MS Specialist Nurses

Business Case and Tools for securing additional or new MS Specialist Nurse Positions and/or hours

Over recent years, MS Australia has partnered with several peak organisations [1] to establish an evidence base to advocate for increased funding for specialist MS nurses in Australia.

The first project phase delivered our inaugural report, Multiple Sclerosis Specialist Nurses in Australia 2017 - a snapshot of the MS specialist nurse (MSSN) workforce in Australia, their clinical knowledge and practice, models of employment and funding, and their key responsibilities and training. We also touched on sustainable caseloads and how MSSNs could meet the demand for support. The report provided a baseline for future funding opportunities and models of care.

Consistent with our support for increased specialist nurse positions and acting as the peak body for people with MS in Australia, we have partnered with a range of key stakeholders including neurologists and MS nurse peak organisations: MS Nurses Australia Inc. (MSNA) and MS Health Professionals Network (MSHPN), to create a business case framework to inform proposals or funding requests to secure additional hours, or new or additional MS specialist nurse positions within your individual organisations.

What is a business case?

A business case is a concise, specific and formal document for a specific audience (e.g. decision makers/funding body) that demonstrates an evidence based case for funding a particular resource/project or proposal to deliver service improvements, benefits and improved outcomes.

For the purpose of this section, we will stick to the term business case although this content could also be used to prepare a project proposal or project plan.

A business case usually states a compelling case for change and proposes a solution to an identified need/or problem by justifying the benefits of funding a particular resource/project or proposal from both the patient and organizational point of view. It provides both measurable deliverables and financial considerations which aids the decision making process.

It also demonstrates how the proposal fits with the organisational priorities, goals and values. It provides an attractive viable option for change. It highlights financial considerations including benefits, affordability and savings projections. And lastly, provides the decision makers with guidance on how such a proposal can be implemented.

Planning and Preparation

Thorough planning is essential before launching into a business case.

First of all it is important to demonstrate that you understand the organisational environment i.e. the legal, policy and practice framework; the funding context and how relevant stakeholders might support such a proposal.

To understand the specific funding context of your organisation, you will need to determine how funding requests are progressed, the decision making processes, template or other preference, and the approval or authorisation process to ultimately position your business case to a particular audience.

To provide an evidence base, you might need to identify data sources or collect data yourself to demonstrate a gap or need; this might include an audit of best practice examples elsewhere and how this might relate to your work environment. You may also need to provide analysis and service projections of how such a proposal might benefit your particular organisation.

A key determinant of a successful business case outcome is the level of consultation activities conducted beforehand to influence how much support your proposal will receive from your key stakeholders. Some organisations may also require that you receive authorisation from your manager prior to putting the business case forward.

Quick Questions to consider before starting a business case:

√	Is there a compelling case for change?
√	Do you have support from others to go ahead with the idea?
√	Will it fit strategically with your employer’s existing priorities, plans, policies and guidelines?
√	Is your proposal or idea viable, affordable and sustainable?
√	Are you clear about the potential benefits for both your employer and patients?
√	What would be required to make this work/implement the idea? Is there a benchmark example of where such a plan worked well?
√	What are the risks and how would you mitigate them?

Understanding the Key Components of a Business Case

If your organisation or employer does not or use a preferred template, the attached business case template example attached has the following key components:

SECTION	CONTENT INCLUDES:
Recommendation	A brief statement to endorse your proposal.
Executive Summary	Overarching intent of the business case summarising your request and affirming the reason for the business case (your key messages): highlighting the addressed problem or opportunity, your proposal outline and the key benefits this may deliver. Key areas required for approval, including key risks and issues, time costs, resources and funding required and a summary of the recommended course of action. This section is often developed last.
Compliance/ Impact Statement	A summary of the proposal’s strategic alignment. How the proposal fits with patient care, focusing on the specialist knowledge and support that this role will offer to patients with MS. Financial and Resource implications – brief clauses or one sentence. Consultation – list of personnel consulted to complete this proposal.
Background	Plan/proposal objectives. A description of the location (site and team structure) in which you envisage this project to occur. Background: how this need or opportunity was identified? Details of the current situation, including the problem and highlighting the need or opportunity that this business case will address (for example): Current service shortfalls Demographic information and stats Patient experience and outcomes measures if available. Data gathering and investigation: highlight any previous investigations or data gathering. Demonstration of the impact the current situation has on: the department, your team, patients, other stakeholders (specialists’ time etc.) and costs. The key measurable benefits i.e. improved safety, reduced costs, better use of existing resources, patient benefits and how would you measure these? Suggested impacts (organisation, patients, costs) if the status quo continues and the problem remains unresolved. Highlight other related projects, studies or proposals that informed your thinking and which might have an impact on this proposal.
Options	Status quo and implications An analysis of whether this proposal can be completed in parts/phases. How would this relate to risk, costs, duration and benefits? What are the implications for stakeholders? Statement of preferred option and why? Potential inclusion of an option comparison or analysis using a table and with your own assessment criteria.
Proposal	Repeat of the recommendation
Risks	Any potential risks/mitigation strategies.
Financial Analysis	Statement as to whether this is a funding request. Have you considered other funding sources? Project costs including estimated costs for each part of this project. Savings or quantifiable economic benefits to be made. How have you estimated this? Is there a payback period i.e. modeling that shows investment over time reduce overall expenditure?
Management Responsibility for Implementation	Next steps if preferred option is accepted. Responsibility for implementation. You can attach a proposed schedule or implementation plan.
Proposed Evaluation (and timing)	Statement as to whether this funding proposal will be subject to an evaluation. How will this occur? And how often?

For your benefit, we have attached a partially completed business plan and suggested addendums (Information needs, PD and DMT) that you can either use as a reference or individualise for your particular circumstances.

Has this been a valuable resource? We would love your feedback.

[1] MS Nurses Australia (MSNA), MS Health Professionals Network (MSHPN) and the Australian New Zealand Association of Neurologists (ANZAN)