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"Did you know that in 2019 the DoH spent £22.65 million on management consultants?"
That's the equivalent to funding approximately:
695 extra SHO's/year, or
635 extra Band 6 nurses/year
A thread on why we need to talk about Management Consultants in the #NHS:
1/ Before I suggest why the use of management consultants represents poor value for the NHS, it's important to understand who they are & what they do.
Mx consultants: "help businesses improve their performance & grow by solving problems & finding new ways of doing things"
Mx consultants: "help businesses improve their performance & grow by solving problems & finding new ways of doing things"
2/ There are lots of different management consulting firms, however the three biggest are known as "The Big 3":
McKinsey - annual revenue $10 billion
BCG - annual revenue $8.5 billion
Bain - annual revenue $4.5 billion
Lets take a closer look at McKinsey...
McKinsey - annual revenue $10 billion BCG - annual revenue $8.5 billion Bain - annual revenue $4.5 billion Lets take a closer look at McKinsey...
3/ 
In 2018 NHS Improvement paid £500k + of public money to McKinsey to help it "define its own responsibilities"
In 2016 they also spent £630k...on the same kind of work
Pretty large sums of money for a company who have engaged in ethically poor practices in the past.
In 2018 NHS Improvement paid £500k + of public money to McKinsey to help it "define its own responsibilities" In 2016 they also spent £630k...on the same kind of work Pretty large sums of money for a company who have engaged in ethically poor practices in the past.
4/ Let's look at McKinsey's role in the opioid crisis, which in 2018 killed over 67,000 Americans.
To help contextualize this figure, to date 74,500 people in the UK have died of COVID-19.
Let's look at McKinsey's role in the opioid crisis, which in 2018 killed over 67,000 Americans. To help contextualize this figure, to date 74,500 people in the UK have died of COVID-19.
5/ The @CDCgov have labelled the opioid crisis in the US as an "epidemic" & steps have been made to try reduce unnecessary opioid prescriptions where possible.
This represents potentially bad news for big pharma, since the opioid market represents 100's of millions of dollars.
This represents potentially bad news for big pharma, since the opioid market represents 100's of millions of dollars.
6/ 
One big pharma company producing OxyContin were Purdue.
Purdue hired McKinsey to advise them.
Documents show that McKinsey consultants suggested "making secret payments to insurance companies...whenever a patient became addicted or overdosed on Purdue opiods".
One big pharma company producing OxyContin were Purdue.Purdue hired McKinsey to advise them. Documents show that McKinsey consultants suggested "making secret payments to insurance companies...whenever a patient became addicted or overdosed on Purdue opiods".
7/ Later, when Purdue had filed for bankruptcy, two senior partners at McKinsey "discussed whether to purge records related to Purdue" i.e. destroy records & prevent a transparent investigation.
McKinsey later publicly apologised for their role in this: https://www.npr.org/2020/12/09/944563257/mckinsey-apologizes-for-helping-purdue-pharma-turbocharge-opioid-sales?t=1609692935918
McKinsey later publicly apologised for their role in this: https://www.npr.org/2020/12/09/944563257/mckinsey-apologizes-for-helping-purdue-pharma-turbocharge-opioid-sales?t=1609692935918
8/ Aside from the astronomically high costs & dubious ethical practices, are consulting firms actually qualified to advise on healthcare challenges?
Do they really understand the complexities of the NHS and are the solutions they provide realistic?
I would argue not.
Do they really understand the complexities of the NHS and are the solutions they provide realistic?
I would argue not.
9/ Not only this, but an analysis on service efficiency showed that for a hospital trust spending £1.2m a year on consulting services they ended being £10600 worse off each year, on top of the fees paid to the consulting firms.
https://www.ingentaconnect.com/content/tpp/pap/2019/00000047/00000001/art00005
https://www.ingentaconnect.com/content/tpp/pap/2019/00000047/00000001/art00005
10/ Some questions for #MedTwitter:
What do you think about the role of management consultants in the NHS?
Do you have any first hand experiences (positive or negative) of dealing with Mx cons?)
How would you change things?
What do you think about the role of management consultants in the NHS?Do you have any first hand experiences (positive or negative) of dealing with Mx cons?) How would you change things?
11/ For this thread I used this important paper:
Title: "Exclusive: Government spending on management consultants trebles in three years"
Author: @mancunianmedic
Journal @bmj_latest
: https://www.bmj.com/content/366/bmj.l5404
Title: "Exclusive: Government spending on management consultants trebles in three years" Author: @mancunianmedic Journal @bmj_latest : https://www.bmj.com/content/366/bmj.l5404
12/ Title: McKinsey Issues a Rare Apology for Its Role in OxyContin Sales
Author: @waltbogdanich and @PekingMike
Source: @nytimes
: https://www.nytimes.com/2020/12/08/business/mckinsey-opioids-oxycontin.html
Title: McKinsey Issues a Rare Apology for Its Role in OxyContin SalesAuthor: @waltbogdanich and @PekingMike Source: @nytimes : https://www.nytimes.com/2020/12/08/business/mckinsey-opioids-oxycontin.html
