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ICBs pay management consultants to help improve GP access

ICBs pay management consultants to help improve GP access
By Eliza Parr
16 January 2024

ICBs have paid for private management consultants to help design GP strategies and improve access, Healthcare Leader’s sister title Pulse has found.

KPMG and PricewaterhouseCoopers (PwC) have been commissioned to undertake work such as modelling of demand in general practice, developing a primary care strategy, and designing a ‘more sustainable’ model of primary care. 

NHS England asked ICBs to provide an update on progress against the GP recovery plan in their October or November public board meetings.

Within these reports, Pulse found that three ICBs – Black Country, North West London (NWL), and Buckinghamshire, Oxfordshire and Berkshire West (BOB) – referred to partnerships with management consultancies. 

In Black Country, health leaders announced that PwC had been ‘selected to support the primary care team in the design of a model of primary care that creates a more sustainable model of general practice for the future’.

The ICB told Pulse the contract with PwC will provide ‘additional support’ for primary care transformation. 

Director of primary care Sarb Basi said: ‘As an ICB we are committed to working with primary care in the Black Country to achieve transformation that will future proof the service, support GPs and community pharmacists, and meet local patient need.

‘We recognise that this is something which needs focused resource and to achieve this we have invested in additional support to help develop our five-year primary care transformation strategy, with all stakeholders appropriately engaged.’

North West London ICB has commissioned KPMG to ‘undertake an analysis of the current pattern of demand’ on same-day services, including primary care, and also to support on a PCN project.

‘The service redesign component is intended to support all 45 PCNs over four waves to develop and redesign their services to offer improved access to patients as part of a “Neighbourhood and Borough” model of same-day care,’ the report said. 

It added that each PCN is supported by a ‘combined KPMG and ICB team through weekly touch points’. 

The ICB told Pulse that it commissioned KPMG due to the ‘intensity of complexity’ associated with redesigning services, and to provide ‘additional capacity’ while the ICB team is focused on other primary care transformation work. 

‘It is still early days but initial feedback from the PCNs that have launched Same-Day Access Hubs include high utilisation rates, extra appointments being provided, much greater resolution of consultations without follow-up appointments being needed and a high patient satisfaction rate, including patients noticing that they are getting appointments more quickly,’ they added. 

Local commissioners across BOB reported that KPMG is their ‘support partner’ on the primary care strategy, and also ‘supporting on components of the financial model’.

Pulse reached out to the ICB for comment but did not receive a response.

GP spokesperson for the Doctors’ Association UK (DAUK) Dr Steve Taylor said he is not opposed to ICBs developing strategies, but they ‘should be asking some of the doctors that are running good services’ to provide advice ‘rather than getting management consultants in’.

He told Pulse: ‘I think the problem with using outside agencies is that they don’t have enough on-the-ground understanding of how the processes work to actually unpick it. So they come up with thoughts and plans that don’t seem to match what can be delivered on the ground.

‘I think part of the problem is that ICBs nowadays have got less and less GPs involved in their boards, as opposed to CCGs which had higher number of GPs as a proportion.

‘It appears to me that ICBs are not asking the right people. They could be getting better advice from people that are working day in day out on the ground, and understand the processes and the needs of general practice.’

Management consultancies have been involved in GP strategies in the past – in 2018, NHS Digital paid £1.2m for McKinsey & Company to assist with its overhaul of GP IT systems, and the year before, KPMG was handed over £100,000 worth of GP ‘resilience’ funding in one area.

The autumn board reports from all 42 ICBs across England also revealed that only three areas had met NHS England’s GP recovery target to expand self-referral pathways by the end of September. 

And many local commissioners said GP practices are struggling to find time to take part in NHSE’s recovery training offers, such as the General Practice Improvement Programme (GPIP).

This story first appeared on our sister title, Pulse.

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