Sunday 20 April 2008

Making the case - what would happen without your service?

This blog will form a part of Chapter 5 of a forthcoming book – watch this space!

A useful tool, and vital for making a business case, is Contrast. Make your case using a hypothesis, for example the usual null hypothesis – “what if nothing happened?”
This doesn’t necessarily mean “what happens at the moment?”, as your business case may be a way to survive or thrive during a forthcoming change. To use a commercial example, you may put together a business case to stock warm coats on the basis that weather forecasters predict a colder than usual winter. But it’s summer at the moment, so nobody’s asking for warm coats. This means “what would happen/ will happen if your solution wasn’t available?”.
We’re considering primarily services which benefit the health, well-being or empowerment of people, services for the public good such as schemes which make life bearable for family members who care for others, or schemes that help society to function in a more creative, productive or engaged way such as networks which give voice to many small groups of people. Without the service you are proposing (may already have running on a small scale and want to expand), what happens or will happen?
Carers who are family members
  1. may feel they have no choice in the matter and
  2. can’t take a break from 24 hour caring
Does this mean they succumb to the pressure and end up making too much use of the mental health services? What does this mean in terms of worklessness, in terms of the cost of care, and if you can quantify it, in terms of simple human misery? Do disaffected groups turn to extreme measures to get their voices heard, such as graffiti or destruction? Or do they just refuse to contribute, with the misery and cost of repairing neglect that that entails? Are there services already in place which address the issues, and if so what about the service you want funding makes it worth funding (better tailored to the needs, delivers more benefit for the same resource input or less resource input, more scaleable, fills a specific gap freeing up the existing services for more appropriate needs)?

It can be difficult to quantify, but this is the nub of how value can be added.
Start by a straightforward SWOT analysis (if it’s common sense, it’s probably right – if it looks like rocket science and you aren’t trying to put a rocket into space, then wonder about the advice given). What are the strengths of your solution, and the strengths of the alternatives? List as many things as you can for each of strengths and weaknesses. It is entirely appropriate to look at these in all four areas: Health and Well Being Outcomes, User Experience, Opportunities for Staff and Resources, and Resource Implications (costs, or shortages of the right skills). If all the Strengths are in the “Opportunities for staff” quadrant then are you really doing this for the right reasons, but if opportunities help you retain staff by giving them new skills and new challenges then it’s certainly an additive factor.

With these lists, start to quantify (how many units of cost does a unit of service “cost”?, how good is the improved outcome? How bad is it when disaffected people turn to destruction or self-destruction? What price worklessness?), start to look at how you can compare the alternatives. It is unlikely that the solutions will be black and white – you will find benefits and weaknesses in each alternative, which is why you need some numbers.
  • Opportunities for staff
  • means easier to retain staff
  • means don't have recruitment costs (£1500 per person), don't have to pay premium wages (£1000 per year), therefore for staff turnover improvement from 8 months to 18 months, 10mths = £1500 * 12/10 recruitment savings + £1000 premium SAVINGS
  • etc

At this point you should see patterns begin to emerge, and should be able to start saying “I can see the benefits in these aspects of the solution I’m putting forward” and understand how to apply that to the priorities of potential funding bodies. We’ll look at how to approach funding bodies in another blog.

See also Mark Outhwaite's blog (on a rather different subject) in

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