Are external management consultancies effective in healthcare improvement, do they reflect value for money and what are the alternative models?

Abstract

Despite the increasing use and costs associated with external management consultancy for healthcare improvement, there is a paucity of formal evaluations examining impact. This paper aims to: (i) discuss the potential benefits and disadvantages of external consultancies in addressing complex healthcare challenges and delivering healthcare improvement in Australia; and (ii) explore potential alternative models, including internal consultancy and hybrid models delivered through platforms of collaborative expertise. We propose that the substantive reliance on high cost external management consultancies without demonstrating value or benefit, is unsustainable. An integrative approach that embeds research and capacity building within healthcare services may be of value.

Transparency in Healthcare Reporting: The Case of External Contractors and Consultants in New Zealand’s Healthcare System

“…While our research has been focused on New Zealand, there are studies which highlight similar trends in the United Kingdom as well as in Australia. 6,10,11 The reliance on ECCs appears to be a sectorwide problem, and therefore demands a comprehensive How many contractors, consultants, including those providing professional services, were engaged or employed in 2016/2017 and what was the estimated total cost? How did this compare to each of the previous four financial years, both in terms of the number engaged and the total cost?…”

“…While our research has been focused on New Zealand, there are studies which highlight similar trends in the United Kingdom as well as in Australia. 6 , 10 , 11 The reliance on ECCs appears to be a sector-wide problem, and therefore demands a comprehensive approach when being investigated. Our research is a start; further research is needed, including across other areas of the public sector which are also known to rely on ECCs.…”

“…ECCs provide various services-technical, policy, management expertise, service redesign and improvement, offering a different perspective, auditing services or to legitimise existing proposals for action-that a public organisation is unable to perform, deliver itself or prefers to contract out. 4 A recent estimate indicates global spending on ECCs providing management-related services in just the health sector has been increasing steadily, 5,6 and is now over $6 billion annually making ECCs a highly profitable domain. 7 Similar, increase in the reliance on ECCs in other parts of the public sector have been recorded.…”

“…A recent estimate indicates global spending on ECCs providing management-related services in just the health sector has been increasing steadily, 5 , 6 and is now over $6 billion annually making ECCs a highly profitable domain. 7 Similar, increase in the reliance on ECCs in other parts of the public sector have been recorded.…”

“Slow science” for 21st century healthcare: reinventing health service research that serves fast-paced, high-complexity care organisations

“…In response to this sentiment as well as fuelling it, governments have for several years now kept level or even reduced funding for academic research ( Atkinson and Foote, 2019 ). Alongside this, management consultants are increasingly tasked with the development of healthcare solutions in the UK ( Kirkpatrick et al , 2019 ) as well as in Australia ( Skouteris et al , 2019 ), even though the increased expenditure on such consultants has been found to be associated with organisational inefficiency ( Kirkpatrick et al , 2019 ).…”