2.10 Initial LIFT business cases set out proposals for first tranche projects and for establishing the local joint venture. Guidance on the content and evidence required for business cases was issued by the Department in June 2003 after they became concerned about the mixed quality of the draft business cases being produced by early schemes. When guidance was issued, it required Strategic Health Authorities to assess evidence which had not been generally collated at that stage, for example on risk management strategies and Information Technology proposals which took time to produce. Business cases produced following the issue of the guidance are generally of good quality and demonstrate that schemes have considered:
■ proposed value for money;
■ affordability for local health economy;
■ compliance with standard NHS LIFT contractual terms;
■ fit with the Strategic Health Authorities' strategic objectives;
■ service modernisation;
■ reform and efficiency; and
■ integration of the service models into the wider context.
2.11 For second tranche schemes, Partnerships for Health have developed a formal project approval process. Using the Strategic Service Development Plan, the Strategic Partnering Board is expected to:
■ issue new project proposals for development by LIFTCo;
■ grant stage one approval to proposals which meet requirements;
■ define detailed service requirements and affordability criteria;
■ review detailed proposals developed by LIFTCo; and
■ grant stage two approval where proposals meet the criteria.
The process ensures that the public sector agrees an upfront affordability cap, sets out its minimum requirements and builds in agreements about how abortive costs are met should a project be abandoned. Primary Care Trusts can link this process into their existing procedures to ensure they obtain necessary Strategic Health Authority approvals for business cases. Given the continuing role that the Strategic Health Authority will continue to play in approving projects, however, we were concerned that in two of our case study areas a representative from the Strategic Health Authority had not been invited to attend Strategic Partnering Board meetings. Local areas may face future difficulties and delays getting proposals agreed if they do not maintain a close working relationship with their Strategic Health Authority.