nhs business plan example

Writing your NHS business case

Supplying to the NHS can sometimes feel like a complicated process.

A common barrier frequently cited to us is the business case. In simple terms, a business case puts forward a proposal requesting resource, whether that is money, people, or time, from an NHS organisation.

These resources are precious to the NHS and a clear and thorough business case can be make or break. It has importance as a source of consistency and understanding for all those involved. It also helps to set a benchmark and manage expectations.

Your business case will be subject to a thorough appraisal process and must answer all the questions and concerns a busy NHS organisation would have.

There are core components of an NHS business case including making a case for change; articulating value for money; commercial viability; affordability; and a capability to deliver.

To cover these core components in enough detail, you’ll need to dedicate time to research and information gathering before you start your business plan.

You may also want to consider these five tips:

1. Treat your NHS business case as unique

An NHS business case will go through different processes depending on the organisation’s governance requirements and the value of the contract. Always understand the status of the internal business case and the stages that will follow before you start the process.

Requirements for non-NHS business cases may be different, so make sure you treat this as a unique case. Your case for change must fit alongside other marketplace policies; pressures; and structures.

Make sure to concentrate on the detail before you start.

2. Know who your business case is for

Approval of your business case will involve multiple stakeholders, it’s essential that you know who this is to understand what information they are interested in. The way your innovation may be funded can be based on the type of organisation, so it’s important to know who you are making the business case for. For example, is it aimed at primary or secondary care? Are they a foundation trust or not?

3. Remember that value is relative

What you deem as ‘value’, may be very different to your NHS customer. Fully understanding your value proposition is a crucial step to getting this part of your business case right.

4. Ask yourself, will your calculations stand up to scrutiny?

Within your business case, you will need to include figures relating to value; finance; evidence; and required resources. Potential investors need to know these are accurate and if they aren’t this will have implications for your business case and the future project.

5. Your stakeholders will want to know ‘what if we choose to do nothing?’

Doing nothing could be an option for your audience. When setting out your case for change, you need to help them understand that doing nothing isn’t an option. This may include outcomes and risks associated with doing nothing, and an overview of what other approaches have been considered.

Further reading

If you’ve found this information useful, you may also be interested in the following resources from some of our heath innovation networks:

• Preparing a successful business case: A practical guide for suppliers of innovative products and services – created by East Midlands Heath Innovation Network
• State your case: 7 questions every innovator needs to ask themselves – created by Eastern Heath Innovation Network

Access health innovation network support

Complete our company registration form to access support from your local heath innovation network to produce your business case:

If you would like to access support from a wider range of organisations like NICE; MHRA; NIHR, as well as the heath innovation networks, we’d advise that you apply to the NHS Innovation Service . There is no need to complete the Heath Innovation Network engagement form if you apply for the NHS Innovation Service. The heath innovation networks will be made aware of your application.

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Strategy, Business Plan and Annual Report

Our purpose: We deliver business service excellence to the NHS to help people live longer, healthier lives.

Our vision: To be the provider of national, at scale business services for the health and social care system, transforming and delivering these services to maximise efficiency and meet customer expectations.

Strategy and Business Plan

NHSBSA Strategy for 2024 to 2029 (PDF: 9MB) This is v1.0 published on 22 April 2024.

NHSBSA Business Plan for 2024 to 2025 (PDF: 8.6MB) This is v1.0 published on 26 July 2024. 

The documents provided on this page are accurate at the time they were published. 

If our plans change (for example, due to changes in government policy affecting the services that we provide) we may issue addendums or changes to these documents. They will be available on this page.

You can view our Digital Strategy for 2021 to 2024 .

Annual reports and accounts

NHSBSA Annual Report and Accounts 2023 to 2024 (PDF: 14.5MB) NHSBSA Annual Report and Accounts 2023 to 2024 (Web accessible version) (PDF: 6MB) NHSBSA Annual Report and Accounts 2022 to 2023 (PDF: 3.3MB) NHSBSA Annual Report and Accounts 2022 to 2023 (Web accessible version) (PDF: 13.8MB) NHSBSA Annual Report and Accounts 2021 to 2022 (PDF: 3.21MB) NHSBSA Annual Report and Accounts 2021 to 2022 (Web accessible version) (PDF: 16.4MB) NHSBSA Annual Report and Accounts 2020 to 2021 (PDF: 8.18MB) NHSBSA Annual Report and Accounts 2020 to 2021 (Web accessible version) (PDF:10.2MB) NHSBSA Annual Report and Accounts 2019 to 2020 (PDF:12MB) NHSBSA Annual Report and Accounts 2019 to 2020 (Web accessible version) (PDF:4.3MB) NHSBSA Annual Report and Accounts 2018 to 2019 (PDF:11.6MB) NHSBSA Annual Report and Accounts 2017 to 2018 (PDF: 4MB) NHSBSA Annual Report and Accounts 2016 to 2017 (PDF: 6.89MB) NHSBSA Annual Report and Accounts 2015 to 2016 (PDF: 2.24MB) NHSBSA Annual Report and Accounts 2014 to 2015 (PDF: 1.87MB)

Earlier annual reports are available on request from our Corporate Secretary.

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NHS England 2023/24 business plan

NHS England have published a 2023/24 business plan which sets out NHS England’s work in leading and supporting the NHS to respond to three key tasks including: the recovery of core services and productivity, progress in delivering key ambitions in the NHS Long Term Plan and transformation of the NHS for the future.

You can view the 2023/24 business plan publication here: NHSE 2023/24 business plan

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HEE Business Plan 2022/23

From our chair and chief executive.

The NHS needs to recover from the pandemic, deal with a huge backlog of care, and prepare for longer term challenges such as rising numbers of people with more than one condition, an ageing population, and mainstreaming new technology.

That is why HEE has been commissioned to produce a new strategic planning framework to identify the drivers for workforce planning in 2037, including social care for the first time, and why we are building a new organisation with NHS England, NHS Improvement and NHS Digital to align workforce, service, finance, and technology.

This Business Plan recognises the need for continued and consistent delivery as we transition to the new organisation over the coming year. It focuses on workforce transformation, skill mix, and growth; education and training reform; widening workforce participation and diversity; and our role in the global health workforce marketplace.

The plan places people at the centre of our work because healthcare is about people; the people who require it and the people who deliver it which is why we need more and different trained and educated staff to deliver for patients and citizens.

We outline how we will use the public money we receive to expand education and training in professions where shortages are most acute. It recognises the need to look after people who already work for the NHS through staff wellbeing, tackling health inequalities, developing multi-disciplinary teams, expanding advanced practice and using quality improvement to drive up quality, safety and productivity.

This Business Plan outlines what we will do to support NHS workforce needs now, over the next year, and into the future.

Chair - Sir David Behan CBE

Chief Executive - Dr Navina Evans CBE

Download PDF version of the HEE Business Plan 2022/23 (Non-accessible, for print purposes)

Introduction

What HEE does for health care professionals in training

HEE Vision, Purpose, Operating Model and Plan on a Page

Strategic context

Our goals and objectives

Our foundations of success

Our Operating Model and Regional Delivery Plans

Financial requirements

Accountability and measuring progress

Contact details

Related Documents

• HEE Business Plan 2022-23 (.pdf) 3.42 MB

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Our 2024 – 2025 Business Plan

We are creating one connected and efficient supply chain that delivers for the NHS.

The NHS is facing challenges but remains committed to providing outstanding patient care. NHS Supply Chain plays a crucial role in supporting the NHS to evolve, deliver on its priorities and continue to put patients first. Together with our partners, we are not just focused on reducing prices; we are working to bring more value to the entire healthcare system while ensuring supply chain resilience and sustainability.

Looking ahead to 2024 – 2025, we are excited to continue enhancing our capabilities and services. This includes upgrading our technology, improving customer experiences, and expanding our inventory management solutions to offer digital transparency across the NHS.

Our goal remains clear: to leverage our talented team and expertise to prioritise patient care. Collaboration is key and by working together, we are dedicated to delivering even greater value to the NHS and its patients.

Our strategy

We are pleased to share our Business Plan with you. It helps us deliver on our ongoing commitment to supporting the NHS to deliver safe and excellent patient care.

One NHS Supply Chain We are one organisation in the eyes of our teams and stakeholders, operating efficiently as a single organisation within the NHS family.

Strengthen Resilience We ensure availability of critical products, supporting the NHS to deliver excellent patient care.

£1 Billion of Value We will create £1 billion of recurrent value to return to the NHS from 2030.

See our Downloads ▼ section to read our full business plan for this year.

Working together for the NHS

As part of the NHS family, our Strategy and Business Plan are firmly rooted in the principle of working together with our NHS partners to deliver patient-led care. We are firmly committed to the NHS value of working together for patients and we will do this through five focus areas:

Organisational Development Developing our clinical capabilities through clinical practice, evidence-based decision-making and effective collaboration; and strengthening clinical leadership across our organisation.

A Sustainable NHS Delivering our Sustainability Strategy in alignment with the NHS Greener Plan and the Chief Nursing Officer Nursing and Midwifery Strategy.

Quality-Led Resilience Building supply chain resilience to strengthen patient safety, patient experience and clinical effectiveness, to ensure we are procuring using the best available clinical evidence.

Products and Category Management Facilitating patient engagement in what we buy and how we buy it; and embedding clinical leadership at each stage of our category development and contract management processes.

NHS Clinical Engagement Collaborating with national healthcare organisations such as GIRFT along with National Clinical Directors, to deliver once for the NHS; supporting local and regional priorities; communicating effectively with all our clinical stakeholders; and utilising clinical feedback to improve how we work.

Commercial transformation Transforming our commercial capabilities

We are here to provide the NHS with superior procurement services that meet all of the latest regulations. Our goal is to streamline processes and strengthen our ability to handle any supply challenges that may come our way.

Here is what you can expect from us in the coming months:

• Implementing higher standards for clinical quality across all procurement activities.
• Identify opportunities to bring new products to market that will enable trusts to lower the total cost of care delivered (for example through reduced length of stay) – known as value-based procurement.
• Collaborating across different categories to strengthen supplier relationships.
• Introduce an eSourcing solution and Supplier Collaboration platform for smoother transactions.

Resilience and sustainability Embed an optimised, resilient and sustainable supply chain

As we move through 2024, supply chains around the world are expected to face various challenges, from shortages of raw materials to disruptions in manufacturing and transportation.

In response, we are taking steps to make our supply chain more flexible, capable, and resilient while also minimising our environmental footprint.

Here is what we have planned for the year ahead:

• Designing a Logistics and Operational IT Strategy to enhance our operations.
• Finalising the procurement of a logistics provider to ensure smooth delivery.
• Getting ready for UKCA marking compliance.
• Making improvements in packaging and promoting a circular economy.
• Through these initiatives, we’re committed to ensuring that our supply chain remains robust.

Integrated Care Systems Connect across Integrated Care Systems and regions

We are dedicated to improving patient care and clinical outcomes by working closely with partners across the NHS. This means enhancing how we communicate and engage with healthcare providers to better meet their needs.

Here is how we are making strides in this direction:

• Building strategic relationships with Integrated Care Systems to improve coordination.
• Collaborating with healthcare providers to create smoother patient pathways.
• Hosting customer panels and working groups to gather feedback and shape our strategies.
• Piloting a new eCommerce platform for select healthcare providers to streamline transactions.
• Rolling out our new inventory management system to improve efficiency in 20 healthcare providers.

Through these efforts, we’re committed to making it easier for healthcare providers to focus on what they do best: caring for patients.

Improving capabilities Develop, empower and engaging our workforce

In the upcoming year, we are committed to embedding the changes introduced via our Target Operating Model throughout the organisation.

Here’s what is in store for the year ahead:

• Welcoming 28 graduates into our graduate scheme to nurture new talent.
• Establishing a Leadership Academy to develop leadership skills within our team.
• Evolving and implementing our People Strategy to better support our team members.

Efficiency improvements Operate a well-run organisation

Our Business Plan will help us deliver our goals for 2030, which are closely tied to the priorities laid out in the NHS Long Term Plan.

Here is where our focus lies:

• Implementing new ways of working that align with our Target Operating Model.
• Sharing best practices across the organisation through our academies.
• Procuring IT providers to support our operations.

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NHS Resolution publishes business plan for 2023/24

Date published: 22nd June 2023

We’re pleased to announce the publication of our 2023/24 business plan . In it, we set out our focus for the next twelve months, as we enter the middle year of our three-year corporate strategy: Advise, Resolve and Learn: Our Strategy to 2025.

We will continue to focus on progressing our four strategic priorities:

Strategic priority 1: Delivering fair resolution All of our services will focus on achieving fair and timely resolution, keeping patients and healthcare staff out of formal processes wherever possible to minimise distress and cost.

Strategic priority 2: Sharing data and insights as a catalyst for improvement We will ensure that our unique datasets help derive usable insights that benefit patients and the healthcare and justice systems.

Strategic priority 3: Collaborating to improve maternity outcomes We will build on our role as a system integrator in maternity, bringing together key parties to determine what further improvements can be made within our areas of expertise to support the system’s plans in the area of maternity safety.

Strategic priority 4: Investing in our people and systems to transform our business We will develop our services to support the changing needs of the NHS by investing in our people, systems and services to continue delivering best value for public funds. This includes continuing to progress our two change programmes, the Claims Evolution Programme and the Core Systems Programme while continuing to support staff in building their expertise and skills.

In the context of an NHS experiencing acknowledged pressure and structural change, we’re focused on making our interactions with the NHS as easy as possible to aid NHS staff who are facing extreme pressures.

We also continue to remain committed to promoting compassion and fairness when addressing shortcomings within the NHS, whilst remaining dedicated to delivering savings and efficiencies to the overall system.

We thank our partners and colleagues across the NHS and health and care system and will continue to work with them to deliver solutions rapidly across the system as needed. As well as this, we will continue to build our external relationships and partnerships to drive our strategic priorities forward. Now, more than ever, our plans remain flexible so that we can respond quickly to any unforeseen requirements of our organisation. Helen Vernon, Chief Executive, NHS Resolution

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The 5 Stages to building a great NHS business case: Our recommended framework for your next proposal

• Published by Aidan Wagstaffe
• October 14, 2021

Writing a persuasive NHS business case: Let’s get down to business

What exactly makes a persuasive NHS business case for School Nursing services? 

With limited funding, School Nursing is one of many services seeking funding for service improvement and a well-written proposal is essential for buy-in from stakeholders to release the funding sought.

For School Nursing, front and centre is the republished Healthy Child Programme driving Commissioner requirements to deliver improved services, more efficiently and effectively ( Healthy child programme 0 to 19: health visitor and school nurse commissioning ). Within a wider context, Provider Senior management is also seeking solutions which will help it demonstrate initiatives to support bids for the newly announced Unified Tech Fund . 

Although the specifics of what makes a persuasive NHS business case will vary from Provider to Provider, there are still some commonalities between all successful NHS business cases. 

How a structured NHS business case helps School Nursing funding bids.

An effective NHS business case identifies why improvements are essential within the context of Child Health and the Healthy Child programme, the specific nature of the planned improvements; and, how your proposal will deliver improvements in service delivery and efficiencies. 

We have isolated a 5-step framework to help ensure you tick all the required boxes to write a persuasive NHS business case.

The 5-Step Framework for Constructing a Water-tight NHS Business Case

• Include relevant background information
• State your proposed solution
• Explain how your solution is suitable
• Describe the benefits
• Confirm acceptability across departments

1. Provide contextual background information

You will need to contextualise the role of School Nursing (not everyone reading the document will know!). So, outline the issues the service faces, and the benefits of your proposed solution. And the more you can back up specifics with references to evidence and data, of course, the better. Provider management needs to fulfil the requirements of Commissioners, and they will want to see how your proposal helps these requirements.  For example, you should provide information on:

The population you are serving – for example, how many children the Trust provides for, or how many schools are in the area. If there are any indicators of specific needs, you should list them. These include high numbers of migrant families or young offenders, or local drug or alcohol issues.  

Current provision resources – relevant information on the current resources such as staff numbers & skill mix, as well as equipment, software & any other resources. 

National requirements – these can be found in the revised Healthy Child Programme guidance 

The Trust’s aims – these can be found on your Trust’s website, or in their annual report.

Any local commissioning aims 

Any current gaps in service provision – this is your first opportunity to really make your case, by highlighting any issues with current service provision. This can include any targets that may have been missed, or any undue risks that may have arisen as a result of outdated or inefficient service provision. 

You can neatly summarise all of this, in an introductory statement, like this: 

“This service has a need for modernisation of XXX, due to failures in current provision (for example, X, Y and Z) , and in order to better meet the National guidance requirements of XXX, trust objective of XXX and commissioning intention XXX. The following business case will summarise our assessment of how this need can be met, and the financial and resourcing implications of doing so.“

2. State your proposed solution

Now is the time to pitch your solution identified in the first step. You will need to give a brief outline of what your proposed solution is, and summarise the costs and benefits. Be specific, and demonstrate that you’ve considered the Value for Money in both absolute terms, and relative to the cost of other solutions.

Purse-strings are always tight so making a strong financial case is essential. Again, contextualise the importance of School Nursing. But, against this, show examples of how your solutions can deliver more effectively and cost efficiently. 

Remember, specific financial information (i.e. we can deliver service A with a saving of £Y over X period) is essential.

However, contextualising these points in the context of children’s health and success is central to building the full picture as to why your proposal needs to be considered as a priority. Funnily enough, proposals from School Nursing will be relatively small compared to many funding bids senior management need to decide on, which is another reason, therefore, to make the contextual case as strong as possible. Your bid may be for X thousands, whilst senior management will often be focusing on bids worth £hundreds of thousands and millions! Hence a story of bang for the buck (and not just the £ amount) is so important.

3. Explain how your solution does the job

Here, you will need to provide technical information on two fronts. Firstly, how your solution meets the service needs. And secondly, how it solves any pre-existing issues that previous provision may have faced. Refer to technical specifications from the proposed service provider, if you have access – you can find many of these ( including SchoolScreener’s! ) on the NHS digital marketplace . 

You, again, will be well-served if you are specific, and accurate here. Ensure that you explain how a specific feature of the proposed solution will solve a previously identified issue. Doing this demonstrates consideration for the wider impact of your proposed change, and is a hallmark of a well-written NHS business case. 

4. Describe the Key Benefits to your solution

You will need to expand on the benefits that you outlined in step 2. This will require a more detailed analysis, however. An effective NHS business case will break down exactly what tasks will be improved, by how much. And, most importantly, it will calculate what that means in terms of cost for the Trust.

Does this decision allow for redistribution of staff? Does it mean a straightforward reduction to operating costs? The more specific you can be about the exact nature of the benefits, the better. Include timelines of expenditure, and return on investment projections.

Present any benefits clearly & succinctly, but be realistic. A successful NHS business case won’t “oversell”; you need to make sure any advertised benefits are deliverable.

5. Confirm Acceptability across Departments.

In any proposal, you must ensure that all key stakeholders have been informed about the proposed changes, and that they approve. Ensure you have a range of departmental heads & clinical staff on-board to strengthen your proposal. 

You will need to include staff of varying skill-levels here. Although departmental Leads may have more expertise, they are not necessarily the staff who will utilise the new or changed service. An effective NHS business case considers the impacts at all levels of service. By including a wider range of staff, you are demonstrating that you have considered the wider-reaching effects of your proposal.

The 5 Steps to Writing A Persuasive NHS Business Case: Summary

We hope that this framework has given you a better idea of what makes a persuasive NHS business case. For some more quick tips and tricks, be sure to:

• Be concise & specific.
• Refer to reliable sources of data.
• Know your finances.
• Check spelling & grammar.
• Get someone to proof-read your proposal.

When it comes down to it, writing an effective NHS business case is simply a matter of time and attention. Follow this framework, and as long as you do your due diligence, and take pains to be as specific as possible, you will have given yourself the best opportunity to secure funding. 

Still Want Some More Support for Your NHS Business Case?

If you still want some further guidance, then there are some other resources on writing NHS business cases:

Guide to Developing the Project Business Case

How to write a robust case for service development

If you found this post helpful, then please read the next part in this series . We will discuss exactly how SchoolScreener can help trusts to calculate the benefits & return on investment of using the SchoolScreener range.

Alternatively, you can sign up today for one of our free webinars on “Building A Better Business Case ”. 

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How to write a robust business case for service development

19 June, 2017

Strategic recommendations and practical tips to help nurses write thorough and convincing business cases. This article is accompanied by a self-assessment questionnaire so you can test your knowledge after reading it

At a time of cuts and savings in the healthcare system, how can nurses convince decision makers to put money into improving or expanding services? A clear, concise and comprehensive business case is a good place to start. This article provides nurses with strategic recommendations and practical tips, stressing that a strong business proposal will need to be linked to local and national priorities, and articulated in the language of financial constraints. Nurses are often reluctant to write business cases but, with the right knowledge and support, they can successfully bring a service improvement idea into the strategic arena.

Citation: Carter H (2017) How to write a robust business case for service development. Nursing Times [online]; 113: 7, 25-28.

Author:  Helen Carter is an independent healthcare adviser, Carter Consulting, Oxford.

• This article has been double-blind peer reviewed
• Scroll down to read the article or  download a print-friendly PDF here
• Assess your knowledge and gain CPD evidence by taking the  Nursing Times Self-assessment test

Introduction

Writing a business case, while time-consuming, is not complicated – but getting it wrong can be costly and frustrating. At a time when the healthcare system is trying to cut costs, nurses who want to improve or expand services need to able to write business cases that stand out and convince decision makers. This article outlines the national context, provides practical advice for all nurses – and specialist nurses in particular – and gives tips for linking a local service improvement idea to an organisation’s general targets and constraints. The advice given is not a guarantee that nurses will win their case; however, as integrated health and social care moves forward, it will certainly allow them to share their expertise of working with specific patient groups and identify how their roles can add quality to service provision.

What is a business case?

A business case is a formal, structured written document submitted to those responsible for approving and/or funding a service development initiative or project. You will need one if you want to obtain, for example, large or costly pieces of equipment, better information technology systems, additional staff, service changes or new services. A business case is usually made at a local level. By contrast, a business plan is the overarching document describing a major initiative or the strategy of an entire organisation – the two terms are sometimes used interchangeably. To increase the chances of a business case gaining approval, it can help to present it as part of a wider initiative, rather than in isolation.

Writing a business case is a time consuming process that usually follows a period of data collection, audit and analysis. It is not difficult in itself, but getting it right can be tricky, especially if the authors are not aware of the local, regional and national priorities that will influence the decision. A business case should reflect the organisation’s priorities, values and goals, and its author(s) should try to understand the complexity of service development and funding.

Understanding the national context

Year on year, there is a continued focus in the NHS on improving productivity to make savings by 2020/21. Clinical staff are expected to participate in the efforts to improve efficiency and reduce costs while maintaining high-quality services.

For nurses who are keen to be part of the current transformation of health and social care, this is a good time to try to influence the process, but they need to understand the national context and learn to articulate the needs of their services in the language of financial constraint. If they do so, there is a realistic possibility they will secure the resources needed to enhance services. There are a number of national documents, frameworks and priorities of which they need to be aware.

Better Care Fund

The Care Act (2014) provided a legal framework for the allocation of money from the Better Care Fund, which organisations can access to promote the integration of health and social care. The Department of Health and the Department for Communities and Local Government (2016) have identified the national conditions that bodies responsible for Better Care Fund plans are expected to fulfil in 2016/17.

Sustainability and transformation plans

Sustainability and transformation plans ( STPs ) were announced in NHS planning guidance at the end of 2015. NHS organisations are now required to develop five-year plans to determine the key priorities for their geographical areas and identify how services are going to be delivered in an integrated way across health and social care.

There is a push towards strengthening primary and community services, as well as encouraging individuals to take responsibility for their health. From April 2017, STPs will be the only way to secure additional NHS funding, with the best plans receiving funding quickly.

The King’s Fund has assessed STPs (Ham et al, 2017) and concluded that:

• They offer the best hope for the NHS and its partners to sustain services and transform the delivery of health and social care;
• They are wide-reaching and propose changes in several areas, from prevention to acute and specialised services;
• A high priority for many STPs is to redesign services in the community to reduce demand for in-hospital care;
• Proposals to reconfigure hospitals could improve quality but need to be scrutinised and considered on their own merits;
• Proposals to reduce capacity in hospitals will only be credible if there are robust plans to provide alternatives in the community;
• Cuts in social care and public health, as well as the lack of earmarked funds to support transformation, will affect the ability of NHS organisations and their partners to implement STPs.

In its assessment, The King’s Fund points out that there is widespread criticism, anger and anxiety in the face of these latest proposals, which appear to be reinventing the wheel or overcomplicating a system that is already suffering hardship (Ham et al, 2017).

NHS England mandate

The government published its mandate to NHS England (NHSE) in January 2016 (DH, 2016a). This set out the objectives, budget and how NHSE’s performance would be measured for the current financial year. On 31 March 2016, NHSE published the NHS outcomes framework and indicators for 2016/2017 (DH, 2016b), which set the priorities for the coming year. The key themes were improving health, transforming care, controlling costs and enabling change.

The DH (2016a; 2016b) set out indicators and improvement areas to which NHSE would be held to account, which included:

• Preventing people from dying early;
• Enhancing the quality of life for people with long-term conditions;
• Helping people to recover from episodes of ill health or injury;
• Ensuring people have positive experiences of care;
• Treating and caring for people in a safe environment and protecting them from avoidable harm.

Key components of a business case

The key components of a business case are described in Table 1. It is likely that your organisation already has a business case template; alternatively, examples can be sourced online. Your organisation may also have a template for risk assessment, which will help you identify risks; these may become apparent as you scope the project.

Before you start writing, remember to find out what your local policy is in terms of:

• Processes to follow;
• People to consult;
• Authorisations to be gained.

This will help avoid disappointment if your bid is not well received.

Nurses who want to get involved in writing a business case need an in-depth knowledge of the scope, feasibility and issues of the proposal. This will involve plenty of discussions with stakeholders. It is important to include stakeholders, patients and line managers in any initial discussions and brainstorm exercises. Qualitative and quantitative feedback from patients can give a strong sense of how services work and why gaps in services are a cause of concern.

Many charities aim to support specialist nursing roles and are likely to be able to provide national data, as well as possible funding sources, to support a bid. For example, the British Heart Foundation (2015) has published evidence of the success of the role of cardiac nurse specialists in the community. Nurses considering writing a business case can benefit from seeking advice from charities in their specialist area.

The five-case model

To help public sector organisations bid for funds, HM Treasury has devised the ‘five-case model’ (HM Treasury, 2015). This requires business cases for new initiatives to contain evidence that:

• The intervention is supported by a compelling case for change that fits with other parts of the organisation and the wider public sector – the ‘strategic case’;
• The intervention represents best value for public money – the ‘economic case’;
• The proposed deal is attractive to the marketplace, can be procured and is commercially viable – the ‘commercial case’;
• The proposed spending is affordable – the ‘financial case’;
• What is required from all parties is achievable – ‘the management case’.

Financial considerations

In the current economic climate, nurses are expected to streamline their work to make savings. However, they are not traditionally taught how to be financially astute, and often lack confidence in the area of service development. By developing the confidence needed to deal with financial issues, nurses can influence change in practice and make their ideas a reality.

When writing a business case, it is vital to identify the financial impact and implications – how much is the initiative expected to cost? How much is it likely to save? A new service will need funding, so the costs and benefits of developing it should be fully researched. All financial aspects must be considered, and presented in as much detail as possible. Estimates are acceptable as long as they are based on the most up-to-date evidence available; they can be updated as the project moves forward. If an organisation is going to invest money in a project, leaders and commissioners will want to know the return on investment (Box 1).

Box 1. Return on investment

To calculate the return on investment (ROI), the benefit (or return) of an investment is divided by its cost, and the result is expressed as a percentage or a ratio.

ROI = (gain from investment) divided by (cost of investment)

The ROI provides an evaluation of the benefits of an investment over a period to time, so it can be used to predict savings and indicate value for money.

Source: Investopedia

As the BHF (2017) explains: “the financial section of any business case is crucial and will be analysed closely. When putting this section together, it’s important to get help and advice from your organisation’s finance department to make sure that any additional or hidden costs are stated clearly.’

The financial section also needs continual review, so if things go haywire, the project is rethought, refocused – or ended.

Questions to consider are:

• What are the estimated costs?
• How will the project contribute to savings, and over what time period?
• What is the measure of success?
• What predictions are being made and how have they been calculated?
• What are the opportunities to update information throughout the project?

Practical tips

Below are some practical tips on how to write a business case that will be taken seriously and stand out from other proposals in a board meeting. Some may seem trivial, but decision makers are human beings who all have their dislikes – to make sure nothing is going to trigger the ‘reject’ or ‘delete’ button, you need to:

• Be clear who your audience is and write at their level of understanding;
• Know your specialty and how it fits into the wider context;
• Be concise;
• Be specific;
• Be factual;
• Use reliable sources of data. Avoid anecdotes – but do use case studies if they add to the proposal;
• Know your finances;
• Make the document interesting to the reader;
• Avoid abbreviations (or add a glossary at the end);
• Use the format that is standard in your organisation;
• Check grammar and spelling;
• Get someone to proofread your proposal.

The British Association of Dermatologists has a checklist that helps clinicians maximise the chances of decision makers supporting their business case (Box 2).

Box 2. Business case checklist

• Is the need clearly stated?
• Does the proposal contribute to the achievement of NHS policy and priorities, and the trust’s objectives and plans?
• Are the benefits clearly stated?
• Is it clear how the benefits will be realised?
• Are the demand, capacity and income forecasts robust?
• Are the capital and revenue costs robust?
• Is it clear why the preferred option has been selected?
• Is the project affordable?
• Are the risks and plans to mitigate them explicitly stated?
• Do the main stakeholders support the project?
• Does the team have the capacity and capability to deliver it?

Source: Adapted from the British Association of Dermatologists

Another useful checklist is the SMART acronym, according to which your project needs to be:

• S – specific
• M – measurable
• A – achievable
• R – realistic
• T – time-bound

What is the value of specialist nurses?

When writing a business case, you may want to demonstrate the value there is in employing specialist nurses. The Royal College of Nursing (2010) has identified that the role can save money, arguing that it helps to:

• Reduce waiting times;
• Avoid unnecessary hospital admissions or readmissions (through reduced complications post surgery, enhanced symptom control and improved patient self-management);
• Reduce the length of post-operative hospital stays;
• Free up consultant appointments for other patients;
• Deliver services at the point of need or in the community;
• Reduce patient drop-out rates;
• Educate health and social care professionals;
• Introduce innovative service delivery frameworks;
• Give direct specialist advice to patients and families.

The BHF (2015) adds that specialist nurse roles are also important in providing care throughout patients’ disease trajectories, from diagnosis to end of life.

There have been concerns that the role of specialist nurses may become overlooked or misunderstood and, in 2014, the RCN highlighted that funding issues were having a negative impact on the role, stating that we were in a situation: “whereby funds are being transferred from the NHS for integrated health and social care with no guarantee that the money will be spent on care provision” (RCN, 2014).

There are different ways to approach integration across organisations, services or between individuals, and different models have been successfully implemented in the UK and beyond (Goodwin and Smith, 2011). The RCN calls for nurse-led teams in hospitals and the community, and in specialist services to develop working relationships and collaborate across health and social care (RCN, 2014).

As Fletcher (2011) pointed out, specialist nurses are held in high regard by patients, and consistently so, compared with other health professionals. It is crucial to gain feedback from patients. However, as Fletcher explained, this feedback in itself is not sufficient evidence for commissioners, as it can be considered anecdotal, and specialist nurses: “need to ensure they have evidence their services are cost-effective and improve patient safety and outcomes.”

Writing a business case can be frustrating. It is made easier by engaging decision makers from the outset to ensure the proposal is set within the national context and identify how it will help the organisation to reach its targets.

You will need to gain the right strategic support and source as much accurate data and information as possible. Researching ideas, gaining feedback from stakeholders inside your organisation and, where possible, influencing people from partner organisations, will help your project gain momentum. Involving patients and getting qualitative feedback to support the quantitative data will enhance your proposal.

Nurses are often reluctant to write business cases, and it mainly falls to leaders or commissioners. However, with the right support, they can develop the confidence to articulate a service development idea formally and bring it into the strategic arena.

• A business case is a formal document submitted to decision makers for approval and/or funding of a service development initiative
• A convincing business case must link the proposed service improvement to local, regional and national priorities and constraints
• The financial section of a business case will be analysed closely, so costs and benefits need to be made clear
• If nurses learn to articulate the needs of their services in the language of financial constraints, they have a good chance of securing funding
• The current move towards more integrated health and social care means this is a good time for nurses to try to influence decisions

• Test your knowledge with Nursing Times Self-assessment after reading this article. If you score 80% or more, you will receive a personalised certificate that you can download and store in your NT Portfolio as CPD or revalidation evidence.
• Take the Nursing Times Self-assessment for this article

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Sample Business Plan Outline

In general, a good business plan includes the following topics:, i. executive summary.

• This contains a brief description of your business, a plan of action (if applying for loan, describe purpose(s) of loan), and why you think this plan makes sense.

II. Ownership

• Who owns the business
• What type of organization is it? (proprietorship, partnership, corporation, limited liability)
• The division of responsibility between owners/employees (if applicable)

III. Description of Business

• History of business
• Products/services presently offered described in detail and briefly whom you sell to and how (store, shows, catalog, wholesale, cold calls, etc.)
• New products/services described & brief description of customers and sales methods
• Number of employees and if planning to expand, increase in jobs
• Suppliers & inventory levels/turnover
• Facility – (own or rent, description of location, size, special features)
• Improvements planned (if applicable)
• Equipment owned
• Equipment you plan to purchase (if loan is for equipment)

IV. Market information

• [To help you write a complete Marketing Plan, visit  Creating a Marketing Plan  in our Resource Center.]
• Industry - (depending on type of business, may not apply)
• Industry outlook (nationally, statewide, locally -if applicable)
• Factors affecting the industry currently (supplies, changes in legislation, market trends, new technologies)
• Your customers
• Describe major customer groups in detail (i.e. by age, geography, income, business type, sex, local or tourist, wholesale or retail) and assign percentages to each group (for example, 40 percent local, 60 percent tourist)
• Buying patterns for each group (season, time of day, day of week, how often, etc.)
• Why these customer groups choose your business
• Trends affecting their choices/decisions/behavior
• Your competitors
• List your major competitors and describe how their businesses are similar/different to yours
• Describe where your business fits into the market
• Discuss your strengths/weaknesses relative to your competitors and how you will use/improve them
• Describe your relationships with your competitors
• Your marketing strategy
• Your image, advertising/promotion plan, and pricing and how they match your target market(s)
• Detail on how you sell, distribute, and service your product/service and why
• Sales goals, strategies for the next year 

V. Management

• Include a resume which describes your relevant experience and education
• Key personnel and their job descriptions (if applicable)
• Describe accounting and record-keeping systems
• Other relevant management systems or techniques (inventory, production, etc.)

VI. Financial information

• Your past three years of tax returns
• Past three years of business tax returns (if applicable)
• Balance sheet  and income statement (if available)
• Source and use of funds  (if plan is for financing/start-up or expansion)
• Include estimates for purchases of equipment, renovations, etc.
• Lists of inventory, supplies, etc
• Projections
• Sales goals, in dollars and units (if applicable)
• Break-even analysis , if new business
• One-year, monthly cash flow projection
• Projected balance sheet/income statement (if applicable)

VII. Other Information

• Lease Agreement or a Purchase & Sales Agreement
• Sales materials (brochures, sell sheets, price lists, etc.)
• Pictures of products
• Pictures of facility
• Customer lists
• Letters of commitment or contracts
• Letter of recommendation
• Market research data
• Other, as appropriate
• Business planning

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Business continuity

Information last updated: 20 April 2023

NHS England business continuity management toolkit

This document highlights the need for Business Continuity Management (BCM) in NHS organisations so that they can maintain continuity of key services in the face of disruption from identified local risks. Under the Civil Contingencies Act 2004 and the Health and Care Act 2022 , all NHS organisations have a duty to put in place continuity arrangements. The toolkit is driven by the Plan, Do, Check, Act (PDCA) cycle along with being updated in line with both ISO 22301 principles , as well as the Business Continuity Good Practice Guidelines 2018 .

• View and download: NHS England business continuity management toolkit

Below are sets of supporting documentation to be used as part of the NHS England business continuity management toolkit.

Part 1 of the supporting documentation refers to the ‘Plan’ aspect of the PDCA cycle. Here is where an organisation establishes the Business Continuity Management System (BCMS) by developing a policy, as well as using documentation and templates. This section also allows organisations to embed Business Continuity into their culture.

• Resource A – Business continuity management system
• Resource B – Business impact analysis templates (basic, directorate and interruption)
• Resource B – NHS business impact analysis template
• Resource C – business continuity plan checklist
• Resource D – site business continuity plan template

Part 2 of the cycle is attributed to ‘Do’ element of the PDCA cycle. This section defines business continuity requirements, determines how to address them and develop procedures to manage a disruptive incident. Once your BCMS is designed, it is necessary to implement it successfully. In order to do this, NHS organisations should understand their role and how to complete documentation that is required for the BCMS to be effective.

• Resource A – business continuity management NHS workshop slides
• Resource B – business continuity workshop delegate book
• Resource C – business continuity facilitators guide

Part 3 focusses on the ‘Check’ aspect of the PDCA cycle. This part of the cycle summarises the requirements necessary to measure business continuity management performance for an organisation. It also links to the BCMS compliance and seeks feedback from top management regarding expectations, gaps and inconsistencies.

• Resource A – business continuity exercise staffing reduced availability
• Resource B – business continuity exercise services and suppliers
• Resource C – business continuity exercise – premises unavailable
• Resource D – business continuity exercise – information (unobtainable) and information systems (unavailable)
• Resource E – internal audit checklist

Part 4 of the PDCA cycle refers to ‘Act’. It identifies and acts on BCMS non-conformance through corrective action. The review of your system also allows the potential to make changes based on updated guidance and changes to the organisation.

• Resource A – business continuity debrief template
• Resource B – business continuity action plan template
• Resource C – business continuity management review and potential evidence

Case studies have been put together from various incident debriefs across NHS organisations. This is to provide examples of approaches to incident reports and allow identification of learning across organisations. There are a wide range of examples including WannaCry, utility disruption, power loss etc.