Endoscopy - writing a successful business case to increase capacity
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Presentation from NHS Improvement endoscopy workshop held at Ambassadors Hotel, London on 29 January 2013 http://www.improvement.nhs.uk/diagnostics/EndoscopyImprovement/Events.aspx Writing a successful business case Dr Roger Prudham The Pennine Acute Hospitals NHS Trust
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Endoscopy - writing a successful business case to increase capacity
- 1. Writing a successful business case Pennine Endoscopy
- 2. Confession
- 3. About us.. • One trust Pennine Acute • 4 Hospitals • 4 endoscopy units • 800k pop • 24000 scopes pa • Directorate of Gastro & Endoscopy 2009
- 4. About us.. • 10 endoscopy rooms • JAG accreditation & BCSP threatened by timeliness issues • Reliant upon WLIs • WLIs affect Service Line
- 5. Problems… • Unprofitable service line • Increasing demand • NAEDI • Age Extension
- 6. Causes • Clinical variability • Organisational inertia due to WLIs • Perverse incentives
- 7. Solutions • Remove variation • Improve standards & quality • Achieve JAG for all 4 sites • Pull capacity into funded sessions in working week • Increase capacity
- 8. 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)
- 9. 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
- 10. 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
- 11. 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
- 12. Making the Case • MARKET POSITION (Internal & External) • BROAD FORMULATION OF OPTIONS – Risks & advantages for each • FINANCIAL ASSUMPTIONS • FINANCIAL ANALYSIS
- 13. 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
- 14. Making the case
- 15. 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
- 16. Summary • Tedious but necessary • Team approach essential Thank you for your attention!