Category: Consulting

Everyone has a story about their dealings with the NHS…

Posted on by The Information Badger in Consulting, Information Technology, Leadership, NHS, Processes and Practices, Technology

In 1948, UK households received a leaflet telling them they were entitled to free health care. The UK’s National Health Service (NHS), funded from general taxation, free at the point of delivery, and available to all based on clinical need rather than income, was born. The NHS still exists, but the way it is organised and care is delivered, has changed considerably. The government of the day sets its budget and spending has grown, on average, by 3.9% in real terms since the 1950s. The NHS is huge.  It prioritizes emergencies ahead of treatments which are not immediately necessary but are important for maintaining or improving a patient’s life. Waiting lists can thus be long and are something the NHS can use operationally to stay within financial constraints. They are currently high and only responding slowly to government initiatives, as this  3-minute video highlights. The public remains sceptical about whether improvements are real because they still encounter frustrations with their NHS interactions. The care received from NHS doctors and nurses is rated highly, but navigating ‘the system’ to get it can be irritatingly problematic.

Everyone has a story about dealing with the NHS. In May 2025, after more than a year waiting, an acquaintance had a day-surgery procedure with an overnight stay and discharge the following morning. They were told on discharge that they’d receive a follow-up clinic appointment by letter for 4 to 5 months’ time. This was also recorded on their formal discharge letter. Having heard nothing by the end of October, they phoned the relevant hospital department to enquire about the appointment. They were passed between different extensions and ultimately to an answerphone where they left an appropriate message and their contact details. Having heard nothing again by early December, they phoned again and were ultimately redirected to a different extension to leave a message on an answerphone! Again, nothing had happened by early January 2026, and so they sent an email to an address buried in their discharge notes. An email reply appeared within two hours saying that the appointments team had been asked to make an appointment. Since then, there’s been nothing!

Yesterday the acquaintance asked the Badger, ‘Given your service operations and IT experience, is this a symptom of a failing service?’ They added, ‘In the old days, I’d have been given a card with my clinic appointment on it on discharge before leaving the ward. Who’s to blame for replacing that for the woeful process of today?’  The Badger answered the first question with yes, and the second with ‘Blame rests with governments, NHS leaders, and the external management consultants whose advice rarely improves NHS efficiency.’  To the Badger’s surprise, his acquaintance, a retired management consultant, agreed fully and added ‘more technology won’t help unless these processes get sorted’. They have a point…

‘A crisis’ – the name for a group of dysfunctional experts.

Posted on by The Information Badger in Business, Consulting, Delivery, Information Technology, IT Project Management, Leadership & Management, Risk, Software, Systems Integration

Many years ago, the Badger took a late morning phone call from his boss asking him to pop into his office for a chat. A reason for the chat wasn’t mentioned, and so it was with a little trepidation that the Badger took the lift to the floor where his boss’s office was located. On approaching, the Badger saw his boss through the open door with elbows on the desk, head in hands, looking morose. Sensing the Badger’s arrival, his boss sat back, smiled, asked for the door to be closed and waved the Badger to a seat.

‘What’s the collective noun for a bunch of experts responsible for designing a huge software intensive system on a fixed-price contract?’ the Badger was asked in a relaxed manner. His boss didn’t wait for an answer. ‘A crisis’, they said with irritation and a flourish of colourful language that would cause apoplexy today. They explained that this answer derived from problems on a multi-tens of million pounds, fixed-price IT development project with a dysfunctional Design Authority (DA) team. This team, apparently, was full of acknowledged experts who seemed incapable of agreeing or deciding anything that was crucial to the progress of the overall project team’s software developers. At the start of the project line management had apparently insisted on staffing the DA team with experts who’d been between assignments and non-revenue earning for some time. The Badger’s boss admitted that, in hindsight, it hadn’t been wise to allow this to trump an individual’s technical and personal suitability for the project.

The Badger was then asked to sort this out and get the project back on track! He joined the project with an open mind and quickly assessed the situation. There were some leadership and management dynamics to adjust, but the DA team was indeed the key problem. Its members were all respected experts with specialist knowledge, but each was focused on expanding and protecting their expertise rather than the big picture and the project’s fixed price delivery. Teamwork, within the Design Authority itself and with the rest of the project, was poor. Experts can add enormous value to any team if used correctly, and so the Badger carefully considered how to rectify the situation. He repopulated the Design Authority with good people drawn from other parts of the project. The experts were released to their home units to be used a couple of days a month for consultancy if required by the new DA team. The experts and their line managers grumbled, but the project went forward to success.

The point of this tale? Simply to highlight that experts who keep their egos in check, never lose sight of the big picture, and have both specialist knowledge and the personal characteristics for teamwork, are valuable assets on tough delivery projects. Those that don’t have all of these attributes are more suited to short term specialist consultancy…

Are Management Consultants useful and good value?

Posted on by The Information Badger in Consulting, Delivery, Information Technology, Leadership & Management, Project Management

A recent item about Management Consultants made the Badger chuckle. It’s  worth a quick read to see if anything resonates and makes you chuckle too. The Badger giggled because the narrative struck a chord and made him remember one particular encounter with a ‘management consultant’ while he was leading the delivery of a very large, fixed-price, IT systems and service development contract for his company. This delivery was a key part of an overall public sector programme transforming the workings of an entire industry. Inevitably, this overall programme was mired in politics, resistance from some quarters of the industry, and commercial gamesmanship by some of the parties involved to ensure they avoided blame for any difficulties the overall programme might encounter.

In private, every party believed the overall programme would be delayed. Their public stance, however, was different because the commercial ramifications of being blamed for delay were punitive. Most expected the key, critical path, IT delivery from the Badger’s team to be late. His magnificent team, however, delivered a system of quality on time, and in doing so exposed unreadiness and delay in other key parts of the overall programme. The overall programme’s stakeholders appointed management consultants from a well-known company to review and advise on the situation, and the Badger, in due course, spent an afternoon being interviewed by one of them. He didn’t come away from the session with much respect for management consultants.

As soon as initial pleasantries were complete, the Badger wondered how the expensive, brash, sharply suited, intelligent but over-confident, youngster in front of him could be a ‘management consultant’ when they were just a few years out of university and simply executing a process with a long list of associated questions. They had no real business, project, programme, or leadership experience, but they had clearly read many books, and drafted many reports and PowerPoint presentations. There was no discussion, just questions with the Badger supplying increasingly curt answers. The interviewer’s brash confidence and superficial real experience was irritating, and their credibility as a consultant providing value dissipated with every question. Two weeks later, the programme’s stakeholders received the management consultants’ overall report and supporting presentation. Both were stylish and well-written, but contained little that stakeholders didn’t already know. It didn’t seem like value for money!

You might think from this that the Badger has a low opinion of management consultants? In fact, he has engaged with many over the years and developed great respect for those who have become management consultants after years of important roles in business, industry, or project delivery. They are useful and provide significant value. Those, however, who call themselves management consultants, have expensive fee rates, but do not have such underlying experience are not great value for money. You may, of course, feel differently…especially if you are a management consultant.