Demonstrating value in the face of change

Threats to services are becoming more common. Space is at a premium. From hydrotherapy pool closures to reallocation of gym space, it can feel like the world around you is shrinking. In this climate of constant change, we share some practical steps to show the value of your service. Remember, you are not alone.  The CSP is here to help, you can contact us 24 hours a day

Why us? And why now?

We all know that public services are cash strapped and tough decisions have to be made about what to fund. It is not always clear about why certain services are targeted for closure or rationing. You need to know how money flows through the system and how your service generates or could generate money.

What could be the reasons your service has been targeted? 

• Perception that your facilities are underused Is your gym space empty for large periods of the day? Do you only offer hydrotherapy services during a standard working day? You need to demonstrate that your space provides value for money. If you have capacity, could it be used to generate income? 
• Visibility  Is the value of your service well understood? Do you showcase your service’s achievements? Do senior managers know and understand what you offer? Demonstrating your value is key. Look for opportunities to showcase your service.
• Other system considerations Sometimes incentives and penalties on outcomes or key performance indicators can have a knock-on effect on your service. Find out if this is the case and where the service fits into cost saving or money generating targets.  
• Another provider offering an identical service for less money Healthcare is now a competitive marketplace. How does your service compare with others? Have you considered your overall efficiency and where improvements could be made? Take a look at what quality improvement tools could help you.

What’s your value and impact?

It goes without saying that when faced with change or threat to your service, it can be a very stressful and emotive time. But it’s really important to remain objective and resilient when being consulted or during negotiations.  Keep it business like. Build a picture to promote the value of your service.

• Understand your audience  What do the people who fund the service expect from it? Know their objectives and what outcomes they are trying to achieve.
• Talk their language How can you frame the promotion of your service against the objectives of the organisation, health board or commissioner? Sew a golden thread through your argument to relate your objectives directly to theirs.  
• Use and understand service data  Demonstrate your value in a clear and concise way. What information do you have to show the quality, cost and productivity of your service? 
• Understand where your service is vulnerable  Are you missing data? Can you do something about it? Is there scope to generate more productivity or income by doing things differently? 
• Use evidence to support your service Think of service evaluation, patient data and clinical guidelines as well as clinical research. 

Who else should I talk to?

Early input and advice from the CSP is essential, but also consider who else you can call on for support, data or another opinion. 

When you’re looking to influence consider the following groups: 

• Internal stakeholders  Find out who your service aligns with/impacts on. What are their views on the proposed changes? 
• Professional networks Seek support and know what constitutes best practice in your field. Consider different service models/options, and benchmark your service against similar providers.
• Patients, patient groups and charities Patient views and experiences can amplify your data. How does your proposed change align or conflict with their national campaigns or lobbying position? And if they support your proposals, can they lobby for you? 

Know the process

Find out what the process is for any proposed change. To maximise your influence, you need to know and use the following:

• What are you asking for and on what aspects are you prepared to compromise?
• What is the timeframe and process for consultation?
• Have governance procedures been followed? for example risk assessment, equality impact assessment.

Constant change is now the norm in the health and care system. By using these suggestions, you can take positive steps to future proof your patient services. What are you waiting for? 

More information

• Acas managers’ guide to equality impact assessments 
• CSP – Improvement and Innovation 
• CSP – Clinical Evidence Briefings
• NHS Service Improvement Tools