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Consultants 'have cost the NHS more than they've saved'

By Gareth Iacobucci

The Government's drive to use external consultants to advise PCTs on commissioning primary care services has cost millions more than it has saved, Department of Heath documents reveal.

Firms including Bupa, UnitedHealth and Tribal have been paid a total of £39.4m, while generating projected savings of £17.5m.

The revelation comes just weeks after a Pulse investigation showed PCT spending on management consultants had more than tripled in the past two years, with PCTs spending an average of £1.217m.

At the same time MPs called for closer scrutiny on how much the NHS is spending on consultants.

The new documents relate to the Government's Framework for Procuring External Support for Commissioners (FESC) initiative, launched in 2007, to encourage PCTs to seek advice from the private sector on how to spend NHS funds.

The scheme was designed to help trusts make efficiency savings, but figures disclosed by the DH show the six projects commissioned so far have cost the health service a net £21.9m.

Last summer Pulse revealed the first project commissioned under the scheme, for BUPA to provide support to Hillingdon PCT, was struggling to deliver on expected savings.

The latest FESC deal to be signed has seen Humana appointed to support all 14 PCTs in East of England SHA.

But despite the latest evidence, the DH insisted the project was delivering ‘tangible benefits'.

In a letter to SHAs, Gary Belfield, DH director of commissioning, said FESC was essential for enabling PCTs to meet their World Class Commissioning targets.

‘We are seeing a number of projects coming forward, some of which are both large and innovative,' he said. ‘Some of the early projects are already delivering real, tangible benefits.'

Dr Johnny Marshall, chair of the NAPC and a GP in Wendover, Buckinghamshire, said ‘the jury is still out' on the scheme.

‘Everyone needs to hold their nerve and understand that savings take time,' he said. ‘Whether it will or not, who knows?'

Meanwhile, the Commons health committee has called for the Government to keep a central record of all money spent on management consultants, and for a sample of contracts to be subject to regular external peer review.

Its report published last week concluded: ‘Making spending subject to public monitoring might improve the way consultants are used.'

Dr Jonathan Fielden, chair of the BMA's consultants committee, called for private management consultants to be ‘ditched' from the NHS.

‘This is hundreds of millions of pounds of taxpayers' money yet to be shown to have benefited patient care,' he said.


Backs to the wall: DH is under fire for its consultants scheme which has so far cost millions more than it's saved Backs to the wall: DH is under fire for its consultants scheme which has so far cost millions more than it's saved

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