Management consultants ‘make NHS less efficient’

21 Feb 18

Management consultants brought in to improve efficiency in the NHS are “making the situation worse”, according to research led by Bristol University.

Academics from the universities of Bristol, Seville and Warwick Business School recorded data from 120 hospital trusts in England over a four year period.

Findings showed that on average £1.2m is spent every year per trust on management consultancy, a cost which is the equivalent of roughly 20 more managers, 10 more consultant doctors or 35 senior nurses.

The research paper also revealed that annual spending on management consultants more than doubled from £313m in 2010 to £640m in 2014 and this number has remained consistently high.

Consulting expenditure was found to have a negative impact on efficiency, according to researchers, amounting to an annual cost of £10,600 for each trust on average.

This number did not include the amount that was spent on consulting, which ranged from zero to £5.6m each year, the academics found. 

Andrew Sturdy, professor in management at the University of Bristol, said: “Our research has clearly shown that management consultants are not only failing to improve efficiency in the NHS but, in most cases, making the situation worse.”

He added it was possible that “consulting projects are highly disruptive, especially if the demand for them has been generated artificially by sophisticated selling, back stage deal-making and revolving doors between politicians, regulators, healthcare managers and civil servants.”

Professor Ian Kirkpatrick of Warwick Business School said: “This study highlights the need for organisations to be more circumspect in decisions about whether and how to use management consultants.

“It also comes down to politics, both in terms of the role of consultants in serving the agendas of politicians and managers, and consultants’ own commercial interests in generating more business.”

Chief executive of the Management Consultancies Association Alan Leaman said: “[The report] forgets that many consulting projects stimulate essential programmes of investment and modernisation, increasing some spending in the short-term in order to deliver better outcomes and effectiveness in the medium and longer-term.

“Like Professor Sturdy, we urge clients to look carefully at how they buy consulting and the value that they derive.”

An NHS Improvement spokesperson said: “We are working with all trusts on reducing their costs which includes spending less on management consultants, and have had some success.

“Since 2013, trusts have reduced their spending on management consultants by £150m, which is a significant improvement on the past.

“In future, we will continue to work with trusts on keeping their consultancy spending to a minimum, and on commissioning it better.”

NHS Improvement is responsible for overseeing foundation and NHS trusts as well as independent providers that provide NHS-funded care.

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