Management consultants in healthcare do more harm than good, but keep getting rehired – new research

Posted on February 17, 2021 by policybristol

This blog post was written by Andrew Sturdy, Chair in Organisation and Management, University of Bristol and Ian Kirkpatrick, Chair in Management, University of York. This article is republished from The Conversation under a Creative Commons license, read the original article here.

The use of management consultants has grown enormously in recent years. In the UK, consultancy brings in around £10 billion a year in fees across the public and private sectors. And while not totally recession-proof, the numbers grew in the run-up to Brexit and then COVID-19. (Remember test and trace? Consultants played a major role.)

Consulting firms can provide advice and extra resources at short notice and can be very effective for the right task and client. But their use often brings controversy, especially when public money is at stake, over the value of outsourcing, for instance. This raises a number of questions. Does consultancy bring improvements such as increased efficiency? If not, how can we explain its huge growth?

In the NHS, there is a remarkable lack of clarity and transparency over how much consultancy is used and with what effects. This falls within broader concerns noted in a recent National Audit Office report on procurement across public services.

In our ongoing research on management consultancy in the NHS, we have started to address these issues.

Continue reading →

Children with eczema: the link to food allergies is not clear cut

Posted on May 8, 2019 by policybristol

File 20190425 121224 d7dvpx.jpg?ixlib=rb 1.1 — TassaneeT via Shutterstock

Matthew Ridd, University of Bristol and Robert Boyle, Imperial College London

Around one in five children have eczema – and even mild cases can have a big impact on both the child and their family. For many, symptoms will come and go before they start primary school, but for others it can indicate the beginning of a genetic tendency to develop allergic conditions such as hay fever or asthma (or both). Continue reading →

What the NHS needs is more managers

Posted on February 1, 2019 by policybristol

File 20181028 7059 1w33xlt.jpg?ixlib=rb 1.1 — George Rudy

Ian Kirkpatrick, Warwick Business School, University of Warwick

NHS managers could do with a facelift. Cure the NHS with far fewer managers and It is nurses working at the coalface of the NHS that we need, not more bosses are commonplace headlines. And cynicism about NHS managers is not limited to the media. Two years ago, the then minister for health, Jeremy Hunt, wondered whether the NHS had made a mistake in the 1980s “by deliberately creating a manager class who were not clinicians”. Both Labour and Conservative governments have tried (unsuccessfully) to reduce their number. Continue reading →

Penicillin was discovered 90 years ago – and despite resistance, the future looks good for antibiotics

Posted on September 11, 2018 by policybristol

File 20180727 106524 l87kc3.jpg?ixlib=rb 1.1 — Shutterstock

Alastair Hay, University of Bristol

When the NHS turned 70 this year, I was reminded of another anniversary which has had an enormous impact on healthcare over many years. Penicillin is 90 this year.

Discovered in September 1928 by Alexander Fleming, it was first used as a cure when George Paine treated eye infections with it in 1930. A method for mass production was devised by Howard Florey and Ernst Chain in 1940, and it was first mass produced in 1942, with half of that total supply used for one patient being treated for streptococcal septicaemia. Continue reading →

What will the NIHR look like at 70?

Posted on August 17, 2018 by policybristol

by Dr Matthew Ridd
Reader in Primary Health Care
Centre for Academic Primary Care
@riddmj

As the NHS celebrates its 70th birthday, I hope that in another 58 years there will be similar celebrations and appreciation when its research arm, the National Institute for Health Research (NIHR), turns 70. Continue reading →

Policy & Politics authors call for a moratorium on the use of management consultants in the NHS until effective governance is established

Posted on July 6, 2018 by policybristol

Ian Kirkpatrick, Andrew Sturdy, and Gianluca Veronesi

A recent study on the impact of management consultants on public service efficiency, published in Policy & Politics, prompted this letter from the authors calling for a moratorium on their use until effective governance is established.

Open letter to the Rt Hon Jeremy Hunt MP, Secretary of State for Health and Social Care

2nd July, 2018

Dear Mr Hunt,

Re Calling for a moratorium on the use of external management consultants in the NHS until effective governance is established

We recently conducted independent research on the use of external management consultants in the NHS in England. This was subjected to peer review to establish the rigour of its analysis and published in an academic journal (Policy & Politics). Since then, it was mentioned in a parliamentary debate (23rd April, 2018, Hansard Volume 639) and widely reported in the media (21st February, 2018), including in The Times, which has also seen this letter. Continue reading →

Food and drink options in NHS settings; new questionnaire prompts changes

Posted on May 2, 2018 by policybristol

Photo Credit: Christopher Gross/Released

Dr Fiona Lithander, Senior Research Associate, NIHR Bristol Biomedical Research Centre.

Fiona explains how a new questionnaire could be used to increase healthy food and drink options in hospital retail outlets

At the National Institute for Health Research (NIHR), Bristol Biomedical Research Centre we are interested in the role the NHS plays in promoting good nutrition and health in children. Recent reports have shown a quarter of children in the UK are overweight or obese; a worrying statistic in itself, and the problem doesn’t appear to be getting any better.

NICE guidelines say that retail outlets in hospitals such as shops, cafes, restaurants and vending machines should offer healthy food and drink options, and that these options should be prominently displayed. They also say that nutritional information about the foods on their menus should be available. These guidelines do not refer to foods served to patients, although patients may have access to foods and drinks for sale onsite.

At NIHR Bristol Biomedical Research Centre we developed a new questionnaire to help NHS Trusts assess how healthy their food and drink options are. This differs from other questionnaires in that it allows Trusts to compare their findings with the NICE guidelines. Trusts can use this questionnaire to measure how healthy prepared foods for sale are, and can make changes accordingly. These changes may involve, replacing sugary drinks with sugar-free options such as water, and replacing chocolate bars with more healthy options such as unsalted nuts.

Using this questionnaire, we measured how healthy the foods and drinks were in two Trusts, and how closely they followed NICE guidelines. Our findings showed a lack of healthy food and drink options for sale in vending machines. Nutritional information on menus was minimal, and there was limited promotion and advertising of healthy foods and drinks. Since the findings were published, both of the Trusts have made improvements.

Our plan is to further develop the questionnaire in conjunction with the NICE guidelines, so that it can be used more widely in NHS Trusts and in local authority settings, such as leisure centres. Making it easier for parents to direct their children to healthier choices should be a central element of our healthcare system.

Disclaimer: This study was supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

This blog was originally published by the National Institute for Health and Care Excellence (NICE)

Repeat prescriptions are expensive and time consuming – it’s time for an NHS rethink

Posted on April 17, 2018 by policybristol

Shutterstock

Rupert Payne, University of Bristol and Céline Miani, University of Bielefeld

Over a billion NHS prescription medicines are issued by pharmacists in England every year – at a cost of over £9 billion. Many of these are prescribed by GPs to manage long-term health conditions, such as diabetes or cardiovascular disease.

The current “repeat prescription” system allows patients to request a further supply of medicines without the inconvenience of another doctor’s appointment. Continue reading →

Management consultants don’t save the NHS money – new evidence

Posted on February 26, 2018 by policybristol

File 20180220 116337 4i3pd1.jpg?ixlib=rb 1.1 — The NHS is strapped for cash.

Andrew Sturdy, University of Bristol

Few topics in the NHS have provoked as much controversy as the use of external management consultants. They provide advice on strategy, organisation and financial planning, and help implement new IT systems and other changes.

While some claim that this brings much needed improvements, critics question their value – particularly at a time when the NHS is strapped for cash. Even Patrick Carter, recently charged with reviewing NHS efficiency, admits that he has “a bugbear with employing management consultants”. Continue reading →

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