Why the NHS needs management consultantsBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c4729 (Published 01 September 2010) Cite this as: BMJ 2010;341:c4729
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Under 'competing interests',among others, Dr Prabhu claims that his Trust's A&E is the "Top performing A&E in the Country" . However, DoH's 'August 2010 Data' do not support Dr Prabhu's claim as there are several other A&E departments which have performed better than the A&E(see row 76;WRIGHTINGTON, WIGAN AND LEIGH NHS FOUNDATION TRUST
) which he seems to refer. In the circumstances,it would be better if Dr Prbahu could now clarify/withdraw his original claim.
NHS need not spend so much money on management consultants(http://www.bmj.com/content/341/bmj.c4729/reply#bmj_el_241198?sid=855a9c2...)
Competing interests: I am aware that Dr Prabhu has made a similar claim on another forum.
Perhaps innovative models of management consultancy may be more
palatable for collaborative NHS partnerships, such as the social
enterprise network consultancy model proposed by Diagnosis
This model harnesses in-house expertise and develops the management
skills of clinicians who act in a consultancy capacity.
Competing interests: Drs Stanton and Lemer are Directors of Diagnosis
The Secretary of State commented not on on the numbers or extent of
use of Consultancy services by the NHS, but on their cost.
I am a GP whose wife owns a small specialist HR Consultancy, charging fees
that are largely inline with my own daily rate. Some of her competitors
are large National firms who charge out at three to four times her daily
rate for arguably lesser quality service.
It is virtually impossible for a small Consultancy firm to find contracts
in the public sector because the sector (including the NHS) has
procurement processes that are biased towards large companies (for example
requiring specific accounting systems).
When, as an NHS GP partnership (an independent Contractor), my partners
and I consider getting outside help, we consider price to be a major
factor in our considerations; NHS Officers, accountable to their
(employed) superiors are likely to see risk reduction as their main driver
with less emphasis on cost.
If it were possible, for example, to reduce average Consultancy costs
across the NHS from, say ?2,100 per day to ?700 per day then on the
figures presented, about ?200 million would become available for patient
care without any reduction in quality. GP Commissioners are likely to be
ale to engage good advice at reasonable cost.
Editor Please note problem with GB Pound sign appearing as question
Competing interests: My wife owns an independent Pay & Reward Consultancy
The NHS doesn't need management consultants. NHS needs good managers,
strong Medical Leadership and 'Fair and Open' and Supportive and learning
culture. NHS needs excellent working relationship between the Primary and
Secondary care and for GPs and Consultants to take the leadership role and
work together, putting our patients first and in the centre of everything
It is only when doctors show the true leadership which our patients
and the NHS deserve, that we can make NHS much better and good value for
the money and make it a strong Institution, providing excellent health
care for the people of this great nation. But, it must be the right
NHS should also teach doctors and nurses at a early stage of their
career about value for money, cost effectiveness, performance management,
patient safety, medical errors, why doctors get in difficulty and how to
avoid medical errors, clinical risk management, valuing and involving
patients, effective team working and clinical risk management and so on.
It is only when we have strong and effective medical leaders that we
can have excellent quality care for our patients. We got to make sure that
NHS is safe, effective, good value for the money where patients feel safe
and receive good quality care and staff feel proud to work. It is not the
management consultants we need but consultants who are managed effectively
and only true medical leaders can do this challenging but most rewarding
job. Management is not about telling consultants what to do but helping,
supporting, guiding and working with them to bring the necessary changes
which will make NHS safe, effective and good value for the money.
Most doctors work very hard, providing excellent quality care to
their patients and they need to feel valued, involved, engaged and
Competing interests: I am the Medical Director of Wrightington, Wigan and Leigh and very proud of my hard working doctors, nurses and many other staff who have made WWLFT a great success. Just in last few months, these are some of our success stories.1. One of the top 10 Trusts to reduce HSMR.2. Top performing A&E in the Country 3. Third best Trusts to reduce MRSA significantly.4. Stroke Service has improved significantly5. Significant improvement in Fracture Neck of femur outcome.None of these would have been possible without some fantastic colleagues and excellent teams.