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Health chiefs have paid a staggering £458,500 to consultants to help draw up plans for far-reaching reforms to the way care should be provided in Kent.
The draft report setting out a blueprint for the next five years has been the subject of withering criticism from county councillors, who have complained much of it was meaningless and lacked detail.
The four hospital Kent trusts along with other organisations that are involved in drafting the Sustainability Transformation Plan (STP) commissioned three firms to help and advise them.
The trusts said it was necessary to take on external advisers as they “provided capacity, skills, experience and expertise that wasn’t available to be freed up within existing STP member organisations.”
STPs are long term plans that will set out how health services in 44 areas of the country should be organised and managed to improve care for residents within certain areas and across all types of spending within the NHS.
In particular, the plans are designed to set out how best to integrate health services with social care provided by councils and address the issue of how to deal with declining budgets.
In Kent's case, that means dealing with a £486 million overspend if nothing is done by 2020.
Consultancy Carnall Farrar Limited was paid £300,000 “for capacity and expertise in financial and activity modelling, strategy development and programme management.”
However, the firm has been paid close to £2.5m since last October for its work on the STP.
A second consultancy MGWR Ltd was paid £43,000 for “interim day-to-day programme management support.”
The third firm engaged was GE Healthcare Finnamore, which was paid £115,500 “for capacity and expertise in financial and activity modelling” - the same reason Carnall Farrar Limited was commissioned.
The figures were released to the KM Group under the Freedom of Information Act.
Cllr Andrew Bowles, the Conservative leader of Swale council and a county councillor, said: “I am surprised, bearing in mind the percentage of their budget which goes on management and corporate costs, they have to go outside to engage experts.”
A statement from the trusts said: “We are extremely cost-conscious and have invested only where it has been absolutely necessary to provide capacity, skills, experience and expertise that has not been available, or able to be freed up, within Kent and Medway health and social care organisations.
“As a consequence of this work, we are starting to design new ways of working and delivering services that will save the NHS locally millions of pounds and at the same time improve the health and well-being and local care needs for some of our most vulnerable residents for years to come."
It added: “External consultants have been required in the short-term to bring expertise, capacity and experience of delivering large-scale change programmes that doesn’t readily exist within existing teams.”
The trusts have since continued to rely on two of the companies to provide additional advice and commissioned a fourth - Hood and Woolf - to work for them to provide public relations and help staff with management.
That has cost £74,000.
They have also spent a further £66,000 on "programme management support" provided by MGWR Ltd.
The concept of STPs has proved controversial and led to fears it might lead to reductions in services in some areas.
Who are these companies?
They are mainly health care consultants offering expert help to both public sector and private sector organisations.
GE Healthcare Finnamore says on its website: “Our team of 70+ healthcare consultants combines local agility, independent-thinking and responsiveness with GE's scale, world-class leadership, and technology base.
With specialist healthcare expertise in consulting, analytics, technology, capital and leadership, GE Healthcare Finnamore’s unique combination of capabilities makes us a potent long term partner for health and social care.”
Carnall Farrar Ltd describes itself as “dedicated to improve health, care and public services.”
Its website says: “We pride ourselves on being able to meet client needs holistically, combining problem solving, managing delivery and change leadership.
“We take a hypothesis-led objective approach to problem solving building on real expertise and active partner leadership.”
Its clients are mainly public sector organisations involved in health care, but it has also worked for Transport for London and devolution for Greater Manchester.