Services

Structured Advisory, Calibrated to Senior Leadership Need

Six engagement structures for NHS boards, senior director teams and programme leaders — each designed to deliver focused, independent senior perspective without the overhead of a substantive appointment.

Diagnose

Independent review and challenge, so you know where you stand.

Design

Commissioning and neighbourhood architecture built to be delivered.

Deliver

Hands-on recovery and retained senior counsel through to results.

01 · DIAGNOSE

Strategic Board Review

A structured, board-facing diagnostic of strategic clarity, transformation portfolio coherence and governance assurance.

Independent assessment of strategy, priorities and delivery architecture
Portfolio and programme coherence review
Governance, risk and assurance evaluation
Board-ready findings paper and recommended sequencing

Track recordFounding Director of a primary care legal entity, Partner Member of an ICB Board of Partners, as well as Chair and Deputy Chair of statutory primary care boards.

02 · DIAGNOSE

Start here

Critical Issue Sprint & Board Challenge

A focused, short-burst intervention to rigorously stress-test major board papers, strategic business cases, or transformation plans prior to formal submission or regulatory review.

Rapid 5-day deep dive into strategic documentation and governance risks
Pre-submission gap analysis and delivery risk assessment
Facilitated senior challenge workshop with the director team
Refined board paper recommendations and risk mitigation summary

Track recordCases for change built to survive the finance meeting, including a £16m intermediate care efficiency case.

03 · DESIGN

Commissioning & System Flow Architecture

Design of coherent commissioning intent, contract structures, intermediate care, and pathway reform aligned to ICB strategy and provider collaborative arrangements.

Commissioning intent and strategy framework development
Intermediate care redesign, discharge integration, and Home First financial modelling
Pathway reform across urgent and emergency care, community, and out-of-hospital services
Virtual ward expansion and multi-agency discharge governance

Track recordDirected system-wide mobilisation of out-of-hospital Urgent Care Hubs in partnership with acute trusts and system partners, avoiding 200+ ED attendances within the first two weeks.

04 · DESIGN

Primary Care & Neighbourhood System Architecture

Strengthening primary care as the structural foundation of integrated care systems — through strategic commissioning, PCN maturity development and neighbourhood operating model design.

Strategic commissioning of primary care and delegated arrangements
PCN maturity development, governance, and ARRS workforce models
Neighbourhood operating model and Integrated Community Team (ICT) architecture
Place-based financial alignment and population health service redesign

Track record100+ PCNs supported across three integrated care systems.

05 · DELIVER

System Turnaround & Recovery Intervention

Targeted, rapid-response oversight for high-risk transformation portfolios, off-track operational pathways, or failing urgent care flow models.

Rapid operational diagnostic of failing UEC, discharge, or community pathways
Redesign of immediate operational controls and multi-agency oversight
Financial efficiency recovery, identifying cashable savings while protecting care
System recovery assurance for ICB, NHS England, and provider boards

Track recordSRO of a system-wide UEC Improvement Programme.

06 · DELIVER

Fractional Senior Director Advisory

Retained senior counsel to a Chief Executive, director team or programme SRO — providing continuity of independent strategic perspective.

Ongoing advisory to CEO, director-level team or SRO
Board and committee preparation and challenge
Transformation oversight and delivery assurance
Discreet counsel on decisions of senior weight

Track record10+ years at senior and director level across provider and commissioning organisations.

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Fees

Transparent fees, agreed in writing.

Each engagement is priced as a fixed fee against a defined scope, based on a standard advisory day rate of £725 — under half the £1,600 a day NHS bodies commonly pay for senior interim and consultancy support, and a fraction of large-firm rates. Additional days beyond the agreed scope are charged at that rate and only by prior written agreement.

Strategic Board Review: Quotation on applicationTypically 15 advisory days
Critical Issue Sprint & Board Challenge: £3,625Fixed 5-day sprint at £725 per day
Commissioning & System Flow Architecture: £5,800 per monthBased on 8 days per month at £725 per day, typically over 4–6 months
Primary Care & Neighbourhood System Architecture: £5,800 per monthBased on 8 days per month at £725 per day, typically over 4–6 months
System Turnaround & Recovery Intervention: Quotation on applicationTypically 25 days across 6–12 weeks
Fractional Senior Director Advisory: £725 per dayDays agreed month by month

Fees are exclusive of VAT where applicable. Travel and accommodation are included within South East London, the Home Counties, Sussex and Surrey; beyond these areas they are agreed in advance with the organisation and recharged at cost.

How fees vary

Priced to portfolio complexity and duration.

The fees above assume a single organisation and a defined scope. Where the brief is broader, the fee is adjusted transparently against the factors below and confirmed before work begins.

Value against the benchmark

NHS bodies routinely pay up to £1,600 a day for senior interim and consultancy support, and considerably more through large firms. Every engagement here is priced against a £725 day rate, held inside a fixed fee, so the cost is known at the outset and the comparison is straightforward.

Portfolio complexity

A single-organisation brief is priced as listed. Multi-provider, place or system-wide portfolios attract an uplift of 10–20% to reflect the additional interfaces, evidence gathering and governance routes involved.

Duration and cadence

Fixed fees assume the stated timeframe. Extended mobilisation is quoted as additional days at £725, or converted to a retained monthly arrangement where continuity is the better fit.

Stakeholder engagement included

Interviews, board and committee attendance and engagement with clinical, local authority and voluntary sector partners are part of the agreed fee, not an extra. The stakeholder map is set out at the start of the engagement so the scope is clear on both sides.

Deliverables included

Findings papers, recommendations, business cases, financial modelling and implementation-ready operating models are all included within the agreed fee. Deliverables are defined at the outset so expectations are clear from the start.

Longer commitments

Retained arrangements of six months or more, and multiple engagements agreed together, are discounted by up to 15%.

Travel and on-site time

Remote and hybrid delivery is assumed, with sustained on-site presence agreed in advance. No travel or accommodation costs apply within South East London, the Home Counties, Sussex and Surrey. Beyond these areas, travel and accommodation are agreed in advance with the organisation and recharged at cost.

All engagements are governed by a written scope, defined deliverables and clear conflict management. See the engagement model for detail.

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