The Best Possible Value (BPV) Decision Framework supports NHS organisations in designing a clear, structured decision-making process that demonstrates good governance and models options based on the value offered to service users and taxpayers. The ‘value equation’ is used throughout to measure the impact of strategic and operational decisions within organisations and local health economies on clinical outcomes, patient experience and safety.

The Decision Framework contains three main elements (which can be applied iteratively or individually as needed) to improve the effectiveness of decision-making:

  1. The Decision Planning tool supports multi-stakeholder groups in designing and planning a structured decision process that clearly defines the value goal and agrees stakeholder responsibilities up-front
  2. The Value Generation tool builds on decision planning to generate a rationale for the impact of a decision on outcomes and value, and details the evidence supporting the decision rationale or assumptions
  3. The Option Priorities tool allows users to demonstrate that decisions have been prioritised based on maximising outcomes and minimising risk, and not solely on the financial or strategic implications

The framework can be used for intra- and inter-organisational decision-making by all healthcare system players including commissioners, providers, regulators, public health and other arms-length bodies. The framework is particularly suited for use by Sustainability and Transformation Partnership (STP) footprints and Accountable Care Organisations (ACOs), and have been designed to support putting value thinking into practice for all individuals holding responsibility for deciding how resources are used.

The BPV Decision Framework is a user guide containing an introduction to the framework and tools, example templates and instructions for completion. An example Decision Handbook for maternity services transformation is included as an appendix.

The BPV Overview Slideset is an introduction to the action area and the framework for presentation to colleagues.

The BPV Decision Handbook contains blank templates for editing and includes instructions for projector display.

The BPV Option Priorities tool is a working spreadsheet for modelling value. Additional supporting user guidance is available via the BPV Decision Framework document.