Endoscopy - writing a successful business case to increase capacity
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Transcript of Endoscopy - writing a successful business case to increase capacity
Writing a successful business
case
Pennine Endoscopy
Confession
About us..
• One trust Pennine Acute
• 4 Hospitals
• 4 endoscopy units
• 800k pop
• 24000 scopes pa
• Directorate of Gastro
& Endoscopy 2009
About us..
• 10 endoscopy rooms
• JAG accreditation & BCSP threatened by
timeliness issues
• Reliant upon WLIs
• WLIs affect Service Line
Problems…
• Unprofitable service line
• Increasing demand
• NAEDI
• Age Extension
Causes
• Clinical variability
• Organisational inertia due to WLIs
• Perverse incentives
Solutions
• Remove variation
• Improve standards & quality
• Achieve JAG for all 4 sites
• Pull capacity into funded sessions in working
week
• Increase capacity
The business cases
• 2011 Increase from 2 – 3 rooms in Oldham
(now operational)
• 2012 Increase from 2-3 rooms in Bury (signed
off, build commencing April 2013)
• Moviprep (agreed & awaiting sign-off)
Secrets…
• Know your market
• Speak the same language
– SLR, RTT, PTL, 62 days, 31 days, CCG
• Business is simply the art of getting things done
• Collaborate
• Delegate
• Speak to the exec team – they will enjoy
discussing it with you
Making the case
• Title of Proposed Service Development
• Funding Source
• Service Lead & Contact Details
• Other Services Affected
• Description of Proposal
• Heath Need & Proposal for Change
– Service Delivery & Performance
– Patient Experience
– Strategic view
Making the Case
• Links to external policies (e.g. NSF’s, NICE, CQC)
– Waiting Times
– Decontamination
– Risks of not making the change
– Other Drivers for change
• Health Impact, Outcomes and Deliverables
– Activity Performance
– Access Performance
– Quality of care/Clinical Governance/Patients Experience
– Management of risk
Making the Case
• MARKET POSITION (Internal & External)
• BROAD FORMULATION OF OPTIONS
– Risks & advantages for each
• FINANCIAL ASSUMPTIONS
• FINANCIAL ANALYSIS
Making the Case
• TIMESCALES
• PROJECT MANAGEMENT ARRANGEMENTS
• FORUM TO WHICH SUBMITTED FOR
APPROVAL
• OUTCOME FROM FORUM OF APPROVAL
• COMMENTS ON OUTCOME
• REVIEW DATE
• APPENDICES – costed plans from estates /
contractors
Making the case
Projected demand - colonoscopy
SHA 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17
North East 28,100 32,100 34,100 37,200 40,600 43,500 46,300
North West 59,100 69,800 74,100 81,000 89,100 95,400 101,700
Yorks and
Humber 48,700 56,700 60,300 65,800 72,300 77,400 82,500
E Mids 32,600 39,900 42,400 46,600 51,600 55,400 59,200
W Mids 38,700 47,300 50,100 55,100 61,000 65,400 69,800
East of
England 43,000 51,900 55,600 61,100 67,600 72,600 77,600
London 61,500 69,700 74,300 81,100 89,300 95,300 101,300
S E Coast 39,200 46,300 49,200 53,800 59,100 63,400 67,600
S Central 30,900 37,100 39,400 43,200 47,800 51,200 54,700
S West 44,200 53,100 56,600 62,100 68,500 73,500 78,600
ENGLAND 425,900 503,800 536,100 586,900 647,100 693,100 739,400
Summary
• Tedious but necessary
• Team approach essential
Thank you for your attention!