Benefits Claimed but Not Evidenced

Several benefits management practices are missing. There are no benefits profiles: each claimed saving lacks a definition, baseline, measure, owner and realisation date. There is no benefits dependency network linking project outputs to the changes needed and then to outcomes. There is no benefits realisation plan, so no reviews are scheduled. The £12 million is therefore an assertion, not a benefit. Before the next funding request I would: (1) define each benefit precisely, separating cash-releasing savings from non-cash efficiency and patient-safety outcomes; (2) establish baselines, for example administrative hours per patient episode; (3) assign a named benefits owner, usually a clinical or operational lead, not the IT project manager; (4) map dependencies and the changes required in working practices; (5) agree measurement and review points, including post-implementation reviews. The portfolio-level benefits register should aggregate these and show confidence. This directly addresses the gateway review and gives the national funder a credible report. It also exposes any benefits that are double-counted across projects.

Financial management should move from capital spend control to total cost and value. The £85 million capital figure excludes revenue costs such as training, support, workflow redesign and clinician time; decisions based on capital alone can look cheaper than they are. I would introduce a portfolio funding envelope covering capital and revenue, with total cost of ownership for each project. Stage-gate funding should be released against evidence, including benefits readiness, not just spend. The finance director should report cost and benefits together: forecast spend versus forecast benefits, with variance and confidence. Contingency should be held at portfolio level, not distributed to projects. MoP's financial management practice includes funding, cost control and benefits linkage; the point is to show whether the portfolio is worth its cost. For the national funder, the benefits realisation report should include the revenue cost of achieving the savings. If the £12 million is not credible, the board should say so before the next request.

Clinicians are not a communications audience; they are the people who must change working practices for benefits to materialise. The resistance and workarounds suggest the system design and workflow do not fit clinical work. I would: (1) recruit clinical leads as benefits owners and visible champions, with time and authority; (2) involve clinicians in redesigning workflows and in decisions about configuration, not just training; (3) establish two-way engagement forums where problems are escalated and fixed; (4) measure and publish the things clinicians care about, such as time per patient and safety incidents, alongside savings; (5) acknowledge that some benefits will take time and may require additional support. This links to MoP's stakeholder engagement and energised change culture: attitudinal and relational factors matter as much as technical delivery. A benefits realisation report that clinicians have helped produce will be more credible than one written by the portfolio office alone.