Are consultants a waste of NHS money?

30 June 2017

  • Study finds NHS is wasting time and money on expensive consultants
  • Research found consultants' quick-fix solution no good for complex issue
  • Consultants were used as way to keep Department of Health happy
  • Yet everybody knew the consultants' plan could not be implemented

Hiring consultants offering quick fixes to long-term NHS problems is a waste of time and money, according to researchers.

With the NHS looking to fill a funding black hole of more than £20 billion, NHS organisations are turning to management consultants to devise efficiency savings plans. Yet such plans deliver far fewer savings than promised.

An in-depth study of NHS organisations’ use of consultants suggests that one reason for this is a conspiracy of silence between senior NHS managers and management consultants, devising plans unlikely to be fully implemented to alleviate short-term pressure from the Department of Health.

In the paper The Silent Politics of Temporal Work: A Case Study of a Management Consultancy Project to Redesign Public Healthcare published in Organization Studies, researchers discuss a consultancy project to find 20 per cent efficiency savings in a group of NHS organisations.

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Local NHS managers were developing a bottom-up consultative process that they believed would deliver sustainable change but with a Department of Health deadline looming, senior NHS managers hired a global management consultancy to help them produce an efficiency savings plan.

Gerry McGivern, Professor of Organisational Analysis, said: “The consultants offered a plan that NHS managers ultimately agreed but both realised would be difficult to implement without sufficient time for dialogue with local clinicians. But having a plan kept the Department of Health off their backs in the short term.”

Describing the ‘silent politics of time’, Professor McGivern added: “The time-frame you view issues through affects what you see. The consultants viewed the NHS’ problems through a short-term lens and drew on standardised global ‘best practice’ to develop an efficiency savings plan within 12 weeks. But they didn’t take the time to talk to NHS managers and clinicians about how it might be implemented in the local NHS, or to get everybody on board.

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“NHS managers and clinicians view change through a longer time frame. Many have decades of experience of the complex, political and often difficult process of making changes in the NHS, and are more interested in the sustainability and impact of efficiency savings for local NHS patients in the long term.”

Sue Dopson, of Said Business School, said: “We found that, faced with what they perceived as simplistic top-down change imposition, an unrealistic deadline and limited opportunities for dialogue, local NHS managers used these temporal differences politically. They superficially agreed changes they knew would fall apart to deflect immediate performance pressure.

“These differences in time-frames were never discussed, but our research shows that if you use consultants as a quick fix you are just storing up problems for the future.”

The Silent Politics of Temporal Work: A Case Study of a Management Consultancy Project to Redesign Public Health Care was written by Professor McGivern, Professor Dopson, Ewan Ferlie and Chris Bennett, of King’s College London, Michael Fischer, of the Australian Catholic University, Louise Fitzgerald, of Said Business School, Jean Ledger, of University College London.

Gerry McGIvern teaches Management of Change and Organisational Behaviour on the Executive MBA and Executive MBA (London), Leading and Managing Change on the suite of MSc Business courses and Changing Organisations on the Undergraduate programme.

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