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

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

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

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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