Questions NHS boards ask before commissioning advisory support.
What kind of organisations do you work with?
NHS provider trusts, Integrated Care Boards, provider collaboratives, primary care organisations and Primary Care Networks, and their local authority and voluntary sector partners. Engagements are typically commissioned by a Chief Executive, director-level sponsor or programme SRO.
How is this different from a large consultancy?
You work directly with an experienced NHS director-level practitioner rather than an engagement team. Experience spans both provider and commissioning sides of the system, so recommendations reflect what a provider can actually deliver and what a commissioner can actually contract for.
What does the provider and commissioning combination give me?
Most system change stalls at the interface between commissioning intent and operational delivery. Having led both — urgent care, community and discharge delivery on one side, delegated primary care commissioning and contracts on the other — the design accounts for both from the outset.
How do you handle conflicts of interest?
All advisory work is undertaken independently and outside any substantive NHS remit. Conflicts are declared and managed transparently, with scope agreed in writing before an engagement begins. Where a potential conflict cannot be cleanly managed, the engagement is declined.
Can you support governance and assurance, not just design?
Yes. Governance is treated as part of the design. Prior roles have included Founding Director of a primary care legal entity, Partner Member of an ICB Board of Partners, Chair of a Primary Care Contracts Board and Deputy Chair of a Primary Care Commissioning Board, establishing primary care governance structures, and building escalation and reporting arrangements for delegated commissioning and discharge programmes.
We have a transformation portfolio that has outgrown us. Where do you start?
With a structured review of portfolio coherence — what is genuinely in flight, how it is sequenced, what it costs, and whether the assurance arrangements can carry it. The output is a board-ready findings paper with recommended sequencing.
Do you work on urgent and emergency care and discharge specifically?
Yes. This includes senior leadership of a system-wide urgent and emergency care improvement programme, redesign of discharge arrangements across a large system, and design of community alternatives to Emergency Department attendance.
How do you support neighbourhood health and Integrated Community Teams?
Through operating model design and mobilisation: blueprint, governance structures, partner engagement and a consistent model across places — the approach used to design and mobilise Integrated Community Teams across a large integrated care system.
What does an engagement cost, and how long does it run?
All work is priced against a £725 advisory day rate, under half the typical £1,600 NHS benchmark. The Sprint is a fixed £3,625, design programmes run monthly from £2,900, and board reviews and recovery work are quoted on application. Full fees are published on the services page.
How do we start?
An initial scoping discussion, without obligation, to test whether independent senior perspective would materially help. If it would, a written scope with deliverables, timeline and fee follows.