CALDERDALE PERFORMANCE REWARD GRANT: BUSINESS CASE TEMPLATE
Please complete the following form and return it to the Partnership Support Team
electronically at firstname.lastname@example.org by 28 February 2011.
Section One: Basic Information
Name of organisation NHS Calderdale Provider Services
Contact Name Ruth Brown or Marie Conway
Phone 01422 281520
Title of proposal Enhanced Health Improvement lifestyle
assessment and client experience
Brief description Calderdale’s Health Improvement Service currently
(max 150 words) provides a wide range of established services to support
Calderdale’s population address and sustain key lifestyle
This project will look to strengthen a client’s journey
through lifestyle change from assessment to discharge
through the establishment of Lifestyle Assessment clinics.
The client would be provided with a dedicated Healthy
Lifestyle Advisor to personally take them through
behaviour change goals, referral(s) into appropriate Health
Improvement services, and reviewing progress against
Client lifestyle change will be monitored through an
enhanced data collection process, assessing and
reviewing weight, BMI, waist circumference, smoking
status, physical activity levels, fruit and vegetable
consumption, emotional well-being, blood pressure,
diabetes risk score, and cholesterol (where a client meets
agreed inclusion criteria).
Three Band 4 Healthy Lifestyle Advisors would deliver
Lifestyle Assessment clinics, supporting a case load of
clients over an average 12 month period.
This project will be piloted over a 3 year period.
Details of all organisations Calderdale’s Health Improvement Service
involved in delivery
Organisations supporting the Calderdale GP Practices
proposal Wider health care professionals i.e. in acute trust
Local employers (all sectors)
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Section Two: Funding Information
Summary of total funding required for the proposal
Total project costs would be £304,450
Specify funding required from PRG: Capital Revenue Total Cost
Salaries plus on costs £219,450
Travel costs £8,000
Please provide details and the source of any other funding or ‘in kind’ support that will be
used in addition to that requested above
In kind funding would include:
0.2wte band 6 NHS Calderdale Health Improvement Specialist post to manage and co-
ordinate the project and provide direct line management support for staff delivering the
Lifestyle Assessment clinics.
NHS Calderdale existing resources, which include office, phones, and printing costs, all
Health Improvement specific service resources i.e. scales, pedometer, leaflets, client
support information, carbon monoxide monitors.
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Section Three: Business Case
It is important that you read the guidance notes before completing your business case.
The issue that your proposal seeks to address
The Lifestyle Assessment proposal would contribute to significantly improving the health
and well-being of Calderdale residents and narrowing the health inequalities gap. This
would be achieved through the provision of a comprehensive lifestyle assessment and
client led care pathway for addressing a wide range of lifestyle behaviour change issues,
including obesity, physical activity levels, smoking status, alcohol consumption, emotional
well-being. Lifestyle change addressed through this project could significantly contribute
to reduction of medication and requirement for specialist care associated with
cardiovascular disease and diabetes etc. It is anticipated that the uptake of local
services would improve due to more effective and appropriate referrals, enhanced
assessment (and re-assessment) of client need and experience whilst accessing
services, and appropriately addressing the identification of individual health problems.
It is envisaged that a Lifestyle Assessment would be a client’s starting point to an
inclusive package of health improvement care, which will address a wide range of
lifestyle issues with individual clients. The Lifestyle Assessment would enable the most
disadvantaged population of Calderdale to check key elements of their health such as
weight, BMI, blood pressure, their risk of diabetes in the next 10 years, and total and HDL
(high density lipoprotein) cholesterol where applicable. Clients who receive a Lifestyle
Assessment will be given 12 months personalised support, via a Healthy Lifestyles
Advisor (HLA), to establish, monitor and review client led behaviour change goals,
discuss, agree, and review appropriate referrals into well-established Health
Improvement services, programmes and activities, and be supported with GP referrals,
depending on level of risk, for specialist treatment relating to BP, diabetes, and
Clients would access a Lifestyle Assessment via their GP or practice nurse, through their
workplace, community links i.e. children centres, or self referral. The Lifestyle
Assessment would be accessible to anyone living or working in Calderdale, clinics would
be delivered in the areas of most deprivation to increase access to those in most need.
The client would be booked in to a Lifestyle Assessment at one of the dedicated venues
i.e. GP surgery, workplace, and would receive a phone call from the HLA to conduct
introductions and remind about appointment times etc (prevention of DNAs). The content
of the initial Lifestyle Assessment appointment would include:
Overview of Lifestyle Assessment and background to referral
Lifestyle Assessment checks, including:
- waist circumference
- diabetes risk assessment
- cholesterol (total & HDL) – where the client meets specific criteria
- brief intervention and lifestyle advice for each check
Determine client lifestyle change targets and agree lifestyle action plan, to include
referral into NHS Calderdale’s Health Improvement programme/service where
Agree review and contact time with client
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Additional lifestyle data that would be collected to support the establishment of the
client’s lifestyle action plan includes:
Physical activity levels
Fruit and vegetable consumption
Data would be recorded in individual client files and/or on electronic programmes such as
After the initial Lifestyle Assessment the HLA would maintain regular phone contact with
client to check progress against their lifestyle action plan. The client would then have a
follow up appointment with the HLA at 1 month, 3 months, 6 months, and 12 months.
The follow up appointments would include a re-assessment of weight, BMI, BP, physical
activity levels, smoking status, emotional well-being, alcohol levels etc, and review and
development of progress against the client’s lifestyle action plan. The HLA would
maintain monthly phone contact with the client throughout this period. The client would
be receiving the appropriate treatment/care during this time through the Health
Improvement services, programme or activity agreed in the lifestyle action plan.
Examples of NHS Calderdale’s Health Improvement services and programmes include:
Altogether Better (Community Health Champion Programme)
Gardening for Health
The client pathway is attached illustrate this.
The Lifestyle Assessment proposal supports effective and appropriate referrals into
existing services and programmes and significantly supports a holistic package of care
available to the population of Calderdale. Client lifestyle assessments would ensure all
elements of their lifestyle are addressed with the client, preventing a targeted approach
to i.e. weight loss, if broader issues may need attention i.e. emotional well-being. There
would be a robust process of diagnosis and referrals into appropriate services and
programmes. The lifestyle checks and data collected, and the client–led establishment of
a lifestyle action plan supports the quality and efficiency of a holistic approach to client
This Lifestyle Assessment model would be piloted over a three year period and the
impact of the learning would be transferred into mainstream services where possible
once external funding ends.
Data and/or statistical evidence to explain the issue or support your proposal
Health inequalities continue to be an issue across Calderdale. The Director of Public
Health’s Annual Report (2010) highlights men from the least deprived areas can expect
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to live over 10 years longer than those in the most deprived areas (71 to 81 years of
age), for women the gap is 8 years (76 to 84 years of age). Lifestyle factors affecting this
are clear, with 25% of adults currently smoking, 27% of adults are obese, and 28% of
adults binge drinking.
Obesity reduces life expectancy, on average, 9 years. The estimated cost of treating
obesity and related diseases is £14.7 million per year. If the trend continues the annual
cost will rise to £16.8 million in 5 years.
NHS Calderdale’s Improving Health, Improving Lives commissioning strategy (2008/09 –
2014/15) provides some insightful information: Approximately 50,000 people in
Calderdale are registered as having a long-term condition (LTC). Nearly a third will have
three or more health conditions and are more likely to suffer from mental health
problems. Another 26,000 people are registered as having hypertension, a key risk factor
to developing vascular disease. Having a LTC, particularly one which is not well-
managed, has a huge effect on the quality of life and well-being of not just the person
concerned, but also their families and carers.
Additional information to support the importance of this proposal includes:
People with long-term conditions are the most intensive users of health care services,
and they account for 80% of GP consultations.
People with long-term conditions who are frequently admitted to hospital account for 36.5
of overall bed day usage
26% of people with long term conditions have three or more other conditions (poly-
morbidities). The number of co-morbidities increases progressively with age, with
higher levels among women. A significant proportion of people with long-term
conditions also suffer from mental health problems.
Stroke is the single largest cause of adult disability in England.
11% of those claiming Incapacity Benefit/Severe Disablement Allowance in Calderdale
do so because of diseases of the respiratory or circulatory system, and 7% because
of diseases of the nervous system
The 2008 JSNA states that 35.9% of all adult female deaths in Calderdale were as a
result of circulatory diseases (34% of men).
YHPHO estimates that Calderdale’s obesity rate in adults is 21.8% equating to some
8000 obese people.
In April 2008, there were 8184 people registered with diabetes in Calderdale, with around
70 new diagnoses every month. Adults with diabetes are twice as likely to die before
the age of 80 as those without the condition
In Calderdale 21% of the adult population smoke and round 250 premature deaths a year
are attributed to smoking. Smoking is a significant risk factor in relation to deaths for both
vascular and respiratory conditions
What will be different as a result of the proposal being implemented and how you will
The short term impact of the Lifestyle Assessment proposal would include:
- provision of a more comprehensive package of care surrounding all aspects of health
- increased collection and monitoring of client lifestyle change data
- improved referral pathway in to holistic lifestyle services to meet the needs of
- establishment of more detailed client-led lifestyle behaviour change action plans
- increased collection of client experience information to use for service development
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The medium term impact of the proposal would include:
- individual lifestyle changes i.e. increased physical activity levels, reduction in weight
and BMI, reduction in alcohol consumption, smoking cessation, increased fruit and
- reduction in client medication i.e. for BP, diabetes, cholesterol (change to medical
- reduction in cost to NHS through effective referrals into existing services, improved
health of individuals and Calderdale population (i.e. reduction in medication
requirements, reduced hospital admissions etc)
The long term impact of the proposal would include:
- reduction in the prevalence of overweight and obese across Calderdale
- increase in population physical activity levels
- increase in population fruit and vegetable consumption
- improved emotional wellbeing (including increased confidence, motivation, self-
- reduction in Calderdale’s alcohol consumption
- reduced level of risk for type 2 diabetes across Calderdale
- reduction in CVD (including heart disease and stroke) across Calderdale (directly
related to improved BP and cholesterol through lifestyle change such as reduction in
weight, increased physical activity, reduction in alcohol, smoking cessation etc)
- increased rates of employment (relating to improvements in emotional well-being,
disabilities, long term sickness issues etc)
The Lifestyle Assessment proposal is a development of existing client pathways to a wide
range of Health Improvement services and programmes. As noted previously, this
proposal would provide a more comprehensive lifestyle assessment for individuals, the
establishment and review of more effective client-led lifestyle change action plans,
improved efficiency in client referrals, reduction in DNAs (therefore cost) to individual
services, improved collection of client experience information, improved monitoring of
specific lifestyle change i.e. increased physical activity, reduction in alcohol consumption,
increased fruit and vegetable consumption etc. The additional investment through the
reward monies would enable existing staff development into the two Healthy Lifestyle
Advisor posts, and would provide the resources required to carry out the comprehensive
Lifestyle Assessment checks noted earlier in the proposal. The funding would also
provide the opportunity for further specialist training to meet the requirements of the
Healthy Lifestyle Advisor posts.
As noted previously, this Lifestyle Assessment model would be piloted over a three year
period and the impact of the learning will be transferred into mainstream services, where
possible, once external funding ends.
It is anticipated that 7,200 Calderdale residents would benefit from the project over the
three years. This figure is estimated using the average annual number of registrations
into NHS Calderdale’s Healthy Weight Service. The proposal would focus it’s delivery on
the target wards across Calderdale to increase access to the most vulnerable residents
across the borough, therefore a higher percentage of the total residents benefited from
the proposal would be from vulnerable groups.
It is anticipated that the quality of life of Calderdale residents would improve significantly
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through the Lifestyle Assessment proposal. The personalised, comprehensive approach
to client care through this proposal would ensure individuals are accessing the services
that meet their needs, recommended by specialist advisors who would assess and
review their health status over a period of 12 months. Individuals would have access to
more information on health improvement service and programme options and be able to
make informed choices about to support the achievement of their lifestyle goals. The
proposal would also provide a function to screen individuals, identify their level of risk for
cardio vascular disease and/or diabetes, and refer to the required services (including
GPs for specialist treatment). NHS Calderdale’s Health Improvement Service has
multiple case study examples of client’s quality of life improving through accessing the
Healthy Weight Service, Stop Smoking Service etc. Examples include clients who have
reduced and/or stopped medication for BP and diabetes due to weight loss, returned to
employment through increased self esteem and motivation, and circulation improvements
to reduce dressings on ulcers and open wounds. It is anticipated that the more detailed
assessment, goal setting and review process would enhance the experience and health
improvements of increased numbers of people living across Calderdale. The proposal
allows monitoring of additional data such as BP, diabetes score and cholesterol, which
would be invaluable in the tracking of individual risk CVD and diabetes and also the
prevalence of such diseases across Calderdale.
The risks to success and how these will be managed
The recruitment of Healthy Lifestyles Advisors who match the essential criteria for the
post would be essential to the delivering of a quality and productive Lifestyle Assessment
The sign up from partner agencies would also be extremely important to ensure an
effective referral process into the Lifestyle Assessment and also for any referrals into
appropriate services and activities outside of NHS Calderdale’s Health Improvement
GPs would be crucial in supporting any ongoing specialist treatment for clients who have
presented at the Lifestyle Assessment with high risk relating to diabetes, blood pressure,
The risk relating to the above points is minimal. It is hoped that existing staff would apply
for the Healthy Lifestyle Advisor posts as a development opportunity, their skills,
experience, and knowledge of current services etc are likely to contribute to successful
recruitment. NHS Calderdale’s Health Improvement Service has built up extremely
strong relationships with partner agencies, including GPs. Regular discussions take place
with all partners as part of service reviews and feedback about existing services and the
potential for Lifestyle Assessment clinics to be established within GP practices has been
extremely positive. GP practices would welcome the sharing of client data collected
through a Lifestyle Assessment to support the quality of care they can offer their patients.
There should be very little risk in obtaining sign up to support the Lifestyle Assessment
What will happen if the proposal is not delivered
If the proposal is not delivered cost of disease will continue to grow across Calderdale.
There will be a missed opportunity to increase screening for blood pressure, diabetes,
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and cholesterol, and there will be limited access to personlised lifestyle assessment and
development of comprehensive behaviour change action plans with a dedicated Healthy
The short, medium and long term impacts that are noted earlier in the proposal will not be
met, this would be a missed opportunity to further improve the well-being and quality of
life of the Calderdale population.
You should send your completed business case to the Partnership Support Team
electronically at email@example.com
1st February 2011
SUBMISSION OF BUSINESS CASES FOR CALDERDALE PERFORMANCE
REWARD GRANT (PRG)
Calderdale is expected to receive £2.6m of reward funding from Government. This
funding is reward for the success Calderdale Council and its partners have had in
delivering targets agreed in 2007 with the Government. The funding will be available
during the 2011/12 financial year, subject to the receipt of the grant from Government.
The submission of business cases for awards from this fund is invited. Further details of
the application process, including eligibility criteria are set out below. Successful
proposals will be able to demonstrate: clear impact; value for money; likelihood of
success; future sustainability or a clear exit strategy; and a responsible approach to risk
The application process & timescales
Successful proposals will be considered only on the basis of the business case
template submitted. Any other documentation submitted will not be considered.
The deadline for submission of business cases is 5pm on Monday 28 February
2011. Any business cases submitted after this date will not be considered.
Business case templates should be submitted to firstname.lastname@example.org.
(Different submission arrangements are in place for Calderdale Council proposals.
Business cases should be forwarded to the appropriate Director for submission).
All business cases received will be published on the Calderdale Forward Website
The final decision on funding is the responsibility of the Council’s Elected Members
and is expected by the end of April 2011. Applicants will be told the outcome of their
application as soon as possible afterwards.
Funding is one-off. No further finance will be available from this source.
Funding must not be used to sustain existing commitments or mainstream services
Any funding received must be used for the benefit of Calderdale residents
Funding will be expected to be spent within three years.
The proposal must address one or more of the priorities set by the Calderdale
Forward Board in September 2010 as listed below:
- Fairness / narrowing the gap
- Jobs / business growth
- Health & Wellbeing
How much will be funded?
All funding is subject to the Council receiving the funding from Government at the end
of March 2011.
A total of £2,623,999 is expected to be available.
A minimum threshold of £100,000 per proposal has been set.
No maximum threshold has been set.
There will be capital and revenue funding available. Proposals must make clear the
type of funding required. The exact amount of capital and revenue split is not
1st February 2011
currently known. As soon as information is available it will be posted on the
Calderdale Forward homepage and all applicants will be informed by email.
Who is eligible to apply?
Public sector and not for profit organisations based, or operating, in Calderdale which
have a written governing document (such as a constitution), a bank or building society
account and/or produce their own annual report are eligible to apply.
Proposals supporting business or enterprise from organisations, based or operating in
Calderdale, are also welcomed. Successful proposals are more likely to come from
not for profit organisations.
Individual organisations can apply, however collaboration across organisations,
partnerships and sectors is strongly encouraged.
All Council and Council-led bids need to be sent to the appropriate Director for
All business cases will be assessed against the following criteria:
- impact of the proposal;
- value for money/cost effectiveness;
- likelihood of success;
- future sustainability; and,
- the approach to risk management.
Each business case at a minimum must address the following key areas:
Key areas Examples of issues it may be helpful to
consider when addressing the key areas
The issue that your proposal seeks to Does the issue fit within one or more of
address the priorities set by the Calderdale
Forward Board? (see funding
What plans are in place to address this
issue beyond the time span of the
Data and/or statistical evidence to Are there references to data sources
explain the issue or support your and/or needs assessments?
proposal Is the problem getting worse?
Has the scale of the problem been
What will be different as a result of the Will the impact be short, medium, long
proposal being implemented and how term?
you will know Does this relate to a new or existing
Is the impact likely to be sustained
after the funding has ceased?
How many Calderdale residents will
How many vulnerable residents will
How will the proposal improve the
quality of life of Calderdale residents?
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Have the outcomes been clearly
Is there a clear monitoring framework?
The risks to success and how these Have all the potential risks been
will be managed identified
What steps have been put in place to
mitigate identified risk?
What will happen if the proposal is not What are the implications if the
delivered application is not successful?
What would be the impact of being
unable to deliver the proposal?
NOTE: The business case section (section 3) should not exceed 4 pages of A4 and
Arial 12 font should be used throughout.
If you are a VCS organisation and unable to meet all of the eligibility or assessment
criteria, Voluntary Action Calderdale may be able to provide you with advice. Please
contact Jo Bolland by email email@example.com or phone 01422 348777
For general enquiries please contact the Partnership Support Team on 01422
Financial viability of organisations will need to be evidenced.
A delivery plan containing financial costings, expected impact, key milestones and
indicators of success must be submitted before formal agreement is reached.
Monitoring arrangements will be clarified prior to entering into a formal agreement.
For any grants awarded for work to buildings, proof must be obtained to confirm the
applicant has full title to the building or where appropriate the permission of the
Successful applicants will be required to enter into appropriate legal documents with
the Council which will include terms and conditions on how funding is to be spent,
monitoring requirements and clawback.
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