Using scenario planning to evidence value for money during service disruption
Value for money does not disappear during service disruption, but the way it is evidenced changes. Commissioners increasingly expect providers to demonstrate that decisions made under pressure remain proportionate, outcome-focused and financially responsible. Scenario planning provides a structured way to balance cost, risk and quality when normal delivery models are disrupted. This article explores how risk assessment and scenario planning support defensible value-for-money decisions and how this aligns with commitments made through business continuity in tenders.
Why value-for-money scrutiny increases during disruption
During disruption, providers may need to:
- Increase staffing costs through agency or overtime.
- Reduce non-essential activity to protect core support.
- Authorise additional management or safeguarding oversight.
Without scenario planning, these decisions can appear reactive or excessive. With structured scenarios, providers can demonstrate proportionality and intent.
How scenario planning supports proportional decision-making
Effective scenario planning:
- Defines what outcomes must be protected at all costs.
- Identifies where temporary efficiency loss is acceptable.
- Sets financial thresholds linked to risk escalation.
- Creates an audit trail for cost-impact decisions.
This allows providers to explain not just what they spent, but why.
Operational example 1: prioritising essential outcomes over uniform delivery
Context: A provider faces sustained staff shortages across multiple services.
Support approach: Scenario planning prioritises essential outcomes such as medication, personal care and safeguarding.
Day-to-day delivery detail: Non-essential activities are temporarily paused, additional staff hours are targeted to high-risk individuals, and management oversight increases for safeguarding assurance.
How effectiveness is evidenced: Costs rise in targeted areas but overall risk reduces, supporting value-for-money justification.
Operational example 2: controlled agency use through scenario thresholds
Context: Agency use risks escalating costs rapidly.
Support approach: Scenario planning defines clear thresholds for agency authorisation.
Day-to-day delivery detail: Managers must evidence risk impact before agency use is approved, with senior sign-off and time limits. Alternative controls such as redeployment or adjusted routines are explored first.
How effectiveness is evidenced: Agency costs remain controlled and defensible during prolonged disruption.
Operational example 3: value-for-money assurance through post-incident review
Context: Commissioners request assurance following a costly disruption period.
Support approach: Scenario planning outputs inform post-incident value-for-money review.
Day-to-day delivery detail: Providers compare planned scenarios against actual spend, outcomes protected and residual risk. Learning informs revised thresholds and future scenarios.
How effectiveness is evidenced: Providers can demonstrate learning and improved financial governance.
Commissioner expectation
Commissioners expect providers to evidence proportional spend during disruption. Scenario planning should show how costs relate directly to risk reduction, outcome protection and system stability.
Regulator and inspector expectation (CQC)
CQC expects providers to manage resources effectively while maintaining safe care. Inspectors may explore whether cost pressures during disruption compromised quality, staffing competence or safeguarding.
Governance and assurance mechanisms
- Scenario-linked financial thresholds and authorisation routes.
- Decision logs linking cost to risk and outcome protection.
- Post-incident value-for-money reviews.
- Board oversight of high-cost disruption periods.
What good looks like
Good scenario planning allows providers to explain difficult financial decisions clearly, showing how resources were used deliberately to protect people, not simply to maintain appearances.