OK, I'm sorry. (I'm not) but BULL SHIT.

I'm calling 'bullshit' on the whole Consultancy scam. @NHSX have commissioned Kaleidoscope H&C to help them produce a Digital Clinical Safety Strategy.

Consultancy takes cash, then go and ask dozens of actual (unpaid) experts.

So the Strategy will actually have been written by unpaid NHS safety and other clinical experts, but a private company pockets a wedge of cash for organising a few Teams calls.

On today's call they had us writing our responses in the Teams chat to make their job even easier.

@NHSX seems to be a machine for recruiting for highly paid Director of <NOUN> posts, and then outsourcing the thing that Director is supposed to have expertise in to an outside company.

I wouldn't mind if this 'External Consultancy For Everything' model was resulting in high quality decisions. But it is very much apparent that consultancies are making stupid decisions, expensively, and unaccountably.

Case in point: PA Consulting were commissioned to plan for the IT systems behind COVID Vaccination in early-mid 2020. Their report has never been published.

All mass vaccination in this country (eg flu) is done by GPs, but PAC chose a *Pharmacy system* for COVID vax IT

Because of this, the existing GP suppliers EMIS Group TPP were initially told NOT to create point of care vaccination solutions.

It was only in Oct/Nov 2020 GP IT leaders got to hear about this report, by which time it was too late to change direction.

The COVID vaccination programme has been a success DESPITE, not because of, the Pinnacle system.

And GPs have delivered 75% of vaccines so far. We could have told NHS England this would be the case, but PAC seemed not to know.

Just one of many failures of external consultancies, advising the NHS on health tech without even the haziest notion of how the NHS works, without any clinical knowledge, and without any technical knowledge.

It takes a particular intellect to hire 'Experts in Strategy' because you need a #Digital #ClinicalSafety #Strategy .

Some people would contend that it makes more sense to hire experts in Clinical Safety.

And furthermore, to make a Strategy work you need to understand the NHS.

I should add that I'm not saying all this to be unkind. I'm saying this because NHS IT is in a parlous state and getting worse.

Safety in NHS IT is neglected in a way that would be a national scandal in the pharma or aviation.

It won't get better unless someone speaks up.