Published date: 15 October 2021

Your guide to building a business case

A business case will often be required for a significant change to the NHS estate, be it clinical or other space, such as a new build, refurbishment, extension, or relocation of services. In this new guide, we outline the key steps and considerations behind building a successful business case, from setting the strategy, to determining the affordability, to exploring impact on management.


What is a business case? It is a structured, economic argument for change, development or investment, appraised against all other options and including the calculation of costs and benefits together with a plan for realisation.

At its most basic level, a business case is a planning and management tool to demonstrate that the scheme or project is the right choice – in terms of strategy and value for money. It should set out clearly:

  • What is the problem?
  • What is the solution?
  • Who is involved?
  • What are the risks?
  • What will be the impact?

Behind any major strategic project in the NHS lies a business case, that requires the review and approval of local health systems (i.e., local Clinical Commissioning Groups, local Provider Trusts) and sometimes NHS England/Improvement.

NHS Property Services has in-house expertise to support the business case process, whether we are developing the case ourselves or supporting a customer. We can also advise our NHS partners, even if we are not to be the holder of the Head Lease on a newly developed property, for example.

For the economic and affordability elements we have a specialist Evaluation and Analytics team, preparing, and validating, in depth financial analysis to drive strategic decision making. We also have a framework of external consultants to help scale this work and can lead or support their appointment.

Read our guide

In this new customer guide we explore what goes into a business case and how NHS Property Services can support the process for our NHS partners.

We explore: 

  1. Assessing the need for and timing of a business case
  2. Setting the strategy
  3. Assessing the economic viability
  4. Building the commercial case
  5. Determining the affordability
  6. Exploring the impact on management
Read the guide
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Learn more

Our multidisciplinary team of property experts offer consultancy services on the most effective use and development of the NHS estate, collaborating with our customers to get the most out of the NHS estate.

Learn more about our teams

We also work with a range of external consultant partners to develop business cases beyond our in-house expertise of economic and affordability validation. We have worked with one of our consultants, gbpartnerships consult, to create this guide.

Learn more about gbpartnerships