Cambridgeshire and Peterborough’s Clinical Commissioning Group has decided to pay consultants McKinsey and Company around £800,000 to train its staff how to problem solve.

The Clinical Commissioning Group is responsible for a £1bn/year NHS budget locally, covering hospital care, out of hours services and ambulances.

The amount of money about to be given to McKinsey and Company was uncovered via a question from MP Stephen Phillips at the House of Commons Public Accounts Committee on Wednesday the 14th of September 2016.

Speaking at a meeting of the Cambridgeshire and Peterborough Clinical Commissioning Group Governing Body on the 13th of September 2016 Chief Officer Tracy Dowling explained the spending on consultants:

I think looking at the financial position for the first four months of this year, and looking at the findings of Price Waterhouse Coopers’ capacity and capability review it is really clear that as an organisation…what’s causing this is not just the collapse of the Uniting Care contract, there is a much more worrying and underlying concern in terms of the ability of the CCG as a commissioning organisation to effect service change on the ground which both maintains and improves quality but does enable us to deliver services which meets the needs of our population within our budget so we have got some really significant organisational turnaround work to do.

We know that what we need to deliver this year and the improvement and development of our staff that we need to deliver this year we will not be able to do on our own, we have therefore undertaken with the support and approval of NHS England an external procurement to bring in support to help us to make rapid improvement over the next four months in terms of our financial position but also to rapidly develop the skills and capabilities of our staff and to support them in focusing on the things which will have the biggest impact for our patients over the next three or four months.

That was a competitive process that we ran through an NHS England approved framework agreement and the governing body approved last week the appointment of McKinsey and Company as the preferred bidder and they will be starting with us next week, and it is really important that we do work really closely with them. They are not coming in to do tours, what we have procured them to do is to come and work with us and really put our systems and processes for quick delivery into the premier league and they are not in the premier league at the moment. There is a requirement that what McKinsey do is teach and train our staff how to problem solve, how to deliver in a way which improves services for patients but also delivers the financial savings that we would expect those schemes to deliver.

The claim the decision to appoint McKinsey and Company was taken at a Governing Body meeting the previous week is puzzling as according to the CCG’s website no publicised Governing Body meeting had been held within the previous ten weeks. One previously secret, private meeting of the Governing Body was referred to in the Chief Officer’s report, which stated:

As the Governing Body is aware, in August the Governing Body held a short meeting in private following the Governing Body Development Session. This was to elect an Interim Vice Chair. There was one nomination for the role of Interim Vice Chair and the Governing Body elected Rebecca Stephens as Interim Vice-Chair.

There’s no mention of the decision to appoint McKinsey and Company at the cost to the public of £800,000 from the NHS budget at the August secret meeting. It appears it is the practice of the governing body not to approve the minutes of its secret and private meetings (or indeed private elements of publicised meetings).

The CCG should publish details of all its Governing Body meetings on the relevant page of its website, not just selected meetings, or parts of meetings.

No report of any urgent decisions taken between meetings was made to the Governing Body on the 13th of September, and no secret, private, meetings of the Governing Body were otherwise mentioned.

The PWC report referred to was mentioned in a report to the July CCG Governing Body meeting which stated:

As the Governing Body is aware, NHSE commissioned a Governance and Finance Capacity and Capability Review of the CCG. This has now been concluded and we are awaiting the publication of the final report.

Actions taken as a result of the PWC review are mentioned in the September Chief Officer’s report but there is no mention of its publication there, or on the NHS England website.

Richard Bacon MP spoke at the Public Accounts Committee on the 14th of September to say the NHS has had money hosed at it for the last fifty years and he isn’t convinced it is being well spent:

Clearly Richard Bacon MP makes an important point, it’s not just how much money we give the NHS that matters, it’s how well it is spent. We should all try and take an interest in how our money is being spent on our behalf by bodies like the Cambridgeshire and Peterborough Clinical Commissioning Group.

Despite the CCG having rules requiring reporting to be carried out only by non-mechanical or non-electrical means such as pencil, crayon, or paint, I filmed and tweeted from a series of meetings they recently held, hopefully that helps publicise what the CCG are doing.

Cambridgeshire and Peterborough’s Clinical Commissioning Group is currently rated “Inadequate” by NHS England and is failing to meet targets for A&E waits, cancer treatment waits in Addenbrooke’s and Papworth, and ambulance response times. The CCG is holds the purse strings in respect of the provision of these services and is responsible for getting value for money from the hospitals and ambulance services.

See Also

• Draconian Rules Restrict Reporting From Clinical Commissioning Group Meetings – January 2014
• GPs Withhold Ambulance Service Funding Due to Lack of Plan to Improve Response Times – January 2014
• NHS England Review of United Care Contract by David Stout
• National Audit Office Investigation into the collapse of the UnitingCare Partnership contract in Cambridgeshire
  and Peterborough