As the official spends from NHS organisations are made public there are plenty of stories about how much is being spent on ‘Consultancy Services. After reviewing the figures myself I found that it wasn’t the actual spend in 09/10 which was the most alarming figure, it was seeing how the sums have increased over the last few years.
From just 2008-2010 the average percentage increase in spend in this area is nearly 150% for PCTs and Hospital Trusts.
Some organisations show dramatic increases such as the University Hospital of North Staffordshire who spent just £18K in 07/08 and £1.8m in 09/10.
So is this a terrible waste of money?
Well that does depend on how the money is spent. From my experience in the NHS, many organisations rely heavily on consultancy services. This is not necessarily a criticism. Most NHS organisations are required to implement very complex information and IT projects and the development of these services are generally short term projects which need specialised support and resourcing. It can often prove much more cost effective to bring in short term consultancy to develop these tools than it would be to employ full time staff and the added overheads these staff would incur.
Over the last few years there have been a myriad of government initiatives requiring organisations to collect, interrogate and report back information on a previously unprecedented level. This has lead to a requirement of specialist services in this area.
There is also the ‘performance review’ aspect. Most organisations now realise that to improve services and be more cost effective they need some kind of measure. The work involved in analysing the huge volumes of information to define these measures and then monitor them is a specialised world.
So is it a waste of money bringing in consultancy services for these specialised and short term projects? Well I guess it depends on what you get for your money. Spending £50K on a snapshot view of performance is not really value for money as the information is soon out of date. Spending on implementing systems which allow information to be monitored on an ongoing basis would seem to be a better prospect.
Consultancy if used appropriately is not a waste of money, indeed, the consultancy bill that has raised so much public concern, is for less than 0.5% of the NHS Budget, not a trivial amount in itself, but a drop in the ocean when one considers the size of the NHS, the complexity of the NHS and as you also pointed out the specialist knowledge and skills which the NHS seems keen to divest itself of at every opportunity.
ReplyDeleteWhere I do agree with the critics, is in the use of consultants in areas where the necessary skills already exist in-house. In my NHS career I've seen many examples where an external consultant was engaged because somehow their output is given more credence and value than staff already employed in the NHS.
Connecting for Health has just culled a large proportion of its contract staff as financial pressures begin to bite, yet the requirement remains the same.
Use consultants where no alternative exists, but look at the staff in organisations, look at their skill sets, the NHS will be pleasantly suprised.
To agree with Andrew, I too have seen many examples of the NHS outsourcing when skills exist in-house, notably on web/IT projects where the general consensus (from those for whom IT is not their area of expertise) is that a third party company will provide a "better", "more flashy" end product. This invariably means poor requirements specification and unclear acceptance criteria from the business resulting in an end product which is incompatible with existing systems, incorrectly branded, non standards compliant and generally not fit for purpose ... oh and costs 10 times more to boot!
ReplyDeleteThe public sector need to identify and nurture the skills/expertise/organisational knowledge they have in-house and be mindful that getting rid of these people when the next raft of cuts come along can surely only increase future dependency on consultants and the associated costs. I’m sure more than a few NHS employees can think of situations where staff have been made redundant only to return on over-inflated consultancy rates 6 months later?!
I feel so much better for getting that off my chest!! ;-)