Terms of Reference v1.0 | Cost Avoidance Analysis | Success Outcome Statement | Proposal Mapping | David Agyei | June 2026
Four documents submitted as part of the EPA portfolio. Each is structured as a collapsible chapter below. Use audio to listen to any document while travelling.
This Terms of Reference (ToR) governs Phase 2 of the SWANN SPoR (Spot, Prevent, Observe, Respond) programme at Shropshire Council. Phase 2 has been initiated to design and implement the digital and data infrastructure required to make the SWANN early-intervention pathway functional, measurable and scalable.
Phase 1 of the SWANN programme launched in October 2024 with three commissioned providers (ICE Creates / Live Well Shropshire, British Red Cross, Community Resource). Phase 1 has not performed as intended: professional referrer uptake is near-zero from two of three providers, a significant referral backlog has accumulated, and there is no data infrastructure to evidence demand deflection. Phase 2 exists to address these failures structurally, not symptomatically.
In scope:
Explicitly out of scope:
The Phase 2 project is governed through the SWANN Phase 2 Wednesday weekly meeting series, chaired by Lisa Middleton (Commissioning Officer). The POAP (Plan on a Page) operates as the standing governance document, updated weekly and shared with all team members via SharePoint. The RAID log is the formal risk and decision record, maintained by David Agyei.
Strategic owner: TBC. This is documented as RAID risk R_003. Lisa Middleton holds effective accountability for operational and commissioning decisions within Phase 2. Escalation above commissioning level is currently routed through Steve Humphrey (PMO), pending formal strategic owner confirmation.
| Name | Role | Responsibility |
|---|---|---|
| Lisa Middleton | Commissioning Officer / Chair | Accountable for Phase 2 outcomes; commissioner decisions; governance oversight |
| David Agyei | BA Lead / Project Manager | Requirements specification; RAID log; POAP; coordination; stakeholder management |
| Kate Hobbs | CRM Developer | Responsible for Workstream A (referral form build) and technical CRM development |
| Katie Done | CRM Analyst | Responsible for Workstream B (provider access) and Workstream E (data capture) |
| Lesley Richards | Contracts Officer | Main contact for Workstream C (dashboard); contract monitoring requirements |
| Jim Ford | Customer Services Manager | Workstream A sign-off; operational referral management liaison |
| Adam Riglar | ICE Creates | Provider engagement; Workstream B consultation; data sharing |
| Steve Humphrey | PMO Lead | Governance quality assurance; escalation route; EPA oversight |
| Strategic Owner | TBC | Accountable above commissioning level; strategic decisions; escalation receiver |
| Name | Role | Status |
|---|---|---|
| Lisa Middleton | Commissioning Officer | Endorsed at 27 May meeting |
| Steve Humphrey | PMO Lead | Endorsed |
| Strategic Owner | TBC | Pending identification of postholder |
This cost avoidance analysis has been produced to support the Phase 2 business case and EPA project proposal. It sets out the financial rationale for investing in Phase 2 infrastructure (electronic referral form, dashboard, provider access) in the context of Shropshire Council's financial emergency and its strategic focus on early intervention.
Cost avoidance, rather than direct savings, is the appropriate financial frame for this programme. SWANN's value is what it prevents: formal Care Act assessments, short-term reablement episodes, long-term home care packages and residential placements that would otherwise occur without early community intervention. Phase 2's infrastructure makes this avoidance measurable for the first time.
| Escalation type | Unit cost range | Source | Status |
|---|---|---|---|
| Formal Care Act assessment | 600 to 900 pounds each | ADASS unit cost data 2024/25 | Published benchmark |
| Short-term reablement episode | 1,500 to 3,000 pounds per episode | PSSRU Unit Costs of Health and Social Care 2023 | Published benchmark |
| Long-term home care package | 15,000 to 22,000 pounds per year | ADASS 2024/25 | Published benchmark |
| Residential care placement | 35,000 to 55,000 pounds per year | ADASS 2024/25 | Published benchmark |
A 20% deflection rate has been used as the baseline assumption. This is the lower end of the range evidenced in NHS England social prescribing evaluation studies (2022/23), which report deflection rates of 20% to 40% across community-based prevention programmes. The 20% figure is deliberately conservative to avoid overstating the case.
A 60% eligible-for-care-package rate is applied to those who avoid escalation. This is based on NHS Digital adult social care data, which shows that approximately 60% of people who receive a formal Care Act assessment go on to receive a care package. The 40% who do not would still benefit from cost avoidance at the assessment stage.
| Step | Figure | Basis |
|---|---|---|
| Annual referrals once form is live | 200 | [ASSUMPTION: PROXY] Pending Lisa Middleton data |
| Deflection rate (preventing escalation) | 20% | NHS England social prescribing evidence, lower end |
| Escalations avoided | 40 | 200 x 20% |
| Assessment cost avoided per year | 30,000 pounds | 40 x 750 pounds mid-point (ADASS 600-900 range) |
| Care package eligible rate | 60% | NHS Digital adult social care data |
| Care packages avoided | 24 | 40 x 60% |
| Care package avoidance per year | 360,000 pounds | 24 x 15,000 pounds/year (ADASS conservative) |
| Total illustrative annual cost avoidance | 390,000 pounds | Conservative proxy estimate |
Phase 2 requests no additional budget. All development is within existing ICT and commissioning resource. The Dynamics 365 licence is already in place. The CRM team (Kate Hobbs, Katie Done) are absorbing Phase 2 development within existing capacity. There is no new spend. The cost avoidance case therefore represents net value: 390,000 pounds per year from zero additional investment.
Currently, SWANN cannot produce a single report showing how many people were referred, what happened to them, and whether they avoided escalation to statutory services. This is not a reporting problem. It is a data architecture problem. Phase 2 builds the architecture. Once the referral form routes data into CRM, and providers record outcomes in CRM, and the dashboard draws from CRM, the evidence chain is complete. The 390,000 pound figure is illustrative of what will become measurable, not what is currently proven.
Meeting scheduled: 23 June 2026. Answers will replace proxy assumptions with real Shropshire data.
This document was submitted as part of the EPA project proposal (5 June 2026). It evidences financial management (S3.1), data interpretation (S9.2) and analytical rigor in conditions of genuine uncertainty. The decision to label all assumptions as proxies and identify the specific questions that would make the analysis real is itself evidence of professional standards.
Prepared by David Agyei, Senior Business Analyst, PMO. Draft v0.1, 28 May 2026. Sent to Lisa Middleton for review ahead of the 1 June meeting and submitted with the EPA portfolio.
Specifically:
| # | Outcome |
|---|---|
| 1 | Electronic referral form is live. Professional referrers can submit referrals digitally at any time, without needing to call in. The form is in active use and is the primary route for professional referrals. |
| 2 | Provider response standard is in place. All SWANN providers acknowledge referrals within an agreed timeframe and provide a substantive status update within a defined number of working days. Customer Services can view referral progress in the CRM without chasing providers. |
| 3 | Referral volumes are growing. The service is receiving a measurable increase in referrals compared to Phase 1 levels, with uptake across professional referrers and, once launched, residents. [Baseline figure to be confirmed with Lisa Middleton.] |
| 4 | Dashboard development is underway, with requirements agreed and build initiated. Lesley Richards and the commissioning team have a clear view of the reporting framework and timelines for a live dashboard. |
| 5 | Self-referral pathway is planned and approved. A communications plan for the public self-referral launch has been agreed, with a target launch date confirmed. |
| 6 | Project governance is sustained. A strategic owner is in post, a RAID log is actively maintained, and the project has a clear handover plan for delivery continuity beyond June 2026. |
These three points require Lisa's input before the outcome statement can be finalised.
This document was submitted with the EPA portfolio for Assessment Method 2. It maps all 25 KSBs for the Project Proposal, Presentation and Questioning assessment to specific evidence locations in the submitted proposal and the 13-slide presentation.
Key: Pass = meets pass grading descriptor. Pass + Distinction = meets both pass and distinction grading descriptors.
KSBs: K1.1, K1.2, K1.4, K10.2, S1.1, S1.3, S4.3, B3.1, B3.2
| KSB Ref | Descriptor (summary) | Project Proposal evidence location | Presentation | Grade |
|---|---|---|---|---|
| K1.1 | Operational management approaches in strategic planning | Section 3.1: sprint-based approach rationale; POAP as strategic planning tool; GANTT (Section 3.2). Section 4: phased delivery sequencing with rationale. | Slide 7: Scope and Objectives. Slide 8: Project Management Tools (sprint vs waterfall evaluation). | Pass |
| K1.2 | Business development tools and techniques for continuous improvement | Section 3.1: analysis and evaluation of sprint vs waterfall approaches. Section 5: evaluation of three analysis methods (stakeholder interviews, CRM data, financial proxy approach). Section 8: three alternatives evaluated with reasoning. | Slide 6: Context and Problem. Slide 8: tools used and their effectiveness. | Pass + Distinction |
| K1.4 | Contingency planning and management systems | Section 3.3: risk register with mitigations for six identified risks. Section 7.1: post-EPA handover plan as contingency. Concurrent Phase 1/Phase 2 approach as operational contingency. | Slide 9: Risk Management approach. | Pass |
| K10.2 | Organisational values and ethics in decision-making | Section 8: Alternative 2 (external consultant) evaluated against value-for-money principle. Section 6: financial transparency with proxy figures labelled rather than presented as fact. Section 7.2: communications approach designed for accessibility. | Slide 13: Communication Methods. Slide 3: Decision Making. | Pass |
| S1.1 | Operational management approaches in planning to meet objectives | Section 3: project plan, GANTT, RACI. Section 2.3: KPIs defined. Section 4: delivery approach linked to objectives. | Slide 7: Scope, KPIs, Objectives. | Pass |
| S1.3 | Business tools in context of managing change | Section 3.1: POAP, RAID log, sprint framework. Section 5: analysis tools evaluated. Appendix A.1: leadership discussion on tool selection with Steve Humphrey. | Slide 8: tools and techniques. Slide 11: change management. | Pass |
| S4.3 | Commercial awareness and identifying opportunities | Section 6: cost-avoidance case. Section 2.1: council financial emergency context. Section 9: recommendation to build measurement framework in parallel. | Slide 10: Financial Case. | Pass |
| B3.1 | Flexible, creative and innovative approaches to solutions | Section 3.1: sprint approach chosen over conventional project workbook. Section 8: standalone form alternative considered and rejected in favour of integrated portal. Concurrent Phase 1/Phase 2 approach as creative solution to Jim Ford's concern. | Slide 3: Decision Making. Slide 8: tools evaluation. | Pass |
| B3.2 | Enterprising when seeking solutions | Section 4: requirements sequencing to unblock electronic form build. Section 6: published benchmark approach to financial analysis when internal data unavailable. Section 8.3: portal vs standalone form decision. | Slide 3: Decision Making. | Pass |
KSBs: K1.5, K2.1, K2.2, K9.1, K10.1, S1.2, S2.1, S2.2, S2.3, S7.1, S9.2, S10.1, S10.2
| KSB Ref | Descriptor (summary) | Project Proposal evidence location | Presentation | Grade |
|---|---|---|---|---|
| K1.5 | Supporting and communicating change | Section 7.2: tiered communications plan. Section 10 (earlier v0.1 proposal): co-design approach. Section 4: provider engagement structured through monthly SWANN meeting. | Slide 11: Leading and Managing People. Slide 13: Communication. | Pass |
| K2.1 | Project management tools for planning and delivery | Section 3: sprint framework, GANTT (Table 3.2), RAID log, RACI (Table 3.4), POAP. Section 3.1: explicit evaluation of sprint vs waterfall. | Slide 8: Project Management Tools. | Pass |
| K2.2 | Risk identification, mitigation and monitoring systems | Section 3.3: risk register (6 risks, likelihood, impact, mitigation). Appendix A.2: RAID log referenced as active tool. | Slide 9: Risk Identification and Management. | Pass |
| K9.1 | Time management tools and prioritisation | Section 3.1: sprint approach enables weekly prioritisation. Appendix A.1: Steve Humphrey's guidance on sequencing. Section 8.1: stabilise Phase 1 first vs concurrent approach as explicit priority decision. | Slide 2: Managing Self. Slide 8: tools. | Pass |
| K10.1 | Critical data analysis for decision-making | Section 5: evaluation of three analysis methods with limitations stated for each. Section 6.2: cost-avoidance calculation with labelled assumptions. CRM data (31 outstanding referrals) used to validate Phase 1 analysis. | Slide 6: Context. Slide 10: Finance. | Pass |
| S1.2 | Supporting, managing and communicating change; overcoming barriers | Section 8.1: Jim Ford's concern addressed as a change resistance example with documented response. Section 4: co-design approach to overcome adoption risk. Section 7.2: tiered communications plan. | Slide 11: Leading and Managing People (change barriers identified). | Pass |
| S2.1 | Planning, organising and managing resources | Section 3: full project plan, RACI, GANTT. Section 6.3: resource requirements analysis. Section 3.1: sprint rationale (resource-efficient). | Slide 8: Project Management. Slide 2: Managing Self. | Pass |
| S2.2 | Monitoring progress and identifying/mitigating risk | Section 3.3: RAID log with 6 risks and live tracking. Weekly meeting cadence for progress monitoring. Section 7.1: handover plan for continuity risk. | Slide 9: Risk Management. | Pass |
| S2.3 | Evaluating effectiveness of project management tools | Section 3.1: explicit evaluation of sprint vs waterfall with benefits, limitations and risk of each. Section 5: evaluation of three analysis methods including their limitations. Sections 8.1-8.3: alternatives evaluated. | Slide 8: tools effectiveness. Slide 3: Decision Making. | Pass + Distinction |
| S7.1 | Various communication forms suitable for audience | Section 7.2: tiered communications (weekly meetings for core team; monthly partnership for providers; targeted comms for professional referrers; separate comms for self-referral public launch). Different register for different audiences evidenced across governance documents. | Slide 13: Communication Skills (methods demonstrated). | Pass |
| S9.2 | Time management and prioritisation approaches | Section 3.1: sprint vs waterfall decision explicitly linked to time constraint. Section 8.1: concurrent vs sequential decision. Appendix A.1: Steve Humphrey guidance on sequencing workloads. | Slide 2: Managing Self. | Pass |
| S10.1 | Critical data analysis for understanding and decision-making | Section 5: three methods analysed for validity and limitations. Section 6.2: calculation with explicitly labelled assumptions. Section 5: encryption issue noted as data quality caveat. | Slide 6: Context and problem data. Slide 10: Finance. | Pass |
| S10.2 | Evaluating problem-solving techniques | Section 5: explicit evaluation of stakeholder interview method, CRM data method, and financial proxy method, including limitations of each. Section 8: three alternatives evaluated against project constraints. | Slide 3: Decision Making and Evaluation. | Pass + Distinction |
KSBs: K3.1, S1.5, S3.1, S6.3, B3.4
| KSB Ref | Descriptor (summary) | Project Proposal evidence location | Presentation | Grade |
|---|---|---|---|---|
| K3.1 | Managing project budget considering financial implications | Section 6: full financial analysis, cost-avoidance case, resource requirements. Section 6.2: illustrative calculation with assumptions labelled. Section 6.3: resource requirements without additional budget. | Slide 10: Finance (budget, financial implications). | Pass |
| S1.5 | Management information and reports for project budgeting | Sections 6.1 and 6.2: cost-avoidance analysis report with unit cost table and calculation. Five questions to commissioner for validation. Proxy approach justified where local data unavailable. | Slide 10: Financial case and reporting. | Pass + Distinction |
| S3.1 | Monitor budgets, financial implications, adjust recommendations | Section 6.2: calculation adjusted to conservative end of published ranges. Section 9: recommendation 1 explicitly linked to financial risk of no strategic owner. Section 8.3: portal vs standalone form decision included cost/complexity analysis. | Slide 10: Finance; budget monitoring approach. | Pass + Distinction |
| S6.3 | Specialist advice: willingness for new ways of working | Appendix A.1: Steve Humphrey guidance on sprint approach and financial methodology; advice followed and its impact evaluated. ADASS/PSSRU specialist financial benchmarks used on Steve's advice. Lisa Middleton's commissioner expertise shapes success outcome statement. | Slide 12: Building Relationships; specialist input. | Pass + Distinction |
| B3.4 | Open to specialist advice and new ways of working | Section 3.1: sprint model adopted on Steve H's advice, replacing planned waterfall. Section 6: financial proxy approach adopted on Steve H's advice. Section 8: three alternatives including external consultant honestly evaluated rather than dismissed. | Slide 2: Managing Self; openness to guidance. | Pass |