The Business Case: A Dynamic Process, Not Just a Product

17th July 2024
Medical team sat around table and in discussion
Jo Gibson
Jo Gibson, Managing Consultant and Lead for Business Cases at the NHS Transformation Unit

When we think of a business case, it’s easy to imagine it as a finished product – a polished document meticulously crafted to persuade decision-makers. However, it’s important to recognise that the development of a business case is not just about producing a final product. It’s a dynamic and iterative process – a journey of exploration, analysis, collaboration, and adaptation that shapes decision-making and drives organisational change. Let me talk you through the journey as I see it.

1. Framing the Vision:

The journey begins with framing the vision—a process of identifying opportunities or challenges and defining the desired outcomes. It involves strategic thinking, stakeholder engagement, and a deep understanding of the strategic context in which the proposed initiative will operate.

2. Exploration and Discovery:

With the vision defined, the next step is exploration and discovery. This phase is about gathering information, conducting research, and analysing data to understand the problem or opportunity thoroughly. It’s a collaborative process that involves seeking insights, challenging assumptions, and exploring different perspectives – all with an eye towards the potential benefits that could be realised. Through this process the case for change will emerge and spending objectives will be agreed.

3. Generating Options:

Once the problem or opportunity is understood, the focus shifts to generating options. This can involve both creativity and logic – a balance between exploring innovative ideas and systematically evaluating them. Evaluation criteria may include factors such as feasibility, effectiveness, affordability, value for money and alignment with strategic objectives. Options that do not meet the criteria are eliminated from consideration at this stage, with the aim of getting to a short list of options and some comparators such as ‘Do Nothing’. This forms the first step towards generating the Economic Case.

4. Evaluating Alternatives:

Each option is carefully assessed, with a key emphasis on conducting a comprehensive cost-benefit analysis. This analysis serves as the foundation of the Economic Case, enabling decision-makers to balance the financial costs against the expected benefits of each option. By thoroughly examining the associated costs and potential returns or savings, the most suitable and advantageous option can be recommended. This analytical approach ensures that decisions are informed by a detailed understanding of the economic implications and are aligned with the overarching objectives of the proposed initiative.

5. Iterative Refinement:

The process of developing a business case is inherently iterative. It requires continuous refinement and adjustment based on feedback, new information, and changing circumstances. This iterative approach ensures that the business case evolves in response to emerging insights and stakeholder input, leading to more informed decision-making. For Green Book business cases, the HM Treasury gateways – SOC (Strategic Outline Case), OBC (Outline Business Case), and FBC (Full Business Case) – provide a structured approach to project development and decision-making. The SOC outlines the project’s strategic context and options, the OBC delves into detailed analysis and proposes a preferred option, and the FBC presents a fully costed and detailed business case. These gateways ensure that projects progress through rigorous assessment stages, enabling informed investment decisions based on evidence and analysis.

6. Collaboration and Engagement:

Throughout the journey, collaboration and stakeholder engagement are essential. Effective engagement with a range of users fosters buy-in, alignment, and support for the proposed initiative. It ensures that diverse perspectives are considered, concerns are addressed, and decisions are informed by a holistic understanding of the context.

7. Decision-Making and Implementation:

Ultimately, the culmination of the business case process is decision-making and implementation. Decision-makers weigh the evidence, evaluate the trade-offs, and make informed choices about whether to proceed with the proposed initiative. Implementation involves translating the decision into action, mobilising resources, and managing the execution of the plan.

8. Continuous Learning, Improvement, and Benefits Realisation:

The journey doesn’t end with decision-making and implementation – it extends into the phase of benefits realisation. This involves monitoring the actual outcomes achieved against the projected benefits outlined in the business case, with a focus on learning and improvement to optimise benefits delivery over time.

In conclusion, the business case is not just a static product but a dynamic and iterative process that guides decision-making, drives change, and unlocks value. But let’s not forget that it’s vital to ensure that the business case we produce is proportional to what we are trying to achieve. Thorough analysis is crucial, but it should match the initiative’s scale and impact. Striking the right balance ensures that resources are used efficiently, and decision-making remains pragmatic and agile.

The NHS Transformation Unit is here to support other health and care organisations, providing guidance and assistance tailored to their needs. We have experience with full HM Treasury green book cases and short-form business cases, ensuring proportionality and value for money. Please get in touch for a conversation to see how we can help you achieve your business case goals.

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