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Civil servants spending spree on consultants

There has been a push to reduce spending on management consultants in the health service over the last few years.

So, the irony of the Department of Health and Social Care almost tripling its spending on consultancy in 2017-18 will not be lost on underpressure NHS managers.

The DHSC’s newly published annual accounts reveal £12.4m was spent on consultancy services in 2017-18, compared to £4.5m in 2016-17.

In contrast, NHS spending on consultancy fell from £384m to £358m in the same period.

And unlike the rest of the health system, DHSC spending on temporary staffing also shot up – from £14.2m in 2016-17 to £21.9m in 2017-18.

The department noted the increases were necessary because of “programmes of a short term nature” that require “specialist support not available within the DHSC”.

One wonders how much support was lost in the DHSC during the last few years after hundreds of jobs were axed as part of a drive to cut running costs.

Among the consultancies queueing up to help DHSC’s programmes was EY, which landed a contract worth up to £20m to help develop and implement the new procurement model for the NHS.

This scheme was cited as one of the main projects that has required external support, and EY will continue to help the department with this in 2018-19.

Consultants were also hired for a “corporate services improvement programme”.

With NHS trusts being told to curb such spending where possible, many in the system will be expecting the DHSC to lead by example in 2018-19.

The revolving door of CCG performance

The clinical commissioning group ratings for 2017-18 are out and there are some surprises hidden in there.

NHS England said the ratings this year were a slight improvement on 2016-17 and looking at the top line national figures that is true. The number of CCGs rated inadequate in the last financial year compared to the prior one, dropped from 23 to 18.

NHS England said this was a result of its new programme launched in January this year to support poor performing commissioners.

On a national level, there was minimal change in the numbers of CCGs rated requires improvement, good or inadequate.

However, underneath these national numbers there is significant variation in local ratings from one year to the next. More than two fifths of CCGs changed their ratings, with 46 getting better and 42 getting worse.

Some changes were noticeable – five CCGs improved by more than one rating, but four fell by more than one rating.

Given these swings, it is questionable how well the system is at driving up CCG performance – it seems for every CCG that improves its rating, another one gets worse. One could say it’s a revolving door.