Building a business case

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Business case definition

“A compilation of information to enable a decision to be reached in terms of making a change that affects the organisation. All key data is brought together and laid out so as to enable a methodical and objective review of the key determinants as required, in order to reach an informed decision.”

What is a Business Case for?

The Business Case serves at least one of 2 possible objectives

  1. To fix a problem

Classic problem-fixing objectives of the business case could be: remain compliant; be more effective; create greater efficiency; improve patient flow; improve patient experience; improve staff experience; save money; be more competitive; remove an ineffective service

2.  To exploit an opportunity

Typical opportunities: develop a new service; create a new revenue stream

Free prose or proforma format?

A Business Case may have to be written within your designated Trust proforma or alternatively, your Trust/Organisation may opt for a free-form approach, where you decide the content and headings. Both approaches have their benefits and draw-backs, but you will need to be guided here by your Organisation’s preferred approach

What is it essential to remember?

When writing a Business Case always remember to align your proposal to the wider goals of the Trust

Your Trust or Organisation will have to invest money in order to be compliant, but a Business Case may still be required

Beyond compliance –and in the current economic reality – whilst your proposal should ensure that patient safety and/or quality is safeguarded or improved, your Business Case will ideally be saving money or else by creating incremental income for the Trust.

Who writes a Business Case?

Head of Service, in the case of LKS. In non-LKS Business Cases, it’s often the Ops Manager. Specialist help can be given by your Finance Manager and other opinions sought in order to compile the Business Case

Who contributes to a Business Case?

Most stakeholders – who inputs depends on who is affected by the case. A robust Business Case has a high degree of input and consultation included before being signed-off for presentation to the evaluating panel

Who evaluates a Business Case?

Usually the executive members of the Board or a similarly senior panel.

Stages within the Business Case

There are a number of elements within the Business Case, which hang together in a logical sequence to make a compelling and structured argument for change. They are all identified in the NHS Innovation document (link below).

This helpful document also contains guidance on completing each section of the Business Case.  It is worth remembering that not all the sections suggested will be relevant or necessary for every Business Case.

The NHS Innovation Business Case guidance notes can be found at

Tips for approaching the writing of the business case

  • Make it interesting –someone has to read this Business Case thoroughly and maybe many others on the same day.
  • Make it clear and concise.
  • Make the links explicit as to how your Business Case initiative helps support your organisation in achieving its wider goals and mission
  • Write the Executive Summary last. It’s just easier to write in retrospect, when you’ve laid out the whole narrative
  • Involve the team and possibly other potential stakeholders in writing parts of the input to help with buy-in, but keep overall editorial control to ensure there is only one consistent style of writing throughout
  • Minimise jargon and conjecture or unsubstantiated opinion.
  • Communicate all facts as part of the overall story
  • Show you’ve done your homework but don’t let the detail bog-down the narrative. Add-in items that act in support of the document, but aren’t essential to the narrative, as appendices
  • Provide the reader with a picture or clear vision of the end position i.e. what you’re looking to achieve.
  • If possible, demonstrate the value the project brings to the organisation and its financial bottom line (the Return on investment or ROI). In simple terms, ROI means “how many £ pounds will we as an organisation get back for every £ pound we’re required to invest in this idea?” An NHS ROI calculator can be found at
  • Demonstrate that it improves quality through innovation, improving productivity and prevention (QIPP)
  • Always provide the panel with a view on the options you have considered (as well as indicating your preferred option). One option should be to highlight the ramifications if we ‘Do Nothing’

Useful links: