Planning hospital services - an option appraisal of a major health service nationalisation

The preparation of Approval in Principle submissions is likely to be a once in a lifetime event for most health districts and is a rare event even for some regions. In consequence, many officers find preparing the major part of the submission, the Option Appraisal, to be an unfamiliar and daunting task. The guidance material written by the Treasury and DHSS, while helpful, is not detailed enough to sort out many of the problems which arise. In these circumstances knowledge of how previous appraisals have been conducted can save much time and effort, and it is for this reason that this Discussion Paper has been published. The appraisal set out in the pages which follow was conducted by a planning team to which this paper's author (RLA) acted as consultant. RLA was responsible for the writing up of the report but received very considerable support from both Regional and District officers. The Approval in Principle document was meant to stand alone, in the sense that anyone picking it up should be able to understand the reasoning processes described therein. Nevertheless, some background is helpful on the reasons why steps were taken in the way they were, and the process involved. To this end short annotations have been added to the original report. They appear in the paper in italic script. The full table of contents of the original donunent is shown on pp.1-4. Some of the appendices shown are not in this published version where what they would contain is obvious. The district etc. names used here are fictitious. The problem to which the appraisal was addressed is more complex than many, but not all, problems handled in formal option appraisals. There is no doubt that it will be familiar to both service and capital planners, confronting as it does many of the questions of determining service priorities which inevitably arise in the strategic planning process.