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Top tips to ensure external consultants deliver

Finding a consultancy to support your PBC organisation can be a daunting task. Gerry McLean advises how to find the best people and ensure they deliver what you need

Finding a consultancy to support your PBC organisation can be a daunting task. Gerry McLean advises how to find the best people and ensure they deliver what you need

1. Ask colleagues and national organisations for recommendations

Ask your colleagues for recommendations and search as widely as possible among local and wider contacts and consult membership organisations such as the NHS Alliance or National Association for Primary Care. Don't just leap for the first name that comes to mind – investigate two or three possibilities.

The Department of Health's PBC Development Framework identifies five providers but your choice is not limited to these – you need to find an organisation that matches your needs. The five are:

• Aetna Health Services (UK) in partnership with PwC and the RCGP

• Catch On Group

• Centre for Innovation in Health Management at the University of Leeds Business School

• Humana Europe in partnership with the NHS Alliance and Dr Foster Intelligence

• Tribal Group in partnership with Quest4Quality and NAPC

2. Make sure they suit your needs and will fit in locally

Ensure the company you are considering has the expertise you want. Find out whether the consultancy has experience of working in the NHS and understands the environment – negotiating with PCTs, acute trusts and local authorities as well as external partners in the voluntary and private sectors.

They should be able to cover the impact of your proposals on other sectors. If you set up a GPSI dermatology service, how will this affect secondary care and how will you persuade the PCT and local acute trust?

You don't want to help them learn on the job. Do they understand how to work with a PCT in financial deficit, for instance?

What sort of projects have they worked on, are they along the same lines as your plans? Take up references – don't just rely on names of former clients without checking.

Meet the consultants who will actually be working with you – will they fit in or rub people up the wrong way? Can they handle any mavericks in your PBC group?

3. Be clear what the return is

Consultants cost anything up to £1,500 a day, but PCTs will pay for this if they think it's worthwhile.

Spell out how PBC decisions will drive spending decisions across primary and secondary care. This is an invest-to-save mechanism where upfront funding will pay off in the long term.

Recognise where the PCT is coming from. The chief executive and their team will be judged on their performance in World Class Commissioning – so set out clearly how funding an external consultancy will contribute to success.

Show how specific plans will lead to identified cost savings and how using the expertise of an outside organisation will help you to move up a gear.

4. Have a specification document

Make sure any company seeking to work for you puts in a comprehensive bid, covering what you want them to do and how they will deliver it.

There can be a tendency to be impressed by a glossy brochure or slick presentation. But the skills involved in delivering a presentation are quite different from the practicalities of delivering the goods.

If you go ahead, first you need to draw up a clear specification document setting out your needs. For instance: ‘We are looking for advice on how to set up a PBC consortium. The current position is we have had a number of informal meetings, the PCT is supportive or not supportive, and we are interested in which legal entity is best for us.'

The company should then provide letters of engagement, setting out what they will do, naming the people who will be working for you, the timetable and a cost breakdown. Make sure the company works with you to draw this up, rather than giving you a general purpose off-the-shelf document.

Get a detailed breakdown of costs – double-check any vague items such as ‘normal expenses'. Is ‘normal' a budget hotel or Claridges?

Ensure the company you are considering hiring sets out a clear communication plan. Don't just get someone in and wait for them to report back in three months.

You need to work together on your business plans or you may get something that doesn't work.

5. Break the project down into stages so you can pull out if necessary

You have to be clear at the outset what the work is you want and what you expect to be achieved.

Set up clear project phases and state what should be happening at each stage so you have opportunities to pull out early if things don't work out.

If you have a relationship that lasts for six months, set up a billing system every four weeks so you have the chance to call a halt.

Seek support from your PCT finance director and department – they have considerable expertise in managing contracts with external organisations.

6. Be transparent and expect scrutiny

Be prepared for the press and public to ask probing questions about expenditure on external consultants.

Make sure you are open about your relationship with outside organisations and have answers to potential criticisms – what is the value of this work, what expertise is the company bringing that isn't available in-house and what cost savings or service improvements are being achieved?

Explain that you have sought permission from the PCT and will have a better service for a specific group of patients as a result – sell the success story. People are chiefly interested in the service they are getting as patients.

Gerry McLean is chief executive of Mac2 Consulting

The DH's PBC Development Framework is available at www.dh.gov.uk - click on 'Managing your organisation' and 'commissioning'

What external management companies can do

What external management companies can do

• Advise on the initial set-up of a PBC organisation – how to choose between different models such as limited liability partnerships or social enterprises such as community interest companies
• Ensure legal requirements such as membership agreements and the contract between PBC group and practices are fulfilled
• Provide support to create robust governance arrangements and resolve conflicts of interest
• Assist in PCT negotiations on areas such as indicative budgets
• Advise on relationships with third parties in the statutory, voluntary or private sector, such as secondary care clinicians or pharmaceutical companies
• Assist with human resources – PBC management staff seconded from the PCT come from a very different culture, and PBC leads and chairs might also require support in defining their new roles and responsibilities
• Help your PBC group bid for a contract
• Provide the necessary skills for you to manage a budget on behalf of the PCT

Related Seminar: PBC Masterclass

PBC Masterclass: Regional events

What: These regional PBC events are designed to equip you with the sophisticated skills needed to overcome barriers and push on towards PBC success.

When: 10 individual events running from October 2009 to January 2010

Where: 10 different regions throughout England. Each event has been tailored to address the learning priorities highlighted by practice-based commissioners in that area.

Next steps: Find out more and book

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