• Commissioners in north west London spent £36.4m over four years on consultants
  • Large sums spent on reconfiguration programme, which NHS Improvement rejected capital case for last month
  • Commissioners spent £16m with McKinsey

Commissioners in north west London spent £36m on consultancy firms over the last four financial years – including millions on service redesign recently stalled by NHS Improvement.

North west London, which has been working on a major reconfiguration of services since 2011, spent more than £16m with McKinsey and McKinsey led projects in the four years up to the end of 2016-17, clinical commissioning group data reveals.

The Shaping a Healthier Future programme has led to accident and emergency units at Central Middlesex University Hospital and Hammersmith Hospital being closed. Urgent care centres now operate from those sites instead.

NHS Improvement must approve the SaHF bid for £500m in funding for the reconfiguration programme before it can be passed to the Department of Health. At its September meeting the proposal was not agreed and was sent back by NHSI’s board.

HSJ understands this was over the degree of optimism in the plans about how much activity could be taken out of the acute sector. The regulator asked for more information on the projections before it would refer the bid to the DH for the next stage of development. (see attached letter)

A spokeswoman for the sector insisted the project had not stalled but there is currently no date set for the proposal to return to NHS Improvement’s board for approval.

The money was to upgrade out of hospital facilities and make changes to non-downgraded hospitals to better cope with the extra work.

North west London’s eight CCGs are under the overall direction of Clare Parker, who is accountable officer of five of them. The area’s sustainability and transformation partnership is led by Ealing CCG chair and GP Mohini Parmar.

Shaping a Healthier Future was once described as the most significant reconfiguration programme in the NHS by the former NHS England chief executive Sir David Nicholson.

There was a public consultation on the plans in 2012 and in 2013 health secretary Jeremy Hunt agreed with the proposals.

The plans are still opposed by Ealing and Hammersmith and Fulham councils.

The consultancy spending data for the four financial years up to the end of 2016-17 comes from CCG disclosures.

In 2014-15, commissioners spent £301,000 with M&C Saatchi Group on work related to the closure of the Hammersmith and Central Middlesex A&E units.

Of the money spent with McKinsey, £9m was on the whole system integrated care programme.

A spokeswoman for the North West London Collaboration of CCGs said: “Investment in the right expertise has allowed us to redesign services and make real improvements to the care we provide our two million residents, across north west London’s eight boroughs. Money spent on consultancy in the last four years supports all our transformation work and not just the Shaping a Healthier Future programme and related business case.”

She added the changes had increased consultant cover in maternity care and at the remaining A&E departments, increased access to specialist children’s nursing and developed the WSIC programme, “which includes our world leading business intelligence tools”.