Benefit realisation can serve as a powerful daily tool to foster a culture of accountability and impact recognition within healthcare organisations and systems.
Effective strategic and operational planning begins with understanding current performance and identifying key priorities for improvement. This process involves recognising population needs, variations in performance and outcomes, benchmarking against peers and aligning with stakeholder, patient, and population expectations.
Setting priorities
When setting priorities, it is crucial to consider all potential benefits and measures for improvement. For instance, if reducing outpatient follow-ups is identified as a priority, the main benefits and value to be delivered must be clearly defined e.g. releasing staff time, reducing waiting time for day case care.
A hierarchy of benefits should illustrate the trade-offs between these and how to optimise the delivery of improved outcomes, quality, resource use and social, economic and environmental impacts. Identifying the biggest target improvement areas, determining trade-offs and risks, and exploring mitigation strategies are essential steps.
Benefits framework
Our framework for benefits considers six areas: population outcomes, clinical quality, resource efficiency, social innovation, economic growth and environmental impact, with over 30 measurement domains and hundreds of measures and benchmarks. All six benefit areas should be visible in the plan and operational delivery wherever possible.
A multidimensional approach
Adopting a multidimensional benefit approach ensures maximum impact from all invested efforts in any priority. It also ensures that everyone involved understands their role in achieving these benefits and feels invested in this narrative.
Addressing risks and disadvantages
Each selected priority must address all target improvements and opportunities while anticipating potential risks and disadvantages. For example, if follow-ups are replaced with digital solutions, measures must be taken to avoid excluding vulnerable groups. Additionally, the carbon footprint benefit from this initiative should be captured.
Planning and implementation
Identifying priorities, selecting comprehensive benefits, understanding potential improvements and mitigating risks are critical steps. Planning how to deliver these benefits through initiatives and transformation programmes is equally important. For each initiative, understanding the required resources in terms of finance, workforce capacity, estates and supplies, then assessing the impact on our operating model is essential.
Modelling impact
For outpatient follow-ups, this might involve retraining staff, changing operational policies, rethinking our use of estates and implementing digital solutions to support patients with new approaches. Investments in digital solutions and the reinvestment of savings elsewhere should also be considered. By modelling the impact of our initiatives, we can understand the resource requirements and the expected return on investment. These benefits need to be quantified in a measurable and understandable way.
Scenario testing
Scenario testing helps us assess the impact of different assumptions. We test four areas: demand, productivity, resources and initiative success. If an initiative only realises 50% of the expected benefits, we need to understand the implications and decide whether to adjust our expectations or implement additional changes. If core productivity assumptions improve or deteriorate, we need to understand the impact and mitigate accordingly.
Comprehensive benefits appraisal
We aim to understand the impact of various initiatives on target benefits and visualise these impacts across the board. It is essential to know what resources are needed to deliver against priorities, including manpower, finance, estates and capacity, then to understand the return on these investments across the six benefit areas. Ultimately, we want to tell the impact story, emphasising a comprehensive benefits appraisal across all initiatives rather than just productivity. By doing so, we can demonstrate a reduced time to value, replicating and adopting proven methods and interventions with the impact and value delivered.
If you would like to talk to us about our benefit realisation methodologies, linked to your wider approach to strategy, planning and innovation, please get in touch with us via agem.integrated-planning@nhs.net
