how to write a case study nhs

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Writing a case report in 10 steps

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• Peer review
• Victoria Stokes , foundation year 2 doctor, trauma and orthopaedics, Basildon Hospital ,
• Caroline Fertleman , paediatrics consultant, The Whittington Hospital NHS Trust
• victoria.stokes1{at}nhs.net

Victoria Stokes and Caroline Fertleman explain how to turn an interesting case or unusual presentation into an educational report

It is common practice in medicine that when we come across an interesting case with an unusual presentation or a surprise twist, we must tell the rest of the medical world. This is how we continue our lifelong learning and aid faster diagnosis and treatment for patients.

It usually falls to the junior to write up the case, so here are a few simple tips to get you started.

First steps

Begin by sitting down with your medical team to discuss the interesting aspects of the case and the learning points to highlight. Ideally, a registrar or middle grade will mentor you and give you guidance. Another junior doctor or medical student may also be keen to be involved. Allocate jobs to split the workload, set a deadline and work timeframe, and discuss the order in which the authors will be listed. All listed authors should contribute substantially, with the person doing most of the work put first and the guarantor (usually the most senior team member) at the end.

Getting consent

Gain permission and written consent to write up the case from the patient or parents, if your patient is a child, and keep a copy because you will need it later for submission to journals.

Information gathering

Gather all the information from the medical notes and the hospital’s electronic systems, including copies of blood results and imaging, as medical notes often disappear when the patient is discharged and are notoriously difficult to find again. Remember to anonymise the data according to your local hospital policy.

Write up the case emphasising the interesting points of the presentation, investigations leading to diagnosis, and management of the disease/pathology. Get input on the case from all members of the team, highlighting their involvement. Also include the prognosis of the patient, if known, as the reader will want to know the outcome.

Coming up with a title

Discuss a title with your supervisor and other members of the team, as this provides the focus for your article. The title should be concise and interesting but should also enable people to find it in medical literature search engines. Also think about how you will present your case study—for example, a poster presentation or scientific paper—and consider potential journals or conferences, as you may need to write in a particular style or format.

Background research

Research the disease/pathology that is the focus of your article and write a background paragraph or two, highlighting the relevance of your case report in relation to this. If you are struggling, seek the opinion of a specialist who may know of relevant articles or texts. Another good resource is your hospital library, where staff are often more than happy to help with literature searches.

How your case is different

Move on to explore how the case presented differently to the admitting team. Alternatively, if your report is focused on management, explore the difficulties the team came across and alternative options for treatment.

Finish by explaining why your case report adds to the medical literature and highlight any learning points.

Writing an abstract

The abstract should be no longer than 100-200 words and should highlight all your key points concisely. This can be harder than writing the full article and needs special care as it will be used to judge whether your case is accepted for presentation or publication.

Discuss with your supervisor or team about options for presenting or publishing your case report. At the very least, you should present your article locally within a departmental or team meeting or at a hospital grand round. Well done!

Competing interests: We have read and understood BMJ’s policy on declaration of interests and declare that we have no competing interests.

Guide to case studies

What is a case study.

A case study is an in depth focussed study of a person, group, or situation that has been studied over time within its real-life context.

There are different types of case study:

• Illustrative case studies describe an unfamiliar situation in order to help people understand it.
• Critical instance case studies focus on a unique case, without a generalised purpose.
• Exploratory case studies are preliminary projects to help guide a future, larger-scale project. They aim to identify research questions and possible research approaches.

We are often looking to develop patient stories as case studies and these will use qualitative methods such as interviews to find specific details and descriptions of how your subject is affected.

Patient stories are illustrative or critical instance case studies. For example, an illustrative case study might focus on a patient with an eating disorder to provide a subjective view to better help trainee nutritionists understand the illness.  A critical instance case study might focus on a patient with a very rare or uniquely complex condition or how a single patient is affected by an injury.

How do you do a case study?

1. get prepared.

• Be very clear about the purpose of the case study, why you are doing it and what it will be used for?
• Think about the questions you want to answer? What are your research or evaluation questions?
• Determine what kind of case study will best suit your needs? Illustrative, Critical Instance or Exploratory?
• Define the subject of study – is it an individual, a small group of people, or a specific situation?
• Determine if you need ethical approval to conduct this case study – you may be asked to prove that the case study will do no harm to its participant(s).

2. Get designing!

• Finalise your research or evaluation questions – i.e. what you want to know at the end of the study. Limit these to a manageable number – no more than 4 or 5.
• Think about where you will find the information you need to answer your questions.  Interviewing research subjects and/ or observing will likely be the central methods of your case study, but do you need to look to additional data sources as well? For example, desk research or evidence/literature reviewing, interviewing experts, other fieldwork and so on.
• Create a plan outlining how you will gather the information you need to answer your research or evaluation questions. Include a timeframe and be clear that you have the resources and equipment to carry out the work. Depending on the nature of the case study or the topic being studied a case study may require several meetings/interviews over a period of many months, or it might need just a one off interview. What does yours need?
• Decide on the exact subject of the study. Is this a specific person or a small group of people? If yes, plan how you will get in touch with them and invite them to take part in the case study. How flexible can you be in terms of time and travel? Does this limit your access to potential participants?
• Design interview questions that are open and will enable the participant to provide in-depth answers. Avoid questions that can be answered with a single yes or no and make sure the questions are flexible and allow the participant to talk openly and freely.

3. Get recruiting!

• You may have a specific individual in mind, or specific criteria. You will need to invite people to participate and make very clear that they are able to withdraw at any point.
• You will need consent from the participants. Make sure the purpose of the case study, why you are doing it and what it will be used, the methods and time frames are extremely clear to the potential participants. You will need written consent that demonstrates that the participant understands this. Additionally, if you intend to digitally record an interview or take notes, make sure you have permission from the participants’ first.
• If your central method is observation, this will be open observation – the participant must be aware of your presence and agreed to it – you are not allowed to observe without the participants’ permission!

4. Get conducting!

• Interviewing – Agree a mutually suitable time and venue for the case study interview. This may be a one off or the first of many over several months. Make sure the participant is in an environment they are comfortable and able to talk in. Equally important, however is that the environment is safe for you and is conducive to conducting a case study interview – i.e.  If it is a private space, are you safe? If it is a public space make sure it is not too noisy or likely to be affected by interruptions.
• Decide what is the best method of recording the interview information – digital recording is less intrusive and you can engage better in the conversation, than if you attempt to just take notes. Taking notes can mean that your concentration is focused on the writing rather than the listening and you can miss vital points. It can also be off-putting for the participant if there is no eye contact because you are scribing throughout the conversation. However, some participants will not like to be digitally recorded – so it is best to discuss this with them first. If you are digitally recording always test the equipment first. Even if you are digitally recording you will still need to take notes on key points, or things that you would like to investigate further, questions that arise or points at which you don’t want to interrupt the conversation or anything that will not be captured by the recording, such as body language or other observations.
• Depending on the total length of your case study, you might hold a one off interview, interview weekly, once every month or two, or just once or twice a year. Begin with the interview questions you prepared in the preparation and design phases, then iterate to dig deeper into the topics. Ask about experience and meaning — ask the participant what it’s like to go through the experience you’re studying and what the experience means to them. Later interviews are an opportunity to ask questions that fill gaps in your knowledge, or that are particularly relevant to the development of the case study or in answering your questions.
• Observing – recording observation can be done manually – i.e. taking notes – or digitally via a camcorder or similar. It is important to capture detail about the subject/participant and their interactions with others and the environment, their behaviour and other context an detail that is relevant to your questions.

5. Get analysing!

• Write up your notes or transcribe (Interviews), make notes (video) from your digital recording. Remember that if you are transcribing it is important to include pauses, laughter and other descriptive sounds and commentary on tone and intonation to better convey the story. Include the contextual information / the external environment and other observations that are important. Such as when and where the interview took place (you will not necessarily make this public) and any issues that arose such as interruptions that affected the interview or if there were multiple interviews anything of significance that happened in the periods between interviews.
• Thematically code (look for themes) and look for key parts of the interviews that will answer your original questions. Also be very aware that the may be new or unexpected information that has come through the process that is very important or interesting.
• Arrange the notes or transcriptions from the interviews and, or observations into a case study. It is not likely that you will be able to use the transcriptions without reorganising them, but if you are rewriting the story in your own words, be careful not to lose the meaning and language that reflects the participant.

6. Get sign off!

• Once you have drafted your case study make sure the participant(s) have sight of it and an opportunity to say whether you have captured their story and are representing it/them as they would like.

7. Get disseminating!

• More information about disseminating evaluations and case studies can be found on the  Evaluation Toolkit site .
• Remember case studies are not designed for large group studies or statistical analysis and do not aim to answer a research question definitively.
• Do background/context research where possible.
• Establishing trust with participants is crucial and can result in less inhibited behaviour. Observing people in their home, workplaces, or other “natural” environments may be more effective than bringing them to a laboratory or office.
• Be aware that if you are observing it is likely that because subjects know they are being studied, their behaviour will change.
• Take notes -Extensive notes during observation will be vital.
• Take notes even if you are digitally recoding an interview to capture your own thinking, points to follow up on or observations.
• In some case studies, it may be appropriate to ask the participant to record experiences in a diary – especially if there are periods between your interviews or observations that you wish to capture data on.
• Stay rigorous. A case study may feel less data-driven than a medical trial or a scientific experiment, but attention to rigor and valid methodology remains vital.
• When reviewing your notes, discard possible conclusions that do not have detailed observation or evidence backing them up.
• A case study might reveal new and unexpected results, and lead to research taking new directions.
• A case study cannot be generalised to fit a whole population.
• Since you aren’t conducting a statistical analysis, you do not need to recruit a diverse cross-section of society. You should be aware of any biases in your small sample, and make them clear in your report, but they do not invalidate your research.
• Useful resource: ‘Case Study Research: Design and Methods’, Robert K Yin, SAGE publications 2013.

Case studies

Find inspiration for your own evaluation with these real life examples

Guidance from a range of organisations for in-depth advice

Services and support

Knowledgeable organisations who may be able to help you

Training resources

Want to learn more? Our training resources are a good place to start

The Evaluation and Evidence toolkits go hand in hand. Using and generating evidence to inform decision making is vital to improving services and people’s lives.

The toolkits have been developed by the NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board (BNSSG ICB), the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) and Health Innovation West of England .

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Soft Skills

• Prioritising
• Influencing for results
• Digital Literacy
• Interview skills
• Business case / report writing

Business case/report writing

We have curated these resources to help you write better buisness cases and reports. They are organised by the time it will take to complete them so you can plan your time accordingly.

15 minutes or less

• Report writing skills: definitions and examples This article from Indeed explores what report writing is, give you some tips to write one and show you a template report.
• How to Write a Report: 7-Step Guide This video from Grammarly provides tips on how to write reports, including what to include and how to edit your work.
• Building an Innovation Business Case This short audio clip focuses on how to build a successful business case when you want to suggest a change or innovation. Important Note: This track is from Bookboon, To access Bookboon, access the Digital Library page on WeShare and scroll down to the bottom. The link to Bookboon is on the left-hand side under the title 'Soft skills eLibrary'.

1 hour or less

• Business Report Writing Skills This workbook will take you through the essential elements of a report and discuss how to ensure your report makes the impact you want. It is produced by e-learning company Litmos Heroes.
• How to Write a Business Case In this video, you will learn what a business case is and the main components that comprise it, who the primary business case audience is, what the business case best practices are, and also walk through a business case template using a case study project.
• Creating an NHS business case This video provides a case study example of creating an NHS business case.
• How to write a compelling business case & get approval for your idea This podcast, although aimed at HR professionals, shares insights on how to craft a compelling business case that significantly enhances your chances of success. It explains what a business case is and the importance of: Simplifying Starting with the “why” Engaging stakeholders early on Progress, not perfection It also gives advice on what to do if your business case is rejected.

More than 1 hour

• How to Create Great Reports in Word (Bookboon) A practical guide to features in Word that will help you write a slick published report. Important Note: This track is from Bookboon, To access Bookboon, access the Digital Library page on WeShare and scroll down to the bottom. The link to Bookboon is on the left-hand side under the title 'Soft skills eLibrary'.
• Business writing made easy: What effective writers really do (Bookboon) Business writing made easy sums up what modern professional writers do in just six simple ideas. It will give you a writing and editing method you can use for all your business writing. Important Note: This track is from Bookboon, To access Bookboon, access the Digital Library page on WeShare and scroll down to the bottom. The link to Bookboon is on the left-hand side under the title 'Soft skills eLibrary'.
• Why writing a better business case is important This video from APMG International is in the format of a Q&A with expert panellists. This episode is about why writing a better business case is important.
• How to create a business case This podcast episode focuses on creating a business case specifically as part of a change process.
• << Previous: Interview skills
• Last Updated: Feb 15, 2024 10:43 AM
• URL: https://bartshealth-nhs.libguides.com/softskills

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Documents and templates

Case study templates are effective in capturing and summarising the outcome of interviews.

The information can be used for advocacy, marketing and promotion of library and knowledge services.

See  Impact questionnaires and interviews  for details of how to find the information you need to be able to write up your case studies.

Case study documents  

C1. Case Study Template

C2. A completed case study example  showing how the form can be used. 

C3. Brief guidance on using the case study template

Contact the Knowledge for Healthcare team on  [email protected]  for any of the documents in an accessible format.

Page last reviewed: 8 April 2024

Writing your NHS business case

Supplying to the NHS can sometimes feel like a complicated process.

A common barrier frequently cited to us is the business case. In simple terms, a business case puts forward a proposal requesting resource, whether that is money, people, or time, from an NHS organisation.

These resources are precious to the NHS and a clear and thorough business case can be make or break. It has importance as a source of consistency and understanding for all those involved. It also helps to set a benchmark and manage expectations.

Your business case will be subject to a thorough appraisal process and must answer all the questions and concerns a busy NHS organisation would have.

There are core components of an NHS business case including making a case for change; articulating value for money; commercial viability; affordability; and a capability to deliver.

To cover these core components in enough detail, you’ll need to dedicate time to research and information gathering before you start your business plan.

You may also want to consider these five tips:

1. Treat your NHS business case as unique

An NHS business case will go through different processes depending on the organisation’s governance requirements and the value of the contract. Always understand the status of the internal business case and the stages that will follow before you start the process.

Requirements for non-NHS business cases may be different, so make sure you treat this as a unique case. Your case for change must fit alongside other marketplace policies; pressures; and structures.

Make sure to concentrate on the detail before you start.

2. Know who your business case is for

Approval of your business case will involve multiple stakeholders, it’s essential that you know who this is to understand what information they are interested in. The way your innovation may be funded can be based on the type of organisation, so it’s important to know who you are making the business case for. For example, is it aimed at primary or secondary care? Are they a foundation trust or not?

3. Remember that value is relative

What you deem as ‘value’, may be very different to your NHS customer. Fully understanding your value proposition is a crucial step to getting this part of your business case right.

4. Ask yourself, will your calculations stand up to scrutiny?

Within your business case, you will need to include figures relating to value; finance; evidence; and required resources. Potential investors need to know these are accurate and if they aren’t this will have implications for your business case and the future project.

5. Your stakeholders will want to know ‘what if we choose to do nothing?’

Doing nothing could be an option for your audience. When setting out your case for change, you need to help them understand that doing nothing isn’t an option. This may include outcomes and risks associated with doing nothing, and an overview of what other approaches have been considered.

Further reading

If you’ve found this information useful, you may also be interested in the following resources from some of our AHSNs:

• Preparing a successful business case: A practical guide for suppliers of innovative products and services – created by East Midlands AHSN
• State your case: 7 questions every innovator needs to ask themselves  – created by Eastern AHSN

Access AHSN support

Complete our company registration form to access support from your local AHSN to produce your business case:

If you would like to access support from a wider range of organisations like NICE; MHRA; NIHR, as well as the AHSNs, we’d advise that you apply to the  NHS Innovation Service  . There is no need to complete the AHSN engagement form if you apply for the NHS Innovation Service. The AHSNs will be made aware of your application.

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Case studies

The NHS Long Term Plan will make sure the NHS is fit for the future.

Find out through our case studies and films about how the NHS is already making significant changes and developing to better meet the needs of patients and their families through every stage of life.

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Case study template

NHS Education for Scotland (NES)

This template can be used to complete your case study and that will provide us with all the information we need to publish it on the organisational matters zone. Your name and board will be kept completely confidential.

Publisher: NHS Education for Scotland (NES)

Type: Document

Audience: General audience

   Download (22 KB)

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Standards of Practice: Case Study Template

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I am resigning from the Tory party and crossing the floor. Only Labour wants to restore our NHS

As an MP and psychiatrist, I see the burden that a service near breaking point takes on patients, their families and healthcare colleagues

Read more: Tory former health minister Dan Poulter defects to Labour in fury at NHS crisis

A longside serving my ­constituents as their MP, during the junior doctors’ strike I have spent more than 20 night shifts over the past year or so ­working as a mental health doctor in a busy hospital A&E department. It has been a truly life-changing experience.

Working on the frontline of a health service under great strain left me at times, as an MP, struggling to look my NHS colleagues, my patients and my constituents in the eye. Throughout the small hours, my clinical colleagues and I cared for many patients suffering from serious psychosis who would routinely be waiting several days, rather than hours, in a windowless room in A&E for a mental health bed.

When beds finally became available, they would often be with a private healthcare provider hundreds of miles from their homes and the vital on-hand support from their friends and families. I saw countless people at potential risk of suicide and others in crisis with a dual diagnosis of alcohol or drug dependence, together with severe mental illness.

The chaos of today’s fragmented patchwork of community addiction services – making A&E the default location for people to get treatment and help – has added pressure to an already overstretched service. The mental toll of a service stretched close to breaking point is not confined to patients and their families. It also weighs heavily on my NHS colleagues who are unable to deliver the right care in a system that simply no longer works for our patients.

It is this which has led me today to have resigned from the Conservative party to focus on my work as a doctor and to support Keir Starmer, Labour’s shadow health secretary Wes Streeting, and the Labour party both before and after the general election on NHS policy .

I shall continue to serve my constituents to the best of my ability until the next election – which I believe Rishi Sunak should call as soon as possible. After 14 years as an MP, including a period as health minister, I shall not be standing for parliament again.

I can well remember when I first qualified as a doctor and began working in the NHS in 2006. At the time, patient care had been radically improved and transformed by Tony Blair and Gordon Brown’s Labour governments, following many years of Conservative neglect and under-investment.

I am proud to still work as an NHS doctor alongside energetically serving as the MP for Central Suffolk and North Ipswich. However, just as was the case in the 1990s, what my healthcare colleagues and I see on the frontline of the NHS today is a health service desperately struggling to deliver the care our patients deserve.

I have come to the conclusion that, once again, the only cure is a Labour government.

The NHS currently has record long waiting lists. More than 7.5 million people are waiting for treatment and more than 250,000 people are waiting over a year for their operations. More than one in three cancer patients wait more than two months to start treatment after an urgent referral, and the UK has some of the worst cancer survival rates in the developed world . In a major A&E department, 44% of patients wait more than four hours for their care, and 235,835 people a year wait more than a month for mental health treatment.

I want much better than this for patients. As a consultant psychiatrist, I am deeply concerned about the failure of the government to implement vital reforms to mental health law and to the 1983 Mental Health Act, many of which were contained in Sir Simon Wessely’s independent review of the act in 2017.

In particular, I am dismayed by the failure to address racial disparities in the use of mental health laws and to reform aspects of mental health law relating to the care of people with learning disability and autism. Community services have been hollowed out, leaving the system poorly equipped to prevent crisis admissions and deliver the transformative care in the community that mental health patients need.

Over the past two years, the government has too often put the politics of public sector pay ahead of ending strikes with healthcare workers. Political ideology has been put before pragmatism and meeting the needs of patients – who are the real losers from the strikes. There has been a failure to address the longstanding pay concerns of NHS staff, and my nursing colleagues in particular , at a time of a cost of living crisis and increasing staff recruitment and retention challenges.

I also believe that, thanks to Keir Starmer , Labour has changed fundamentally. The Labour party of 2019 – roundly rejected by the British people – has been consigned to history. With Starmer’s leadership, the party understands that strong public services – and particularly a strong NHS – must be built on the bedrock of a strong economy. The Labour party is now a serious party of government, and it’s one in which I and the British public can put our trust.

I believe it is now incumbent on me as a medical practitioner passionately committed to our NHS to throw my weight behind the Labour party in its determination to ensure we again have a health service of which we can be proud, and which best meets the needs of every patient.

It is abundantly clear to me that the Labour party alone has the will and the trust to restore and reform the NHS. That’s why we need a Labour government, and why I believe Keir Starmer must lead that government as our next prime minister.

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