Belfast Trust spent £600,000 on management consultants in two years

The leadership of a Northern Irish health trust has come under fire for doling out more than £600,000 for advice from management consultants in just two years. According to official figures, the Belfast Health Trust paid £7,100 to a private management consultant for 15 days of support in relation to a damning hyponatraemia report, which examined the deaths of five children, finding that four of the deaths were avoidable.

The consulting bills of public health providers across the world have come under mounting scrutiny in recent years, as, irrespective of allegedly rigorous tender processes and assurances that such external expertise will help the keystone state service line do more with less, the public and most opposition groups remain largely unconvinced. This came to the fore recently in the UK, when analysis of 120 NHS trusts found that the more they spent on management consultants, the less efficient they became. For the notoriously under-funded institution, this was particularly shocking, with researchers finding that for every £100,000 spent enacting the advice of consultants, there was a correlation with an extra £900 in costs, amounting to average losses of around £10,600 per trust.

Meanwhile, in Australia, public ire was provoked following the leaking of financial records pertaining to the National Disability Insurance Scheme (NDIS), showing that executives in charge of running the government agency behind the scheme spent more than AU$180 million on consultants and contractors between July 2016 and October 2017. Of that figure, as much as AU$41.5 million was spent on just two major consulting industry players for “strategic advice”, while the service failed to meet the most basic needs of the vulnerable citizens dependent upon it.

Now, Northern Ireland has become the latest nation to witness calls for the reigning in of consulting spending in public health provision. As the health service across Northern Ireland faces unprecedented financial pressures, with the Healthcare Financial Management Association (HFMA) releasing a report in January warning that Northern Ireland's health service could have a funding gap of up to £540 million a year, the Belfast Trust has been criticised for its spending of more than £600,000 on management consulting services, in the space of only two years. On top of this, the group has also tasked another private management consultant to help with work around the on-going recall of more than 3,000 neurology patients in the Belfast Trust, in a role which is expected to take 30 days to complete, at a cost of £15,000.

Health trusts across Northern Ireland are becoming increasingly reliant on cash injections from in-year monitoring rounds and the DUP-Conservative confidence and supply deal just to make ends meet. Despite the apocalyptic proportions of the crisis faced by health providers in the country, however, figures released by the Business Services Organisation reveal that even as thousands of patients spend up to five years waiting in acute pain for operations on debilitating conditions, the HSC Leadership Centre (HSCLC) is paying private consultants £500 a day for their services while providing consultancy services to the Belfast Trust at a cost of £630,701 between 2016 and 2018.

The HSCLC, which comes under the BSO, provides a range of services to health and social care organisations in Northern Ireland, including consultancy services, leadership development programmes, support for improvement, team development and other support, including investigations. The HSCLC currently has a pool of about 90 private consultants, known as associate consultants, who are drawn upon as and when required.

Alliance Member of the Legislative Assembly Paula Bradshaw expressed concern at learning the private consultants had been engaged at such a cost to the public purse. Bradshaw added, "In my opinion, the role of the health service is to support patients and their carers at times when health needs arise; and the funding that is allocated to the Department of Health for the provision of care and treatment to meet these needs is finite and in fierce demand right across the sector, and so I will be following this up to find out why the consultants were engaged.”

"Having supported a number of individuals and families affected by the neurology recall process and the Hyponatraemia Inquiry, I am particularly curious to learn more about the nature of this commissioned work and sincerely hope that it is not for the purpose of crisis management,” Bradshaw added.

A spokeswoman for the Belfast Trust contrasted this with the assertion it has used the resources of the HSCLC for two specific pieces of work "through normal business arrangements."

She added, "Firstly, to provide additional support to the trust in the implementation of the 96 recommendations of the findings of the inquiry into hyponatraemia-related deaths which was published on January 31 this year and which are actively being addressed within the trust and as part of the departmental framework. Secondly, in preparation for the independent inquiry panel as a result of the recall of neurology patients, we have secured additional assistance to support us in providing the inquiry with all relevant, extensive, and detailed documentation in a timely way."

Related: NHS selects 107 consultancies for Management Consultancy Framework.