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  5. The Nutrition and Hydration Digest 3rd Edition
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  7. Appendix 4: Business Case Guidance

Appendix 4: Business Case Guidance

Business Case Guidance

Here is some guidance for writing a business case for a Food Service Dietetic role in order to obtain funding for the role.   It is not a comprehensive list but provides some points to consider.  Ask your Trust whether there is a business case template or required format for writing a business case.

  • State why the role is needed and provide evidence to support this. It is now a requirement under the National standards for healthcare food and drink to have a named food service dietitian and these standards will form part of the legally binding standards in the NHS Standard Contract as well as already being part of the NHS Long Term Plan (1).
  • Describe the current food service situation – use current guidance to support (1), (2), (3), (4).  Refer to any clinical incidents/near misses related to food service that may have occurred (5), (6). 
  • State the benefits/advantages of the role e.g. cost-savings, improved patient satisfaction, less clinical incidents, improved partnership working, improved food and drink service, make service more patient-focused.
  • Also state any disadvantages of not having the role, e.g. impedance on clinical dietetic time, increased risk of clinical incidents, especially around choking and allergies.
  • Highlight how the role serves to further the Trust’s overall Strategic Plan. 
  • Summarise what you aim to achieve by having the role with a timeline, important working relationships and expected outcomes.
  • Who would the role report to and where does it sit in the overall organisational structure? We would suggest considering a hard line report into Dietetics and a dotted line report into Facilities as workload is generated from Facilities. We recognise this may not suit all situations.
  • Anticipate and address any potential pushback that could come from the review panel (or whoever signs off the budget), e.g. have any other methods of efficiency been explored and tried before considering the creation of this role.  For instance, investing in technology or software to get the job done.
  • Tasks such as report writing, menu planning and menu capacity analysis require extended periods of concentration; due consideration should be given to the flexibility to work from home, as a busy clinical environment may not provide the most conducive work environment for certain tasks.
  • State anticipated costs such as salary (minimum expectation is NHS Band 7) (2) as well as those associated with training, office equipment and any staff benefits.  For instance, the role definitely requires a laptop and mobile, especially if covering multiple sites and to facilitate working from home.
  • It is recommended that this role be a senior, specialised full-time role, taking into account the complex nature of hospital catering.  The majority of the role also requires a lot of autonomy and high level decision-making, influencing and senior stakeholder engagement.
  • Consider the number of user groups and sites in addition to number of beds as the basis for funding allocation because these all determine how many stakeholders need to be engaged, the number of menus required, amount of training required to equip food service staff and the delivery of the food and drink service.  Bear in mind that if covering multiple sites, there may be different food and drink contracts and food/service suppliers across the sites which will increase workload.
  • Realistic consideration needs to be given to how much the Food Service Dietitian can do; the more sites the more demanding the role. A workload of more than 2 to 3 sites will be very demanding for one person to manage.  The remit needs to be very clear.  It may be that only patient dining is covered and not retail or staff health & wellbeing.  If retail and staff health and wellbeing are included, the remit needs to be clear as to what percentage of time will be spent on each aspect. 

References

  1. NHS England. National standards for healthcare food and drink NHS England » National standards for healthcare food and drink [Accessed 30th Nov 2022]
  2. NHS Hospital Food Review. Report of the Independent Review of NHS Hospital Food Independent review of NHS hospital food - GOV.UK (www.gov.uk) [Accessed 31st May 2022]
  3. The British Dietetic Association. Nutrition & Hydration Digest
  4. NHS Digital. Patient-Led Assessments of the Care Environment (PLACE)  Patient-Led Assessments of the Care Environment (PLACE) - NHS Digital [Accessed 31st May 2022]
  5. NHS England. Patient safety alert: Resources to support safer modification of food and drink NHS England » Patient safety alert: Resources to support safer modification of food and drink [Accessed 30th Nov 2022]
  6. NHS England. Patient safety alert: Risk of death from asphyxiation by accidental ingestion of fluid/food thickening powder NHS England » Patient safety alert – Risk of death from asphyxiation by accidental ingestion of fluid/food thickening powder [Accessed 30th Nov 2022]