Implementing Telecare
Develop the business case for service re-design

While senior management may agree to an expansion in principle, they are likely to require to be convinced that this will be a good use of resources before they formally commit to them. The same is true if funds are sought from another agency or from central government. A business plan, or business case, is a written document that summarises the case for expanding the service in a particular way, what it is likely to cost, and how it will be done. It draws together the information supporting the project in a single, coherent document that can later guide many implementation activities. It is likely that, in the context of local telecare projects, the business case may take the form of a report to the telecare project steering group, and / or local authority or NHS board committees.

A typical business case will contain six elements:

Executive summary

A brief overview of the expansion project, how it relates to the early implementation and to related activities of the authority, with recommendations for progressing.

Focus of the proposed expansion

Which population groups, the likely benefits of the change to them and to other stakeholders, what the expansion will consist of – numbers, locations etc, also justifying the reasons for focusing on this group of the population, rather than others. It can also show how this builds on the lessons from the initial implementation.

Analysis of the context

How this fits to other initiatives and changes, in the authority and in health care, local and national strategies, demographics, dependencies, other installations that have produced good results, and so may support the case here.

Description of the expansion

How it is going to be achieved – changes in service delivery methods, technology, working processes, staff etc – an indication of all the likely changes required. Also describe who will be involved, and how the change will be managed – the steering group, project team, project lead.

Financial implications

What the project will cost and the timing of the expenditure. This needs to include not only the initial and subsequent capital cost for equipment, but estimates of future revenue expenditure on staff, training, maintenance, building and installation etc. Under-estimating these might help the project to be approved, but will lead it to difficulties later, when expenditure is required, but there is no budget. Check widely with users of similar systems to identify as fully as you can the costs likely to be incurred. A convincing statement of how the capital and revenue costs will be met – government grants, health boards, local authority, housing association, charitable bodies etc. will be most influential.

Also identify and calculate the efficiencies which may plausibly arise from the expansion – reduced use of care homes, fewer delayed discharges etc – and which agencies will benefit from these – based on a plausible evidence base.

Supporting documentation

This can help the case, either by providing more detail on summary tables in the text, or by showing photographs, case histories, charts and other visual tools which make the story more accessible and convincing.

See Tool 16 on the next page for a summary table of the key aspects of a business case which need to be included.