Business Case & Continuity

Question 1

Business continuity - machine down/staff shortage

Answer 1

1. Prioritise
   - unwell patients (ICU)
   - immunosupressed patients
   - sterile site specimens (eg blood, CSF)
   - specimens that are difficult to repeat (eg
   BAL)
   - Prioritise specimens/organisms of medico-legal or public health importance

Expected duration of shortage:
Organisms likely to survive storage pending reinstatement of supply
Access to alternative inference methods

Other sensible options accepted

• access to alternative labs/send away
• look to business continuity plan
• consider storage of samples

-? call a meeting- who would you invite

Every lab should have a business continuity plan in place for such events.

The plan is discussed amongst the senior managers of the pathology service and should be available electronically and as a hard copy (paper)

Consists of three main components:

1. Lists out the staffing details/ other resources eg
   Premises, vehicles, equipment, computers/ details of work performed /stake holders involved. It also describes the essential requirements for sustaining a service eg.how long a service can be sustained if the staffing level goes down to 75%-50%-10%. If any staff can work from home and may req IT support etc. Or according to the estimated time duration of disruption the level of staff requirements. Also lists the other requirements eg. IT support, vehicles needed
2. It lists out the various scenarios which can occur as possible emergencies: access or denial to premises, loss of IT support, non availability of key staff, loss of other resources, loss of key support or resources. These are classified according to the likelihood of occurrence and the impact it would cause on the service.
3. lists out the various proactive and reactive strategies in place to deal with these events.

Activate the business continuity plan.
Sit down with the lab manager and find out the expected staffing level and the estimated duration of disruption.

Assess the tests performed and prioritise them. Eg Bloods/ CSF essential. Stool/urine/GUM screens can wait.

Inform the service users explaining the situation and asking for cooperation.

Neighbouring hospitals for help and experience

Review at regular intervals.

Question 2

Writing a business case

Answer 2

A business case is a proposal seeking authorisation for the allocation of resource (i.e. money, people, time) by an NHS organisation. One is required when the proposal involves delivering something new, purchasing something new, or making a change to an existing process. The business case sets out the case for undertaking a project, weighing up the objectives and benefits against the estimated costs and risks. It aims to make a compelling case to the stakeholders tasked with judging its merits and will be subject to a thorough appraisal process.

The methodology requires that the business case is: FEMCS

1. supported by a robust Case for Change – the strategic case;
2. able to deliver Value for Money – the economic case;
3. commercially viable – the commercial case;
4. financially affordable – the financial case;
5. capable of being delivered – the management case.

FORMAT:

1. purpose - explain the purpose with estimated cost. Explain what the test is and how it’s different from existing tests.
2. Strategic context: provide audit results, staffing, population data on why it’s useful.

SAFETY & QUALITY of patient care.

3. Case for change - business needs, additional staffing requirements, Benefits.
4. Disadvantages of NOT introducing assay.
5. procurement route
6. Funding and financial anaylysis - revenue, costs, profitability.
7. Risk appraisal.
8. Management arrangements - who will take responsibility?