Making Robust Decisions: Securing Capital Investment

21st June 2023

In June 2021, NHSX commissioned the Transformation Unit to support the PODAC Team (a team working across Pharmacy, Optometry, Dentistry, Ambulance and Community Services) to create a business case. The purpose of this business case was to help to secure the funding needed to transform the way the sectors worked. There was a need to invest in maturing digital capability to improve connectivity between health and social care systems. This would improve the way patients received care, and ultimately deliver a better patient experience.

The Challenge

The NHSX Digital PODAC programme needed support to produce a HM Treasury Green Book compliant business case. This approach uses a ‘five-case model’ that aims to explore the proposal from five different perspectives.

The Five Case Model:



The purpose of the business case was to justify the investment needed to implement the 3-year digital strategy for the five sectors. This strategy described the ambition of investing in the PODAC sectors enabling them to be more in line with other primary care and acute services in their use of digital tools and systems. This investment would facilitate better and more efficient processes and ways of working. It would also ensure continuity of the PODAC Team’s work after October 2021.

Our Approach

The TU worked alongside the NHSX and NHS Digital PODAC teams to produce the necessary inputs to the business case. We also engaged with wider stakeholders from across NHSX, NHS Digital and NHS England which helped to produce a high-quality business case. Our support Included:

  • Overall coordination and authorship of five case model business case
  • Facilitating workshops to agree spending objectives and critical success factors
  • Designing and facilitating a robust options development approach
  • Appraising the long list of options against the critical success factors to determine a short list of options
  • Conducting an economic appraisal of the short-listed options
  • Facilitating workshops to identify benefits using a logic model approach
  • Quantifying benefits based on local knowledge and national benchmarks
  • Working with the project team to cost the initiatives
  • Providing robust modelling including benefits, costs and risks
  • Demonstrating affordability and compiling the financial statements
  • Facilitating agreement of the preferred option
  • Socialising key inputs with stakeholders
  • Engaging with NHSX, NHS Digital, DHSC Assurance SMEs to ensure business case was fit for purpose and sufficiently robust for formal assurance processes
  • Finalising the business case in response to comments from formal assurance and review


The Outcome

We secured an investment of £30.3m approved by the NHS England Investment Committee. The programme has now progressed to Year 1 of implementation.