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‘Consultant delivered service’ means consultant 24-hour presence or ready availability for direct patient care responsibility. 

Implementing consultant delivered services

The future of service delivery in the NHS will be based on a consultant delivered care. Like any significant change, implementing a consultant delivered service presents significant challenges. But the benefits present a compelling case for change.

Ways of working across the NHS are changing.

Patient expectations continue to increase, services (and the consultant role within them) are undergoing reconfiguration and the way in which training is delivered is also changing. This requires a new approach to workforce planning, with a focus on creating a consultant delivered service and the subsequent realignment of the entire workforce.

Concerns are being expressed over the move to a consultant delivered service, and the implications of the changes inevitably present a challenge for many. It will be important to be clear about the long-term outcomes and ensure the patient is at the heart of the case for change.

Looking at the benefits of a consultant delivered service presents a compelling case for change.

Designing a consultant delivered service is an opportunity to realign clinical teams to patient needs

Designing a consultant delivered service is an opportunity to bring together clinical and non-clinical staff at all levels to examine the patient pathway, remembering that ‘one size does not fit all’ and recognising the unique needs of each circumstance. For example, 24/7 consultant presence is not necessary in all situations. The right resources (not the available resources) can be allocated to every point of the pathway giving the best possible care for the patient. 

Doctors in training will feel more supported

With the introduction of consultant delivered care, doctors in training will be able to follow consultants through all stages of the care pathway. Currently, the way some rotas are designed means the trainer and trainee may not work together for significant periods of time. This leads to a less-than-optimum training experience for the trainee – and the future reduction in the number of doctors in training will further impact the amount of resource available for service cover.

Doctors in training will feel more supported and empowered through consultant delivered services. Trainees are likely to have less direct service delivery responsibility and they will be learning in a safe environment, thus reducing the stress placed upon them.  

With consultant delivered care, consultants will be able to do more of what they do best

Doctors chose to go into medicine to treat patients. In planning a consultant delivered service, teams should analyse current consultant tasks and reassign or eliminate anything that does not require their level of expertise. This will give consultants more real time with patients and mean they spend less time doing administration and other related activities. Additionally, the majority of consultants see the development of the next generation as a meaningful part of their role and the model of a consultant delivered service gives better opportunities to train effectively.   

Increased consultant time will save money

Consultant pay isn’t the only measure of cost in this model. The impact of more correct first-time diagnoses and earlier interventions (shorter bed stays, lower treatment costs, less waste) will all help to reduce overall costs. Furthermore, doctors in training will be learning more effectively, by observing consultants and then acting with supervision – overall, this is likely to reduce errors and produce a more confident and competent trainee. 

The implementation of a consultant delivered service will deliver the best outcomes for patients, increases the proportion of consultant time spent in direct clinical care and gives the best learning opportunities for doctors in training.

To find out how we can support the development of consultant delivered care in your organisation, please contact us now .

Catharine Berwick
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Chris Steel
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