ABSTRACT
A high proportion of human capital investment is currently in effect supply-sided commissioned because there is a good supplier, a good course or an available budget. It is important to shift to a demand-sided approach for this expenditure: to link these plans to impact outcomes that are important to organisations and funders. People clarify organisational needs with the help of Theory of Change models or with Systems Analysis and Root Cause Analysis processes. Combining Theory of Change or Systems/Root Cause Analysis with an impact outcome framework built from the logic model provides the detail that people require to express the sequence of needs that will enable us to define Specific, Measurable, Achievable, Realistic and Timely, SMART objectives from which people can build a chain of impact. Treating pressure ulcers costs the National Health Service (NHS) billions of pounds each year, estimated to be up to 4 per cent of the total NHS expenditure.
