To: General Managers, Planning & Funding
Purpose: / National Services Business Case - majorPaper title:
Author/s:
Ministry of Health principal reviewer:
Date of meeting:
For your: / Discussion ( ) / Decision ( ) / Noting ( )
DHB Attendees to present to GMs: / (Please insert names and titles)
Presentation equipment required: / (Please advise equipment required)
Ministry review checklist (signature and clearly written name)
Pricing Programme / ___/___/___ extn:
Capital & Funding / ___/___/___ extn:
Office of the Chief Medical Officer / ___/___/___ extn:
Service Commissioning
Other / ___/___/___ extn:
Other People consulted
Name / Position / Business Unit / Extn
Presentation History
Version / Date/s previously presented / Reason rejected
National Service
Business Case
Major
[name of business case]
This business case sets out the justification for funding for more than $500,000 per annum:One off / (select 1) / (insert estimated value)
Up to 3 years / (select 1) / (insert estimated value)
Ongoing / (select 1) / (insert estimated value)
Prepared by:
Prepared for:
Date:
Version:
Status:
DHB Sign Off (signature and clearly written name of those that have endorsed the business case)
Role / Name / Date / Contact
Service Manager / Delete if not applicable / ___/___/___
Clinical Director / Delete if not applicable / ___/___/___
Director, Planning & Funding / ___/___/___
Chief Operating Officer / ___/___/___
Chief Medical Office / Delete if not applicable / ___/___/___
Chief Financial Officer / ___/___/___
Chief Executive Officer / ___/___/___
Contents
Section 1: Document Control
Section 2: Summary
Section 3: Strategic Case (Case for Change)
Section 4: Financial Case
Section 5: Economic case (assessment of options)
Section 6: Risks
Section 7: Delivering the Change
Section 8: Appendices
Table 1: Cost of proposal
Table 2: Chase for change
Table 3: Revenue
Table 4: Cost gap assessment
Table 5: Options identification
Table 6: Options assessment
Table 7: Cost of preferred option
Table 8: Monetary benefits of preferred option
Table 9: Non-monetary benefits of preferred option
Table 10: Risks
Table 11: Implementation timeframe
Table 12: Stakeholders
Table 13: Communication approach
Section 1: Document Control
This document has been developed for consideration by the Ministry of Health and General Managers Planning & Funding, for a designated National Service.
Document HistoryVersion / Issue date / Changes
Document Reviewed By:
Role / Name / Date / Contact
___/___/___
___/___/___
___/___/___
___/___/___
___/___/___
___/___/___
Supporting Documents (list any relevant)
Title / Author/s / Date of release / Document
Section 2: Summary
2.1 Key points
List the key points in the business case?
2.2 Executive summary
Provide a brief (1 page) summary of the key points, findings and recommendations
2.3 Background
Describe what you are requesting and why – what is the background that has led to the development of the business case?
What are the key links to patient/DHB/Triple Aim/Health Strategy goals?
2.4 Purpose
The purpose of this business case is to seek agreement for[describe here what you are requesting funding to support.
2.5How much will it cost?
The proposal is for a one off / two year / three year / ongoing(select one) investment. The annual estimated cost of this proposal is summarised below:
Table 1: Cost of proposal
Year / Amount / Description of servicesYear 1
Year 2
Year 3
Total
Section 3: Strategic Case (Case for Change)
3.1 Goals
Discuss the overarching goals and/or health sector priorities that this business case will support – how does this link to DHB priorities and the New Zealand Health Strategy
3.2 Benefits
What are the key benefits that will be achieved for patients of the Service? How critical is this?How will you achieve and maintain equity of access?
3.3 Status Quo
What is the existing model of care, service model or arrangement? What opportunities to improve performance and get better value have already been implemented? What are the problems with maintaining the status quo?
3.4Service Needs
Provide a robust and compelling case for change that demonstrates:
- The populations currently receiving the service, including levels of access and achieving or improving equity
- a thorough understanding of the model of care the service is seeking to achieve
- how this differs from the current model of care (existing arrangements)
- the difference between the two, which represents the service gap (or service needs) that this proposal is intended to address. This gap analysis assists in providing a compelling case for change based on better outcomes for patients/service users.
Use data to support the current situation and the impact where appropriate, including a DHB population breakdown of the current state, levels of access and desired outcomes.
3.5 Case for Change
The case for change is summarised below.
Table 2: Chase for change
Investment Objective One / What you are seeking to achieve?Existing Arrangements / Summarise the current state.
Business Needs / Describe the business gap, the difference between the current state and the desired future state.
Potential Scope / What degree of change is required to successfully achieve the objective? What is a core must have? What is desirable, aspirational or out of scope?
Potential Benefits / If the objective is successfully achieved, who will benefit, how and how we measure the gain (or loss)?
Potential Risks / What contingent events could impact on the achievement of the objective?
Constraints and Dependencies / What are the limiting parameters within which the investment must be delivered? What other actions outside the scope does success depend on?
3.6 Measuring Success
The overall outcomes supported by the proposal are[your text goes here]
Describe the baseline performance in these measures, and the level of improvement projected – include data/graphs
3.7 Collaboration and consultation
How does this proposal relate to other projects or programmes that are in place or being developed?
How might this proposal impact on other DHB services, including requirements for changing models of care for these patients, different provision of support services, different technology impacts
What consideration has been given to collaborative or shared care models with other DHBs, particularly in outreach situations. Summarise why these are/are not being pursued.
What are the longer term plans for the service? Is there opportunity for the model of care be localised at some point in the future, providing care for patients closer to home?
What consultation has occurred with interested stakeholders in developing this proposal.
Section 4: Financial Case
4.1 Revenue
Describe the financial situation, including all current sources of revenue received to provide the service, how the revenue is used/distributed and factors influencing access to revenue.
Describe the actual funding allocated to the DHB for the Service
Table 3: Revenue
Funding type / Year before last / Last year actual / This year planned / Next year plannedTop slice
Programme fee
DRG
Tertiary Adjustor
Non DRG
ACC
Other
Total Revenue
4.2Service Cost Gap Assessment
Describe the factors impacting on the cost of providing the service, including fixed and variable costs. Insert additional rows into the table, or attach relevant spreadsheets or data if required.
Where costs have exceeded revenue, describe actions taken to manage or reduce costs.
Table 4: Cost gap assessment
Funding type / Year before last / Last year actual / This year planned / Next year plannedTotal Service Revenue
Direct costs (minus margin)
Overhead
Total Service Costs
Variation
4.3Financial Justification
Describe why the service needs or proposal cannot be managed within existing funding, including steps taken to achieve greater efficiency or reduce costs.
Section 5: Economic case (assessment of options)
5.1Options identification
Describe the steps taken to develop a range of options and prioritise these for consideration. Describe the how the options will/will not address the service needs and realise the benefits. Classify options according to the following
Table 5: Options identification
Dimension / Description / Options within each dimensionScale, scope and location / In relation to the proposal, what levels of coverage are possible and how will equity of access be managed?
Service solution / How can services be provided?
Service delivery / Who can deliver the services?
Implementation / When can services be delivered?
Funding / How can it be funded?
5.2Options assessment
On the basis of the initial assessment of the long-list options (by dimension), the following short-listed options were selected for further economic analysis.
Table 6: Options assessment
Option 1: Name (status quo)Description
Advantages
Disadvantages
Conclusion
Option 2: Name (preferred)
Description
Advantages
Disadvantages
Conclusion
Option 3: Name
Description
Advantages
Disadvantages
Conclusion
Option 4: Name
Description
Advantages
Disadvantages
Conclusion
5.3The Preferred Option
Each option has been assessed and the economic case is outlined in the tables7-9 below. The options analysis uses the following assumptions:
Describe assumptions
The preferred option is (name option) because(describe why preferred over other options)
5.4Costs of the Preferred Option
Provide a breakdown of costs of the Preferred Option in Table 7. Describe the justification for these costs and any factors influencing costs in any area.
Table 7: Cost of preferred option
Year 1 / Year 1 / Year 3 / Out yearsCapital Costs
Personnel Costs
Other Costs
Total Costs
5.5Monetary benefits of the Preferred Option
Describe any monetary benefits from the proposal/investment in the table below, how these were assessed and any assumptions that apply
Table 8: Monetary benefits of preferred option
Monetary Benefits / Estimates and Timing / Description5.6Non-Monetary benefits of Preferred Option
Describe any non-monetary benefits from the proposal/investment in the table below. Describe how non-monetary benefits were assessed, and any assumptions that apply.
Table 9: Non-monetary benefits of preferred option
Non-monetary Benefits / DescriptionSection 6: Risks
6.1 Proposal risks
Describe any risks associated with the proposal, including operational, implementation and other risks, and any mitigations.
Table 10: Risks
Risk description / Rating / How risk will be managed6.2 What risks will the proposal mitigate?
The proposal will mitigate the risk of [describe the consequence of doing nothing]Consider what this may mean for current patients of the Service, and potential new patients.
Section 7: Delivering the Change
7.1 Implementation
Describe the intended implementation or change process that is expected if the proposal is accepted.
Consider and describe the following:
- reporting and monitoring changes and how performance, including activity, quality and equity, will be monitored
- recruitment requirements, steps and anticipated timeframes – describe contingencies if recruitment is not successful
- internal DHB changes required to achieve the described outcomes
- how changes will be communicated to referrers
- how changes in provision of outreach services (if applicable) will be managed
Include a description of the anticipated timeline for completing the implementation, and achieving improvement.
Table 11: Implementation timeframe
High-Level Milestone or Deliverable / Target Date7.2 Stakeholder engagement
Describe stakeholders critical to implementation of the proposal, their relationship and the planned engagement approach.
Table 12: Stakeholders
Stakeholder / Relationship to Project / Engagement ApproachPerson or group / They’re the intended end-users
They’ll be an interested party because
They’ll be an affected party because
Their support is crucial to
7.3 Communication approach
Describe the intended implementation or change process that is expected if the proposal is accepted.
Table 13: Communication approach
Audience / Communication outcomes / ApproachWritten communication
Meetings
Workshops
7.4 Progress reports
Describe how you will report back to the NHB and Funders on:
- the status of the change programme
- how you will measure and report on levels of patient activity and access by domicile
- identified measures of success (as identified in section 3.6)
- achievement of non monetary benefits (as identified in section 5.6)
- realisation of monetary benefits (as identified in section 5.6).
Section 8: Appendices
Supporting Documents (list any relevant)Title / Author/s / Date of release / Document
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