Writing a successful business

case

Pennine Endoscopy

Confession

About us..

• One trust Pennine Acute

• 4 Hospitals

• 4 endoscopy units

• 800k pop

• 24000 scopes pa

• Directorate of Gastro

& Endoscopy 2009

About us..

• 10 endoscopy rooms

• JAG accreditation & BCSP threatened by

timeliness issues

• Reliant upon WLIs

• WLIs affect Service Line

Problems…

• Unprofitable service line

• Increasing demand

• NAEDI

• Age Extension

Causes

• Clinical variability

• Organisational inertia due to WLIs

• Perverse incentives

Solutions

• Remove variation

• Improve standards & quality

• Achieve JAG for all 4 sites

• Pull capacity into funded sessions in working

week

• Increase capacity

The business cases

• 2011 Increase from 2 – 3 rooms in Oldham

(now operational)

• 2012 Increase from 2-3 rooms in Bury (signed

off, build commencing April 2013)

• Moviprep (agreed & awaiting sign-off)

Secrets…

• Know your market

• Speak the same language

– SLR, RTT, PTL, 62 days, 31 days, CCG

• Business is simply the art of getting things done

• Collaborate

• Delegate

• Speak to the exec team – they will enjoy

discussing it with you

Making the case

• Title of Proposed Service Development

• Funding Source

• Service Lead & Contact Details

• Other Services Affected

• Description of Proposal

• Heath Need & Proposal for Change

– Service Delivery & Performance

– Patient Experience

– Strategic view

Making the Case

• Links to external policies (e.g. NSF’s, NICE, CQC)

– Waiting Times

– Decontamination

– Risks of not making the change

– Other Drivers for change

• Health Impact, Outcomes and Deliverables

– Activity Performance

– Access Performance

– Quality of care/Clinical Governance/Patients Experience

– Management of risk

Making the Case

• MARKET POSITION (Internal & External)

• BROAD FORMULATION OF OPTIONS

– Risks & advantages for each

• FINANCIAL ASSUMPTIONS

• FINANCIAL ANALYSIS

Making the Case

• TIMESCALES

• PROJECT MANAGEMENT ARRANGEMENTS

• FORUM TO WHICH SUBMITTED FOR

APPROVAL

• OUTCOME FROM FORUM OF APPROVAL

• COMMENTS ON OUTCOME

• REVIEW DATE

• APPENDICES – costed plans from estates /

contractors

Making the case

Projected demand - colonoscopy

SHA 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17

North East 28,100 32,100 34,100 37,200 40,600 43,500 46,300

North West 59,100 69,800 74,100 81,000 89,100 95,400 101,700

Yorks and

Humber 48,700 56,700 60,300 65,800 72,300 77,400 82,500

E Mids 32,600 39,900 42,400 46,600 51,600 55,400 59,200

W Mids 38,700 47,300 50,100 55,100 61,000 65,400 69,800

East of

England 43,000 51,900 55,600 61,100 67,600 72,600 77,600

London 61,500 69,700 74,300 81,100 89,300 95,300 101,300

S E Coast 39,200 46,300 49,200 53,800 59,100 63,400 67,600

S Central 30,900 37,100 39,400 43,200 47,800 51,200 54,700

S West 44,200 53,100 56,600 62,100 68,500 73,500 78,600

ENGLAND 425,900 503,800 536,100 586,900 647,100 693,100 739,400

Summary

• Tedious but necessary

• Team approach essential

Thank you for your attention!