Is the NHS really being ripped off?
Over the last few weeks I have been reflecting on this question. I'm not talking about procurement, I'm talking about agency and management consultancy spend.
It was a hot topic at the NHS Confederation in Liverpool and Hunt made it clear that he plans to cap agency spending as the health service goes 'hell for leather' on efficiency.
Under the new spending controls announced recently, any trust that wants to pay a new manager more than the £142,500 earned by the prime minister will have to justify it to the Department of Health.
The Department of Health has estimated that the proposals will lead to £400m in savings on agency staffing and reduce consultancy spending by £150m. Is this a reasonable intervention over agency and management consultancy costs? Or is it an intervention that will hinder NHS performance in the long run? Will the proposed cap on doctors and nurses working in the NHS have a negative effect to supply? Will this affect the front line services if trusts are unable to recruit due to spending cuts?
Hunt also suggests that there will be a requirement for trusts to seek 'specific approval' from regulators when signing a consultancy contract for more than £50,000. Is this process realistic?
An outright ban on the use of agencies that have not signed up to pay framework agreement, seems to me, a positive move as these frameworks are designed to regulate and control the margins that agencies charge. What will be interesting to see is if the market can stick to the interim executives' pay rates that are proposed under the new frameworks. Or will this simply erode the supply of talent?
It will also be interesting to see how these spending restrictions will be applied and monitored. Will it be more difficult with Foundation Trusts, as they have been granted a higher level of autonomy from the DH and Monitor?
Additionally, will these changes shift the supply of talent and knowledge away from the NHS? Will experienced NHS managers move to different sectors? What knowledge gap will that leave for the NHS?
Personally, I don’t think that the proposals will affect the management consultancy interim NHS market all that much. The reason Trusts come to me for interim help hasn’t vanished overnight. There are still gaps on boards, people on maternity leave, projects being designed, implemented and delivered. There are still trusts that need to go through large scale change, trust that need help to get out of special measures and trusts that need support to turn around services to meet national guidelines. In all of these situations Trusts need to call upon extra resource. These issues can’t be solved by the people who have their day jobs to do. Trusts need to be able to benefit from a flexible workforce that, in some cases is available at the drop of a hat. The demand for senior interims in the NHS is not about disappear.
As a provider of senior interims into the NHS, it is important to me that clients have visibility on the value add of their interim. This is especially important now that there is a magnifying glass over efficiency.
ROI (Return on Interim) is our cloud-based performance management system.
Designed from the ground up, ROI gives you full visibility of the performance of your interims. It enables you to evaluate their impact in real time.
It transforms the way you measure the value that your interims deliver, helping you identify what is working and easily compare the return different associates give you.
ROI presents real-time data in a visual way. It takes the guesswork out of finding the best interim resourcing solution, and enables you to make informed decisions based on the results delivered.
I would value your thoughts on this debate. What is your experience as either an interim or a client in need of interim resource?
Claire Carter is the Principal of Healthcare at Interim Partners.