This is a guest blog for Bladder & Bowel UK, written by Dr Benjamin Disney, a Consultant Gastroenterologist at University Hospitals Coventry and Warwickshire NHS Trust.

Part of our work at the Bowel Interest Group is to raise awareness about the need for improved bowel care management within healthcare services and promote better bowel health. The financial impact of poor management cannot be ignored, with the group estimating that constipation cost NHS England an alarming £168 million in the year 2018-2019.[1] The stigma surrounding bowel problems plays a significant part in delaying treatment once symptoms appear, and when patients do finally seek treatment, healthcare professionals may be ill-equipped to deal with chronic bowel dysfunction.

Alleviating pressure on the NHS will require action on both the primary and secondary care front, to speed up treatment and strengthen understanding of bowel issues, promoting better bowel health. Yet, both these endeavours will require some form of investment from healthcare establishments who must carefully allocate available funding. So how should healthcare professionals wanting to make a positive impact for their patients go about making a business case for better bowel care? Here, we’ve outlined four steps you can take to help get things moving within your own establishment.

Step 1: Reach out for support

If you are a healthcare professional working in bowel, colorectal, gastroenterology, neurology or A&E, it is likely that you have a sound understanding of where improvements need to be made. Nonetheless, you will most likely need to get extra support during the pitching and planning process. Start by reaching out to other stakeholders. By getting other departments and teams involved, not only will your business case be more robust but you’ll have an easier time implementing these changes and making them work in the long run.

Think about who will be impacted by your proposed changes. For instance, you may wish to begin speaking with Clinical Leads (Consultant), Clinical Implementors (Nursing/Physio), Business Managers, Directorate Managers, Finance Managers, and if necessary, the Estates department. Crucially, you will also need to consider who will be paying for the project if your proposal is accepted – be aware that you may need to seek external finance if your employer is unable to afford the investment.

Step 2: Work out the required budget

Next, take ownership of working out both the financial cost and the cost saving benefit of your proposal – don’t leave it up to the payer to work this out. You should make your calculations as thorough and accurate as possible. For this part, it’s always a good idea to reach out to business and finance experts rather than trying to do this on your own.

You should be answering the following questions: how much capital is needed to achieve these set goals? How will you demonstrate the positive impact of the investment once it is implemented? You will be in a better position if you can demonstrate that the investment will eventually become self-paying by reducing the overall cost of chronic bowel dysfunction treatment on the establishment.

Finally, it’s helpful to suggest a variety of options in case the full investment is ruled out. Put together a few alternative routes for what could be achieved with only part of the funding. Lay down the benefits and costs of each option clearly and concisely, including the outcome from making no changes at all: what would be the risk of failing to deal with the problem proactively and not implementing your proposed solution?

Step 3: Map out a timeline

The impact of your project is unlikely to be immediate. To avoid setting investor expectations too high, be sure to clearly map out a realistic timeline of expected outcomes. In this way, they’ll know when to expect the project to be running at full capacity and delivering results.

You should also break down the impact of the proposed solution by department; this will demonstrate awareness of the wider effects on the organisation as well as the importance of keeping KPIs healthy within each division. Additionally, review how much training and resources will need to be allocated to each department involved in implementing the solution.

Step 4: Make your case

When presenting your business case and all its options, conclude by recommending the best course of action and use your research to back up this decision. Leave out any subjective claims and dive straight into the measurable outcomes that this route would deliver. We would also suggest mentioning stakeholders that you have partnered with to put together this business case. This will add weight to your argument and may even act as a tipping point for your potential investors.

Find the Bowel Interest Group’s how-to guide on making a business case here: https://bowelinterestgroup.co.uk/resources/business-cases-for-better-bowel-care-a-how-to-guide/

[1] Bowel Interest Group, Cost of Constipation, 2020 : https://bowelinterestgroup.co.uk/resources/cost-of-constipation-report-2020/

If you are experiencing bowel issues or would like more information to promote better bowel health, please contact Bladder & Bowel UK’s helpline on 0161 214 4591.