Max Pardo-Roques on Develop Consulting's impact in the healthcare sector
Having been asked by CEO Steve Boam to come aboard from Develop Consulting’s launch, Max Pardo-Roques has spent the past five years heading up the firm’s marketing efforts, as well as helping to manage key contracts such as with NHS England. Looking back on his time with the firm, he tells Consultancy.uk Editor Jack Brinded how the firm has helped the health institution adapt to some of its most difficult years, and how the firm plans to develop within its own niche over its second half-decade.
“Develop Consulting has worked with about 1,500 general practice sites over the past five years,” says Pardo-Roques, looking back at the last five years. “Over that time, we’ve seen that it’s continually got more challenging for general practices to operate; to meet patient demands, and also to provide a good service.”
“That’s for a number of reasons – from staff shortages, to Covid – which had a major impact, changed the way a lot of practices had to work with the public.”
“Many practices will also tell you that funding is a major issue; and amid all the inertia of being in an election year – and being unclear how that will change the agenda if a new administration takes control – it can be tough to see how to deal with any of that.”
However, Develop Consulting has also encountered some areas of strain which are avoidable, and is currently working to help general practices buy themselves some much-needed breathing room, as they bide time before whatever the political future holds in store.
According to Pardo-Roques – Develop’s Commercial Director – “patient demand is also insatiable”. While that might seem unavoidable with an ageing population, and the aftershocks of the pandemic still being felt across the UK, there are ways which the NHS can help alleviate at least some of this pressure.
Pardo-Roques notes, “We’ve been working with some practices recently, and we’ve noticed that they are bringing 40% of demand on themselves in terms of calls coming into practices. And they don’t seem to have a good set of data to understand what’s causing this demand of why it gets worse, or how to change to deal with it.”
Change fatigue
Citing work with one large practice in England, he recalls how Develop asked the client to record “some data that they wouldn’t have otherwise have had”, over the course of a week. Analysing the resulting information, Develop’s experts found that across 3,500 patient interactions – that could be a patient walking to the front-desk, calling in, or using their online systems – “only 60% of those initial interactions were resolved in the first instance”.
“So, 40% of the time, the patient has to come back around and ask for their inquiry to be resolved again. Now, even a small change of that, when you are talking about a list-size of 40-50,000 patients, would make a big difference to how that practice operates. If you can get it right the first time, resolve those queries the first time, it will have a knock-on impact. If you don’t, there is a compound impact, where even if the patient comes back for a second attempt – or even a third – that won’t necessarily see the queries cleared either – so that is just generating extra demand.”
As well as helping practices to better deal with those initial contacts, addressing this issue also involves encouraging behavioural change among patients. According to Pardo-Roques, “a lot of people want to speak to the doctor” – and some have been told to expect this across the “potentially their entire lives”, making it especially difficult to change. But being able to educate them that they can in some circumstances see a nurse or a pharmacist to alleviate demand on GPs, “who have a very precise special skillset that isn’t necessary in every scenario”, will be one important way of safeguarding the NHS’ future.
“Between that and reducing secondary care waiting lists, those two things are probably going to have the greatest impact on the way practices improve in the years ahead,” he adds.
But while you might expect a commercial director to follow that line through to suggesting his firm is key to the preservation of healthcare as we know it, Pardo-Roques is determined to remain grounded.
As proud as he is of the firm’s interventions with general practices, he asserts that “we don’t think the work we do is a silver bullet”. Instead, he points to “incremental change” that Develop Consulting is enabling as a “one small cog in a humungous system” – and insists the important thing is that “we just try to help that one small piece to the best of our abilities.”
This candour might be one part of Develop’s proposition which makes it so attractive to the NHS in the first place. Over the years, the consulting industry’s largest and most commercially successful players have regularly overseen transformation projects in the NHS, and not all of them may have lived up to their initial promise.
“There have been so many initiatives promising to change things – some have worked and some haven’t – but generally that means the people we work with in general practices are fatigued from change. You have to build their trust immediately, and their understanding of why this will be different. We have encountered resistance in the past from people think that consultants always deploy a cookie-cutter approach, and that we’re going to come in, tell them they’re doing something wrong, tell them we’ve seen something good elsewhere, and that they need to just implement those best practices.”
The problem with this is that practices are all extremely different. Even “GPs just three or four miles apart” can have “entirely different demographics”, which mean it has to operate accordingly. Imposing a one-size-fits-all set of solutions in that environment is doomed to come up short – and has fostered a distrust of consultants which Develop has to work to counteract.
Making the difference
To help do that, Pardo-Roques says Develop spends the early phases of engagement listening to each practice, hearing what specific challenges they face, and where they think they need help. Then, the importance of the “small things” comes back into play.
“Once we have listened, and we see and understand where quick wins exist, we help to implement quick wins,” he continues. “And as soon as you do that, you’ve got buy-in, because people can see and feel the change. When people can’t see the difference in change, they won’t stick to it. But a lot of practice staff feel powerless about the challenges they face – but working with us to feel those small changes quickly, they realise they actually have more power than they realised. We schedule this on their time – general practices obviously can’t work with us every day, so we engage with them weekly; and that regular drum-beat really helps to build momentum that helps those little victories to steadily stack up. It’s at that point that a lot of people we work with become evangelical about our work.”
That’s a particularly impressive turnaround, considering Develop’s agile methodologies are primarily drawn from the private manufacturing sector – a realm seemingly far-removed from the world of public healthcare. But despite that, and the wider change fatigue blighting practices, Develop has managed to build increasingly strong ties with NHS England over its five years in business – and was recently rewarded with a new nationwide engagement with its largest healthcare client.
Pardo-Roques explains, “We’ve just had some exciting news about winning a new contract, for the continued roll-out of the general practice improvement programme. We’ve been awarded one of five national delivery partner slots in that, which means we will be supporting that project for at least the next year.”
Looking back at Develop’s track-record with NHS England, the firm’s impacts have been pronounced enough to catch eyes well beyond the health service too. It’s been featured in BBC articles, reported to government ministers, and even mentioned at the dispatch box in Parliament. But while those snippets of praise admittedly give the firm’s professionals a good feeling, what really makes them proud is what they hear from practice staff.
“We hear regularly, especially from GPs, ‘I was feeling burned out, I didn’t want to do this anymore. I was ready to go. But working with you, I see there is a different way we can approach these problems, I feel we have some control back, and I am going to stay.’ The drain on clinical capabilities in general practices is really severe – and when you lose those experienced partners, it’s almost impossible to replace. So, our ability to change their daily lives, so that they’re willing to stay in practice, has a huge impact as well.”
The future
Develop’s approaches to its work with clients, and its goals for those engagements typically mark it out from its competitors in the consulting space. Having been part of its launch team back in 2018, Pardo-Roques understands its unique culture well, and it might not therefore be a surprise that when asked what the firm’s plans are for the next five years, his own answer is somewhat atypical of consulting leaders.
“We’re not trying to be the world’s biggest consulting firm,” he admits. “We know our space, we know what we’re good at, and we just want to specialise in that, to do that the best we possibly can. We’re able to offer good service to good blue-chip clients, who appreciate what we do, they get good outcomes from it – and we’re at a size that is comfortable for us, where we don’t have to think about all those operational issues that come with being a big business – and instead we can focus on the clients.”
“Maybe we could get just slightly bigger than we are now. But still, the aim is to stay the right size to maintain and excel engagements with six-to-eight manufacturing clients, and our work in the healthcare sector.”
At present, Develop Consulting has a permanent team of around 35 employees, supplemented by a pool of between 30 and 40 associates, depending on the demand the firm encounters. While there might not be much intention of growing that headcount, however, that does not mean there are no ambitions to expand what the resolutely niche consultancy does for its clients.
First, Develop’s sister-company click2learn – which offers digital workplace education solutions to its clients – has recently launched a healthcare product, about how to run projects well in a healthcare setting. It is also about to launch a new course on leadership training in a manufacturing setting. At the same time, the firm has launched another subsidiary, called Innovative Online Products, to help channel the expertise the firm has accrued over the last five years into more actionable insights for healthcare operators all over the country.
“Our assessment, having worked with 1,500 practices over the last five years, has given insight into the kinds of data they hold. Practices hold data that is more reactive than proactive. It’s all about what has happened, rather than what should happen. They lack an overview of how they might improve how their practice runs – and how patient outcomes might also be boosted then. So, we developed this software called ‘The Demand and Capacity Optimisation Tool’, which we deploy to help practices gather data that just isn’t available anywhere else – and it produces a report with detailed charts and analysis they’d not have anywhere else.”
The tool applies the methods which Develop has been deploying with practices for years – after ‘listening’, it helps to determine where weaknesses are, and then lists what the opportunities are to improve a practice, and what the first steps are to putting those things right. That’s something which Pardo-Roques concludes is another “huge opportunity” to do the small things right, and help empower practices to make their own improvements in the years to come.
