Decision-Making Business Case

The attached draft Decision-making Business Case (DMBC) is based on the evidence set out in the Pre-Consultation Business Case (PCBC), feedback from consultation and further evidence compiled post-consultation.

The DMBC describes the work undertaken to date to determine the best solution to address the three challenges ESTH is currently facing. This document outlines the:

  • Case for change – which describes the barriers to delivering our vision for future healthcare
  • Proposed clinical model – how we will deliver district hospital services and major acute services to provide excellent care in the future, integrated with and supported by out of hospital services.
  • Options to deliver the clinical model and address the case for change – including how potential solutions were developed and assessed following a standard approach for options consideration.
  • Previous assurance undertaken – our proposals have been assured by a range of organisations which include the Joint Clinical Senate for London and the South East, and NHS England and Improvement.
  • Decision-making for consultation – which includes an outline of how we’ve arrived at a decision to proceed to consultation with a preferred option.
  • Consultation and engagement process – which includes a detailed description of the promotional activities and programme of engagement undertaken to reach out, disseminate information and listen to the views of the local populations.
  • Feedback from consultation – the DMBC provides a summary of the main findings of the consultation report and identifies a number of cross-cutting feedback themes such as travel and access, workforce, clinical model, population and bed modelling, deprivation, out of hospital and site-specific themes (such as multi-site working).
  • Process for addressing the themes from consultation – For each consultation feedback theme, the DMBC describes how we have:
    • Listened to the feedback from consultation;
    • Developed and assessed any new evidence and proposed alternative solutions based on detailed analysis of consultation outcomes; and
    • Used the feedback from consultation and any additional evidence to understand any impacts on the proposals, shape and inform the decision-making process.
  • Further assurance of proposals following consultation – including the final Integrated Impact Assessment, the Mayor’s assurances and the Improving Healthcare Together Joint Health Overview Scrutiny Committee.
  • Process for decision-making – the DMBC sets out a number of resolutions and recommendations for implementations made by the Programme Board to the Committees in Common.
  • Process for implementation – how the IHT proposals would be implemented in terms of governance following any decisions made by the CCGs and the role of commissioners in scrutinising future processes and business cases.

This document formed part of the papers (Paper 3) for the Committees in Common in Public meeting held on 3rd July 2020.

Click here to find out more about the decision-making meeting.

Click here to find out more about next steps.