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The HMT 5 case model is a good format when used appropriately. It's quite correct to have a process which ensures the spending of public funds looks at all reasonable aspects of risk and planning. However, we are in a situation whereby we have NHSE/I guidance atop of the green book and it can become a quagmire of bureaucracy as approvers interpret the guidance in their own way. We also need to recognise that the model does not follow the development of capital projects in the same timescales. For instance, if the business case is to seek funding, then the costs of design and feasibility a bore by the applying organisation 'at risk' if approval is not granted. The FBC should detail the design and plan to be delivered. However, the design cost of a major construction project is mostly at pre-contract or Stage 4 (RIBA) and can be a large sum of money. It's not just the cost of architectural design, but structural engineers, mechanical/electrical, surveys, as well as planning, etc. Many of these business cases will need input on pathway redesign and activity modelling. Co-production and consultation are all required for the detail in the business case and again this can all be before investment has been approved. In short, the only piece of the 5 case model affordable 'at risk' is the SOC. Funding ought to be given to develop the OBC and FBCs up front. Indeed, the BC format is only supposed to be used for major projects of a value above a threshold (a sensible value would be c£15m) which reflects the effort and cost of the project's value. Capital projects are complex and deserve the justification such business cases provide but can be incorrectly used/applied. Don't make an industry of this, just be clear what and where the project is and the point the BC is attempting to justify. There's little point in progressing planning of a capital construction project to RIBA Stage 4 if you're not pretty certain it will go ahead. Use the SOC, OBC and FBCs accordingly with funding approvals at each document and this will reduce failed submissions getting to FBC stage.