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Step 4: Set clear and realistic goals

Business cases for improved services will need to be informed by robust modelling of the likely impact of service change on patient outcomes, costs and savings. 

Robust data collection can inform budget holders of likely demand, identify areas where resources can be used more productively, and reduce financial risk.

The cost of service improvement can be minimised by making better use of existing resources. For example, some areas have released podiatrist time by using healthcare assistants to perform administrative tasks and undertake roles such as escorting patients to transport. Others have trained podiatrists as independent prescribers so patients do not need to visit their GPs for foot medications.

The cost of service improvement, the potential for improved outcomes and likely savings will vary from place to place; they will depend in part on baseline service provision, outcomes and costs. Case studies suggest that savings can substantially outweigh the cost of service improvement. It is important to ensure that data collections are put in place so savings are measurable. Reductions in amputations can be identified in routine hospital data. Reductions in ulcer duration can lead to much larger savings, but these can only be measured if comprehensive data collections are established for ulcer care.  

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