150,809 members

Skip to content. | Skip to navigation

Case Studies

This area is for commissioners to provide examples of their use of health investment tools/PBMA to inform commissioning decisions.  Please share your case studies so that others can learn from your experience.


Please send your examples to: england.healthinvestmentnetwork@nhs.net

Western Cheshire

Helen Bellairs, Chief Executive, NHS Western Cheshire and NHS Warrington

Matthew Cripps, Transformational Delivery Lead, NHS Western Cheshire and NHS Warrington

"In Western Cheshire we have used an evidence based approach to health investment, backed up by a lean business process focussing on delivery. This has resulted in: £11m of savings, improved patient care, an ongoing service review and system reform, and further savings of up to £25m planned for the next 15 months. The tools and guides on this site will provide you with a sound baseline for the analysis needed to deliver transformation of this magnitude."






Case Study 1

NHS Western Cheshire delivers £11m savings using Health Investment process (NEW)

NHS Western Cheshire has designed a new systemised approach to reform, decisions and implementation.  The PCT's objective was to drive down spend by focusing on allocative efficiency to produce the right 'quantity' of each service. The process ensured that management time was focused on projects resulting in improved outcomes for patients whilst getting better value from resources.  The result is that demand for acute services is starting to fall.

£7m of the savings were delivered in just 6 months.  The tools and data available on this website supported the process.  For a summary of the approach and details of the service reviews undertaken, click on the following icons:

For further information, contact Matthew Cripps at matthew.cripps@wcheshirepct.nhs.uk
W Cheshire summary
W Cheshire service reviews

Case Study 2


Derbyshire CCGs identify over £20m potential savings


Following the launch of PCT Health Investment Packs in 2010, work was carried out to build on this success. Packs were piloted with emerging CCGs in 2011/12.


This exercise was successfully implemented within the Derbyshire PCT cluster area. Aggregated CCG potential savings of £20.8m over the cluster area were identified together with case studies and recommendations of improvements to care pathways to tackle un-warranted variation.


Click on the image below for an anonymised version (Erehwon CCG) illustrating the presentation of data and findings.


Derbyshire Case Study


Case Study 3

Mental Health PBMA


Programme budgeting and marginal analysis (PBMA) is a recognised tool for commissioning healthcare. The objectives of this project were to test the acceptability, data availability and practical value of PBMA within the sphere of mental health. The PBMA methodology was applied to the consideration of Norfolk Primary Care Trust's National Health Service expenditure on mental health for 2006/7.

The project successfully attracted the interest of, and contribution from, important stakeholders with the exception of general practitioners. The process led to the identification of areas for disinvestment, releasing funds to be made available for the new services, or enhancement of existing services.



RC Psych society_logo v1.2