Monday, 23 July 2018

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NHS body ‘wastes millions on flawed financial advice’

North West London Clinical Commissioning Group under fire as cost of implementing management consultants’ plan soars to £1.3bn


 Protesters march in London against the NHS financial crisis last February. Photograph: Chris J Ratcliffe/Getty 


A large NHS body has spent millions of pounds on management consultants for a plan designed to save money – but which could cost more than £1bn to put into practice.
Over the past six years, the North West London Clinical Commissioning Groups has spent £66m on 41 different management consulting firms – including the big four: McKinsey, EY, Deloitte and PwC – for a five-year programme to improve healthcare in the area while closing a £1.4bn budget gap forecast by 2021. However, costs have ballooned and the trust said it now needs £1.3bn to implement the programme. It declined to quantify the savings that have been made to date.
It is just one example of the huge sums being spent on management consultants across the health service, despite growing concerns that they do not deliver value for money. Research from the University of Bristol and Warwick Business School suggested higher spending on management consultants made hospital trusts less, rather than more, efficient.
Stephen Cowan, the leader of Hammersmith & Fulham council, said the £66m spent by the NHS in north-west London was “a complete waste of money, evidenced by the fact that they couldn’t produce a business plan”.
One doctor working at Ealing hospital said staff felt completely demoralised by the changes taking place: “First they took cancer care, then they took obstetrics, then they took children’s in-patient services. There is a feeling of planned demolition.”
Management consultants drafted and redrafted the investment case for the trust’s transformation plan, which is now being revised after the regulator said assumptions about reductions in demand for certain services were “counterfactual”. Colin Standfield, a campaigner with Ealing Save our NHS, said: “That is exactly what we said six years ago. We said the numbers don’t work.”
It is a common complaint about management consultants working in the health service. Roger Steer, a former NHS chief executive who reviews NHS plans for local authorities, said: “It’s wishful thinking. You balance the books by assuming that demand can be reduced, then cuts can be justified by the fact that the service won’t be needed in the future.”
He said management consultants were often brought in to give plans a “plausible gloss”. A report by The King’s Fund, a healthcare thinktank, suggested the current wave of plans had “created an industry for management consultants”.
In north-west London, plans continue to be implemented despite the delay in approving the investment case. The first step was to close acute A&E departments at Central Middlesex and Hammersmith hospitals, replacing them with urgent care centres to deal with minor illnesses and injuries. That had a major impact on A&E waiting times in north-west London, which have been consistently worse than the rest of the country ever since.
A spokesperson for North West London Clinical Commissioning Groups said: “Investment in the right expertise has allowed us to redesign services and make real improvements to the care we provide our 2 million residents. Over the last three years we have significantly reduced our spend on consultancy.”
Peter Spilsbury, director of the Strategy Unit, an internal NHS consultancy, said individual trusts are also not sharing informationabout projects, so management consultants can resell their work to different parts of the health service.
He contrasted that with the work of the Strategy Unit. “The knowledge developed stays in the NHS. When we produce knowledge, we publish it whenever we can. If we’ve done a piece of work for one NHS client, we don’t sell it again.”
The lack of transparency has a further impact on staff morale. The doctor at Ealing hospital said: “Everybody feels things are done behind their back with ulterior motives, in a confrontational rather than cooperative way.
“Clearly we are in terrible trouble. When we look back at this period of austerity, I think we are going to see this in the statistics of the healthcare indicators. I’m sure that it will show up.”

Commemorating the NHS 70th anniversary at Charing Cross Hospital 05/07/2018













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PHOTOS- NHS's 70th Birthday 30/06/2018













John McDonnell MP,  Shadow Chancellor 


Dr Mike Galsworthy and  Dr Bob Gill 


Dr Lauren Gavaghan  and Peter Stefanovic 




​​
Mark (ARTIST TAXI DRIVER) 






PS: If you want to see all the photos of the NHS Birthday march,​please ​check this site:




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Press officer: ​Jim Grealy, jgrealy@f2s.com
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Friday, 1 June 2018

Revealed: The huge financial pressures facing two west London hospitals

The trust that runs Charing Cross Hospital and St Mary's Hospital is planning to make £48 million in savings in the coming financial year


The trust that runs Charing Cross Hospital is under pressure to make millions of pounds of savings to overcome a £20.6 million deficit.
Imperial College Healthcare NHS Trust is planning to make £48 million in savings for the coming financial year and will be able to access a portion of an NHS Improvement fund to help with its budget.
However, to be eligible for the money Imperial's hospitals must meet four-hour A&E waiting time targets 95 per cent of the time; a requirement labelled "illogical" by the British Medical Association (BMA).
The trust's healthcare facilities include St Mary's Hospital, in Paddington, and Charing Cross Hospital, in Hammersmith, which both have A&E departments the trust is expanding.
Charing Cross Hospital 
A campaign is under way to "Save Charing Cross Hospital" from an eventual proposed partial demolition.
Imperial says the cost improvement plan would not affect its £7.2m investment in the Charing Cross A&E redevelopment, due for completion by next June.
At its board meeting last week the trust unveiled a £20.6m deficit before funding from the NHS Improvement, Sustainability and Transformation Fund (STF) for the new financial year is taken into account.
The trust is optimistic about successfully implementing its cost improvement plan, a spokeswoman said.
"We expect to meet our financial target, as we have for the past two years, despite significant external cost pressures." she added.
The goals it has set itself gives it access to £34.2m from the STF pool.
The size of its slice from the STF is two-thirds contingent on the trust meeting its financial targets, and one-third on meeting the A&E targets.
As of this April, it was meeting the A&E target 84.6 per cent of the time.
It did not achieve it in the last financial year either, meaning it missed out on a £6.2m portion of the STF.
In its report to the board, the trust described increased demand on its emergency services, more ambulance and daily trauma patients at St Mary's, and bed pressures.
The Government launched the £1.8 billion STF pool in its 2015 spending review.
A share of the cash is contingent on providers achieving financial and performance targets.
Health Secretary Jeremy Hunt last March told providers they must take action to meet the A&E targets. NHS England and NHS Improvement then tagged the targets to its STF criteria.
BMA council chair Dr Chaand Nagpaul said this placed a burden on "overstretched" trusts.
"It is illogical and counter-productive that funding to support and improve hospital services should come with the precondition to achieve government targets first," he said.
"The government must recognise that with pressure on NHS services increasing year-on-year and national A&E waiting times consistently falling below the 95 per cent target, the problem lies not in the financial management of individual trusts but rather in years of chronic underinvestment."
Imperial did achieve its financial targets against a much smaller deficit plan in the last financial year, despite missing out on the STF portion for A&E targets.
Its planned £4.5m deficit benefited from a winter pressures top-up of £2.5m, with the trust ending 2017/18 with a £3m surplus.
The trust had set itself a cost improvement plan of £54.4m in 2017/18, but missed that target by £11.3m, which it partly blamed on winter pressures.
It made savings last year through clinical income, including from private patients, and also from saving on drugs, procurement and facilities, and reducing staffing costs like overtime and agency temps.
It planned to make similar savings this financial year, the spokeswoman said.
The trust planned to move patients through its urgent and emergency pathways "as effectively, as quickly and as safely as possible," its spokeswoman said.
Imperial's programme includes offering better alternatives to hospital admission, improving emergency department processes, specialist decisions and pathways, as well as bed management, ward and discharge processes.
Charing Cross Hospital's £7.2 million A&E expansion plans
• Increase the number of rooms in the urgent care centre from seven to nine.
• Increase the number of "majors" cubicles in the emergency department from 12 to 15.
• Increase the number of resuscitation bays in the emergency department from five to eight.
• Create two dedicated mental health rooms.
• Expand capacity for ambulatory emergency care, with same-day consultant review for patients with urgent or emergency health problems without the need for hospital admission.
By
  • 17:33, 30 MAY 2018
  • UPDATED17:36, 30 MAY 2018
    • https://www.getwestlondon.co.uk/news/west-london-news/revealed-huge-financial-pressures-facing-14725929

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