An NHS trust is essentially a non-profit-making business whose chief executive and board are accountable for delivering high, safe standards of care for its patients through the effective and efficient use of resources within an agreed annual budget.
Business planning
An NHS trust is
essentially a non-profit-making business whose chief executive and board are
accountable for delivering high, safe standards of care for its patients
through the effective and efficient use of resources within an agreed annual
budget. Each year trusts undertake a business-planning exercise. Within each
NHS trust the business-planning process is intended to align trust services
with national priorities and local priorities. National priorities are
described each year by the Department of Health in a document called the NHS
operating framework, and primary and secondary care organisations must plan
their services with this in mind. Local priorities will be dictated by the additional
requirements of those commissioning the services (primary care trusts at the
time of writing but soon to be general practitioner consortia) and these will
depend on demographics and epidemiology in the local health economy as well as
the specialist services that the trust provides.
For an NHS trust the
primary objective of the business-planning process is to describe its vision
and to develop organisational objectives that will support the delivery of that
vision. Chapter 1 described the organisational arrangements of trusts –
divisions or directorates making up the whole. Divisional and directorate
objectives will be developed which then support the trust objectives, and the
pharmacy objectives should be derived from these and other documents which relate
to the quality, safety and the professional pharmacy agenda. It is important
that all staff have an annual appraisal and have their own objectives agreed
which are derived from the pharmacy business plans so that staff are clear what
they are required to deliver during the year and how their work supports the
trust’s plan.
The
business-planning process is often underpinned by a requirement to prepare a
detailed business case that provides a thorough analysis of the implications
for changing or developing services. Not only will a business case be used to
judge the merits of the specific proposal and how it contributes to the
delivery of trust objectives and performance targets, it may also be compared
with business cases from other departments or directorates as part of a
prioritisation exercise. Pharmacy managers need, therefore, to muster all their
skills, knowledge and expertise to produce a well-reasoned, robust case which
can withstand detailed scrutiny and then market the benefits of the changes
that any funding will bring. Understanding the intended recipient of the case
is vital – what are their priorities and objectives?
In most business
cases it is expected that a range of options will be described. These may range
from the ‘do nothing’ approach to an option that requires the highest level of
funding in terms of capital investment and revenue consequences. The business
case will need to be well argued, show a detailed financial analysis and,
perhaps most importantly, set out the benefits to the organisation and to
patients.
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