The NHS paid £350 million to management consultants in England last year, according to figures released today.

The Royal College of Nursing said that the spending — the equivalent of 330 fully staffed 28-bed medical wards, 9,160 experienced staff nurses or 267,647 bed days in an intensive babycare unit — was "utterly shocking”.

About £273 million of the money was not related to patient care, said Peter Carter, the RCN chief executive, who obtained the figures through freedom of information legislation.

The bulk of the money was spent on increasing competition in the health service and supporting bids for foundation status by NHS trusts, he added.

“These figures are utterly shocking when you consider the difference that this money could have made to patients,” Dr Carter said.

“A very significant sum of money is clearly being spent on setting up competition in the NHS and pursuing foundation status, rather than being invested in patient care. You only have to look at what happened at the Mid Staffordshire NHS Foundation Trust to see the consequences of this.”

A report earlier this year into up to 1,200 deaths in Mid Staffordshire criticised the trust board for being more interested in attaining foundation status than caring for patients.

The RCN believes that the total spent on management consultants in 2008/09 may be higher, as more than 40 per cent of the NHS organisations which it contacted did not provide details of their spending.

Reducing the amount spent on management consultants could deliver 11 per cent of the £2.3 billion savings demanded from the Department of Health in last month's Budget, Dr Carter said.

“Before the Department of Health and local health trusts look at cutting frontline services, training budgets or new facilities, they need to look very carefully at the money spent on external advice and what value is added to the patient experience,” he said.

“When some individual management consultants are getting more than £1,000 a day to advise on finance, we must surely be able to afford improvements to the quality of patient care.

“Savings in this area could contribute a huge proportion of the savings to be made by the Department of Health, without jeopardising patient care."

According to the the RCN, 39 per cent of the money spent on management consultants was allocated to market testing designed to help providers and commissioners identify the most profitable options in the NHS market. Twenty-three per cent was used to support applications for foundation status, 13 per cent to achieve “provider separation”, and 12 per cent to buy advice on the Private Finance Initiative.

The Department of Health said: “Individual NHS organisations decide how best to invest their resources to ensure local people get the best possible care and services. We expect organisations to consider value for money and patients’ interests in all aspects of their expenditure.

“All spending and investment is subject to independent audit — £350 million equates to less than half a per cent of total NHS expenditure for the last financial year.”

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