The Consultant Conundrum: Navigating Change in Healthcare

The healthcare landscape is a perpetual churn of innovation and adaptation. From the burgeoning promise of digital health to the ever-present challenge of an ageing population, healthcare systems face relentless pressure to evolve.

Having led complex healthcare transformations as a consultant, and having held director-level positions in both private and public sectors across Europe, I've gained a deep understanding of this ever-evolving environment. I've seen firsthand the growing need for external consultant expertise to support organisations navigate these changes.

However, the use of consultants in public healthcare systems, particularly those with significant expenditures like the UK's NHS, often sparks debate, especially regarding cost-effectiveness.

A Hefty Bill: The Public Purse and the Price Tag

The National Audit Office (NAO) reported a staggering ￡962 million spent on management consultancy services by the NHS in England for 2021/22 (National Audit Office, 2023). This figure underscores the substantial public investment in external expertise within the healthcare system. While headlines often focus on the "big four" consulting firms – Deloitte, PwC, EY, and KPMG – the landscape is diversifying, with a growing presence of smaller, independent consultancies carving out their niche (Kirkpatrick et al., 2013).

Now, before we jump to conclusions, it's crucial to understand the rationale behind this trend.

Beyond the Buzzword: Why Consultants Now?

So, why exactly are healthcare organisations turning to consultants? The answer lies primarily in the nature of the challenges they face:

• Transformational Initiatives:?Implementing large-scale changes, like integrating digital health solutions or overhauling system-wide processes, requires specialised expertise. Consultants, with their vast experience gleaned from working across diverse healthcare environments, bring a wealth of best practices to the table (Ghani et al., 2019). They can provide valuable insights into successful implementation models, and potential pitfalls to avoid.
• Change Management Prowess:?Successfully navigating change within a complex system like healthcare demands skilled change management professionals. Consultants can serve as neutral facilitators, fostering buy-in from stakeholders often resistant to disruption (Kotter, 1996). They can help navigate internal politics, address concerns, and build consensus around new approaches.
• Access to Specialised Skills:?Whether it's leveraging data analytics for population health management planning or developing strategic plans for value-based care, specific skill sets might be scarce within healthcare organisations. Consultants offer a readily available pool of experts who can hit the ground running and provide immediate value (Fernandez-Milne et al., 2020).

Beyond the High Price Tag: Weighing the Benefits

It's important to acknowledge that the high cost of consulting services is a valid concern. However, a purely price-driven perspective risks overlooking the potential benefits:

• Faster Implementation:?Consultants can accelerate implementation timelines by leveraging their experience and pre-existing frameworks. This can lead to faster realisation of benefits and cost savings in the long run.
• Reduced Risk:?Consultants can help identify and mitigate risks associated with complex change initiatives. This can save organisations from costly mistakes and ensure a smoother transition.
• Knowledge Transfer:?Ideally, a well-designed consulting engagement should involve knowledge transfer to internal teams. This empowers the organisation to develop internal change management capabilities for future initiatives.

The Future of Consulting: AI on the Horizon?

While the healthcare consulting market shows no signs of shrinking, the traditional model is poised for disruption. Enter Artificial Intelligence (AI), a game-changer with the potential to reshape the landscape:

• AI-powered Automation:?Imagine AI-driven tools tackling tasks currently performed by consultants, such as identifying areas for cost reduction, predicting patient readmission risks, or even developing entire white papers on pending or current issues. This provides the potential for large cost savings and/or frees up human consultants to focus on higher-level strategic guidance and relationship building (Brynjolfsson & McAfee, 2017),
• Democratising Expertise:?AI-driven knowledge management systems can make a consultant's knowledge readily accessible to healthcare professionals. Empowers healthcare professionals to tackle change initiatives more independently and fosters a culture of continuous improvement within the organisation (Davenport et al., 2022). Reducing the reliance on consultants and empowering the frontline will not only save large amounts of money but speed up improvements and improve patient outcomes.

These are just a few ways AI might reshape the consulting landscape. Ultimately, the future lies not in replacing consultants altogether at this phase of adoption, but rather in leveraging AI to augment their expertise and deliver even greater value to the healthcare system.

Navigating the Maze: Finding the Right Path

The road ahead for navigating change in healthcare will undoubtedly involve new players and innovative approaches. Staying informed about these trends is key for healthcare leaders. Here are some closing thoughts:

• Scrutinise the Need:?Before engaging consultants, healthcare leaders must clearly define the need and desired outcomes. This ensures the chosen approach provides the most effective solution.
• Invest in Internal Capabilities:?While consultants offer valuable expertise, building internal change management capabilities is equally important. This fosters long-term sustainability and reduces dependence on external resources. Partnering with consultants to develop internal talent creates a win-win situation.
• Embrace Innovation:?The healthcare landscape is constantly evolving. Healthcare leaders must be open to innovative solutions, including those driven by AI. By embracing new technologies, they can optimise the use of consultants, remove the need in some cases and empower their teams to drive continuous improvement.

In conclusion, the role of consultants in healthcare transformation is multifaceted. While the high cost associated with their services is a valid concern, their expertise can in some cases be instrumental in navigating complex change initiatives. However, a purely transactional approach is short-sighted. The key lies in striking a balance – leveraging consultants' specialised skills while simultaneously building internal capabilities for long-term success. As the healthcare landscape continues to evolve, embracing innovative approaches, including AI-powered solutions, will be crucial for navigating the path toward a more efficient, effective, and future-proof healthcare system for all.

References

Brynjolfsson, E., & McAfee, A. (2017). The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies. W. W. Norton & Company.

Davenport, T. H., Barth, P., & Beanioff, M. (2022). The AI Advantage: How to Put the Artificial Intelligence Revolution to Work. Harper Business.

Fernandez-Milne, E., McGuire, A., & Mittler, J. (2020). The Role of Management Consultants in Healthcare Systems Transformation: A Scoping Review. Health Research Policy and Systems, 18(1): 143. [DOI: 10.1186/s12961-020-00620-9]

Ghani, J., Rastogi, S. C., & Misra, S. (2019). Management Consulting in Healthcare: A Systematic Literature Review. Journal of Healthcare Management, 24(3): 143-153. [DOI: 10.1108/JHC-03-2018-0026]

Kirkpatrick, I., Sturdy, A., & Veronesi, G. (2013). Using Management Consultancy Brings Inefficiency to the NHS. LSE Blogs - Politics and Policy. https://blogs.lse.ac.uk/politicsandpolicy/using-management-consultancy-brings-inefficiency-to-the-nhs/

Kotter, J. P. (1996). Leading Change. Harvard Business School Press.

National Audit Office. (2023). Management Consultancy Services in Central Government.