Economic case

In the economic section of a Green Book business case for improving Wi-Fi in an NHS site, the focus is on providing analysis and evaluation of options and demonstrating value for money. This section should include a cost-benefit analysis, the identification of preferred options, and an assessment of risks, benefits, and impacts.

Examples of sections and content to include:

Options appraisal

Identify options: present a range of options, with appropriate technical detail, for improving Wi-Fi including various levels of investment. For example:

option 1 - minimal upgrade of existing infrastructure for devices no longer in support or a security risk
option 2 - comprehensive upgrade to high-speed, site or organisation wide Wi-Fi
option 3 - implementation of an entirely new, Wi-Fi system with future-proof capabilities (such as support for the latest wireless standards, internet of things devices and real time location services)
do-nothing option - include a 'Do nothing' scenario to serve as a baseline for comparison - highlight the potential risks, such as continued connectivity issues, reduced efficiency, and non-compliance with digital healthcare standards

Cost-benefit analysis

Costs: outline the costs associated with each option, including:

capital costs - equipment purchase (switches, access points, servers), surveys, installation, cabling, and initial setup
operational costs - ongoing maintenance, support contracts, software licenses, and potential staff training
implementation costs - downtime or disruptions during installation, project management expenses, and temporary solutions during the transition period

Benefits: quantify and describe the benefits, both financial and non-financial. For example:

cashable benefits - potential cost savings from improved operational efficiency (such as reduced paperwork or streamlined patient data access), reduced network outages, and increased staff productivity
non-cashable benefits - improved patient care, enhanced communication among medical staff, ability to take calls from community and emergency response, better support for telemedicine and remote monitoring, and increased patient satisfaction
monetising benefits - where possible, assign monetary values to the benefits. For example, estimate the time saved per staff member due to access to improved Wi-Fi, and multiply by an average staff members salary to convert into a cashable cost saving.

Sustainability: highlight any sustainability benefits, for example reduced power consumption from more efficient equipment or reduction in travel time due to enhanced connectivity at remote sites. See Greener NHS (NHS England) for recommendations.

Socio-economic: any benefits for wider communities or society, such as providing an improved patient and guest Wi-Fi network to improve patient experience.

Economic appraisal

Benefit-cost ratio: provide a ratio for each option to demonstrate value for money.

Payback period: indicate how long it will take for the benefits to offset the costs of investment.

Risk assessment and sensitivity analysis

Risks: identify economic risks, such as cost overruns, delays in implementation, technology obsolescence, and potential for not achieving anticipated benefits. Assess the likelihood and impact of each risk (check for a local risk matrix to use for this).

Mitigation measures: discuss strategies to mitigate these risks, such as phased rollouts, vendor support agreements, and future-proofing technology investments.

Sensitivity analysis: conduct a sensitivity analysis to examine how changes in key assumptions (such as costs and benefits) affect the economic case. For example, analyse how variations in Wi-Fi usage levels impact the overall costs.

Preferred option

Identify the option that provides the best balance of costs, benefits, and risks. Explain why this option is the most economically viable, based on the analysis conducted. For example, a comprehensive upgrade might offer the best long-term value by enabling and supporting future healthcare technologies.

Considerations

Consider the wider impact of connectivity when listing benefits. Connectivity can provide a platform and be the enabler for other technologies, such as real time location services, internet of things (IoT) monitoring and Voice over Internet Protocol (VoIP).

List the targeted impact of benefits and try to tie these to clinical and patient outcomes wherever possible, such as real-time access to electronic patient records (EPRs) for staff.

See the table below for some examples of how to tie benefits to outcomes.

Example benefits table
Benefit (examples)	Cash releasing or non-cash releasing	Description of benefit and how it will be measured
Improved patient satisfaction by freeing up time for after care by reducing number of delays in clinical staff accessing and updating health records and EPRs.	Non-cash releasing	Staff and patient surveys, pre and post installation.
Improved staff and patient experience by ensuring full Wi-Fi coverage across the estate, reducing time spent travelling to areas with connectivity and reducing congestion in those areas.	Non-cash releasing	Questionnaire to be completed by guest Wi-Fi network users.
Provides the connectivity required across all sites for adoption of new technologies, allowing for deployment of newer technologies and reducing their future cost of deployment.	Non-cash releasing	Track spend on Wi-Fi equipment and infrastructure requirements in future digital technology business cases.
Improve patient access to online health applications and appointment booking application which allows them to access up to date information on their appointments.	Non-cash releasing	Measure number of missed appointments.
Improved Wi-Fi coverage will allow for reduced spend on mobile data allowance as staff will have access to the connectivity they need via Wi-Fi.	Cash releasing	Mobile data usage and cost to be measured.

Last edited: 26 February 2025 10:55 am