New guidance promotes greater alignment of service change and capital business cases in the NHS16/05/22
NHS England and Improvement (NHSEI) has published an addendum to its service change guidance “Planning, Assuring, and Delivering Service Change for Patients”. The addendum seeks to improve the alignment of service reconfiguration and capital business cases and the evaluation criteria that are used to identify preferred options. This clarification will benefit programme managers and directors working on business cases for planned service changes, including those under the New Hospital Programme.
When do I need to prepare a business case?
Where proposed service changes require capital investment there is a need for a pre-consultation business case (PCBC) and a capital strategic outline case (SOC). The PCBC provides the information that enables the decision-maker to decide whether the programme can go to public consultation. The SOC is the first step in the capital approval process, which may require NHSEI, and possibly the Department of Health and Social Care (DHSC) and HM Treasury (HMT) approval.
The approach to alignment of business cases is illustrated in this diagram.
How will the addendum impact on my business case?
The addendum explains that for schemes requiring both service change and capital investment, relevant SOC guidance should be used to construct the PCBC. In most schemes requiring capital, the PCBC should align with the SOC requirements set out in the HMT Green Book guidance.
When preparing the PCBC, advice and input should be sought from NHSEI (and through them, DHSC and HMT if appropriate). In order to further support the alignment of the PCBC and SOC, the addendum advises that the SOC should take more of a system view, rather than having the traditional provider/trust focus.
Finally, the addendum includes an appendix setting out fundamental criteria to help assess whether the business case is sufficiently complete to progress through to the detailed review and assurance process. The appendix includes criteria for cases that only require a PCBC or a SOC, as well as those cases where both PCBC and SOC are needed.
How Capsticks can help
We regularly advise on the content and preparation of business cases to support major service change and capital investment, including for projects under the New Hospital Programme. Business cases can be subject to legal challenges – to avoid this, we can help you to ensure that your business cases are compliant with legal requirements in respect of public involvement and consultation, equalities and inequalities and the requirements of HM Treasury’s Green Book.
For more information please contact Peter Edwards, Matthew Hunter or Lee Clarke to find out more about how Capsticks can help.