The Royal Free Hospital in Hampstead

HOW long before consultancy firm directors join the strikers demanding more income from the NHS?

Millions of pounds are being channelled out of north London’s health service each month to dozens of limited companies for a range of services that are often not so easy for the public to scrutinise or quantify.

Some cash-strapped hospitals are buying in advice to help them make cut-backs.

The Royal Free has more than doubled its consultancy spend to £3.7million for 2022/23 compared to £1.4million for the previous tax year, according to the Hampstead NHS Trust’s annual accounts published this week.

That outlay is enough to fund around 60 more managers, 30 consultants doctors or 100 senior nurses at the hospital.

A breakdown of payments shows how £1.4m was paid to Moorhouse Consulting “to support delivery of trust efficiencies”.

Meanwhile, £419,000 was spent on outsourcing “referral to treatment validation work” to MBI Healthcare, a company that says it helps trusts struggling to manage patients and costs. KPMG was paid £156,000 for help with an “existing data strategy” and £124,000 was spent on helping the NHS business service develop a “target-operating model”.

More than £360,000 was spent smoothing the course of projects run by Royal Free London Property Services and £187,000 on estates and capital projects.

A further £109,000 was spent with Maxwell Stanley to “identify income opportunities”, the annual accounts said.

The Hampstead hospital’s payments – which will be similar to other trusts up and down the country – pale in comparison to the huge sums being spent on consultancy firms by North Central London Integrated Care Board (ICB).

It lists of monthly expenditure show how the ICB – that decides where hundreds of millions of NHS funding in north London goes – paid more to one consultancy firm in April than it did to any other “healthcare providers”. Carnall Farrar Ltd, which received more than £980,000 just for April from NCL, was set up by Dame Ruth Carnall and Hannah Farrar.

Both were former senior directors at NHS London before the former capital’s health authority was wound-up.

The firm is just one of several companies receiving regular payments from the ICB for health care services, including InHealth Ltd and Circle Health. Optum – a subsidiary of the United States health giant UnitedHealth, which older anti-privatisation campaigners in Camden will remember – was paid £400,000 in April.

Figures obtained by an FOI by Open Democracy found that NHS England was paying some individual consultants £2,500 a day for support with the vaccination programme.

Unite’s national lead officer Onay Kasab said the figures being spent on consultancy firms “would be much better spent providing a proper pay rise for NHS staff to end the recruitment and retention crisis that is crippling health services”.

Recent studies have shown how NHS Trusts that used management consultants tended to become less efficient over time

. I contacted the companies for comment this week, but there has been no meaningful response.