Presenting the options

There are always different ways to address an issue. You need to show that you’ve thought through a number of alternatives, ranging from ‘do nothing’ to your preferred proposal.

Start by looking closely at what you want to achieve, and breaking it down into realistic options. For example, will it be possible to achieve the overall aim, or is it more realistic to achieve part of it?

You should include an introduction summarising all the options available and the effects of each option on the current situation.

It is important to provide a list of pros and cons for each option. Highlight your preferred way forward, with reasons. It is key to show a summary of the financial effects and how the options are financed, for example, external savings and external financial support. You will also need to summarise what you want to achieve in an estimated timeframe.

Impact on other services

Think about how your business case will impact on other services within your area, and whether this needs to be accounted for. If you discuss your proposal with the appropriate staff right at the start, you can account for any potential impact in other departments.

Remember to consult with departments and organisations – such as the ambulance service, x-ray department, medical records, pharmacy and local leisure services – to enable you to judge any likely effect of your proposal on their services.

Examine the current service

You need to demonstrate that the current service has been examined rigorously to cut out duplication, underutilisation of resources or wasted resources.

Systems that produce poor results first need to be redesigned in order to maximise investment. In some cases, that by itself is all that is needed to change an ineffective service into an effective one. In other cases, further investment will be necessary. The process of redesign will show exactly where work and investment are needed: quite often, this is not at the site of the apparent problem.

Service redesign

Redesigning or modernising services is an increasingly important part of national and local planning and commissioning processes. Doing this will strengthen your business case and help it compete with other funding priorities.

Once the service has been redesigned, it will become clear where results will not improve without further investment. Now you will be able to present a clear case for the need, informed by the work done in mapping the patient journey, and monitoring and analysing patient flow.

Use the right tools

The three diagnostic redesign tools that are particularly helpful in building up a business case are:

  1. process mapping
  2. statistical process control
  3. demand and capacity analysis.

These methods will:

  • help you understand your service in detail and show you where improvements need to be made
  • show you which improvements can be made through redesign; for example, by changes in working practice
  • show you where improvements cannot be made without further investment.

Interpret the data

Include information about the diagnostic data you have gathered during your redesign work, and about the changes you have made to your service as a result. This will show commissioners or funding bodies that:

  • you have a thorough understanding of your service
  • you have done everything in your power to improve it without additional funds
  • you can show exactly where funds are needed to create further improvements
  • their investment will contribute to positive outcomes for patients and is unlikely to be lost in a poorly functioning system.


< 3. Making your case     5. Dealing with finance >