Making a Business Case

Details of the developer and other partners to the schemeKey areas to include:

  • Background
  • Executive summary
  • Strategic context
    • for example will help meet performance targets, will help patient safety
  • Development proposal
    • Brief description of the options
  • Preferred option
    • Reasons for choosing the preferred option
  • Details of the proposed development
  • Details of the developer and other partners to the scheme
  • Legal and financial implications and affordability:
  • Funding options
    • Details of funding streams to be provided for the scheme, e.g. 3PD, Local Authority grants, private loan arrangements, lease rentals from proposed tenants, etc
  • Timetable
  • Management arrangements
  • Other resource implications
    • Need for additional clinicians, administrative staff, etc
  • Risk assessment
    • An assessment of any factors that are likely to have a significant impact on the scheme
  • Key benefits and outcomes
    • Summary of the main beneficial aspects of the development scheme including improvements in patient satisfaction, quality of care, staff morale, operational aspects such as faster response to enquiries to patients, communications etc
  • Conclusion
  • Appendices

**Taken from ‘The Knowledge’ management booklet**

Example management exam questions:

  1.  You are keen to have a CDU in your department as you feel that it would help.  Currently all patients are referred to the medics/surgeons or breaching if they go beyond 4 hours


Background: this is quite a common solution that many departments have used to address their 4 hour wait.  Unfortunately it is not always possible to process patients in 4 hours.

Executive summary: Summary of all the points below

Developmental proposal: the options available

  1. Ward style option: beds, toilet facilities, fully nursing staffed.
  2. Chaired area only for patients expecting to go home but awaiting results or attending for ambulatory care.
  3. Combination of the two options

Preferred option: will entirely depend on the demographics and acuity of patients who are waiting in the department more than 4 hours.  Is there a bed issue with inpatient specialties?  In which case it could be argued that funding for another ward would be better spent on inpatient beds and a chaired area is appropriate.

Details of the proposed option – need to go into considerable detail with regard to funding, plans, where, when, how, staffing,

Legal and financial implications and affordability – this will be where the business manager can help!

Funding options: again where the business manager can help!


Management arrangements: likely to be managed by the ED but there may be a shared space arrangement

Other resource implications e.g. need for additional staff (medical, nursing, clerical)

Risk assessment: would be tailored individually

Key benefits and outcomes: in this case – better flow, better morale, better patient care,