specific examples of decision-making that they have been involved in. The interviews are the second step in operationalising H1 and H2 because they will provide us with insights into the views of those affected by the CCGs�� decisions on the legitimacy and fairness of CCG decision-making. Data collection The application of the DMAT to publicly available CCG documents such as mission statements, terms of reference, minutes of meetings and other relevant documents will provide the first data set for analysis. A comparative analysis of the results of the decision-making audit will enable us to assess the relative position of CCGs in meeting principles of fair and legitimate priority setting.