Are we right to be worried about US involvement in NHS?

When two London patients were asked to help set up a ‘new way’ of suppling joined-up Health and Social Care for the elderly, they were horrified to discover Attain, the American Management Consultants tasked with setting this up by the Dept. Health, were proposing to import 200 nurses from America, earning £50,000 p.a. plus expenses,  to work the scheme.

Patient Representatives, which the NHS calls ‘Stakeholders’ (giving me visions of being burnt at the stake if I talked out of turn!) suspected we were asked just to tick the box for  ‘Patient Representatives consulted.

Setting up the Systems

At the first meeting Attain bombarded us with statistics, lectured us in acronyms. and bemused with Power Point presentations.  These were a jumble of slides that got us cross-eyed trying to decipher, but surrounded by doctors and NHS professionals, we assumed everything was OK.

Gradually we started questioning, and sat up when it was announced that the system would be using American Physician Associates to assess patients. We couldn’t see why UK trained staff couldn’t be used., but were told there weren’t any available. But had anyone told NHS staff that pay was going to be £50k p.a.?

Churchill once said America and Britain were two great nations divided by a common language; the mind boggled at what would happen when an old dear asked for help with her waterworks ….. let’s not go further.

It became clear that Attain didn’t understate what British OAPs required – even suggesting if they wanted a cup of tea they would like to leave their comfy chair in Reception, walk down a long corridor and sit in a quiet room.  We tried to explain that this visit might be their only outing of the month, so they wouldn’t want to miss any action,. But the ‘expert consultant’ running the meeting hadn’t a clue what elderly people wanted.

Wake Up Call

Then it was announced that the CCG (a.k.a. Cynical Commissioning Group) had been flown over to the States by the Management Consultants to see their training school. The CCG then decided to employ American nurses.

This had to be stopped, which called for lateral thinking  

We asked if everything was being done to ensure these American nurses were made welcome?

Yes, they were all having an Induction week (200 x 1 week’s salary)

Would they get the same benefits as British nurses i.e. would they be guaranteed NHS healthcare? And would this be mentioned in job advertisements?

The ‘expert consultant’s head nodded eagerly.  “of course”.

  • In the States, your Medical Insurance package is the first thing you look at before accepting a job.
  • US nurses know all about the NHS and its problems, waiting times, etc.

The end result was only six  U.S. nurses applied for the job.


Each time we questioned costs, we were brushed aside.  Attain didn’t seem worried about where the money would come from, but stamped on our suggestions to involve Charities providing Specialist Nurses for dementia, cancer, osteoporosis, Parkinsons, etc., even leaving unanswered an important email from one of the charities keen to be involved, at no cost to the NHS.

After the service was up and running, Attain tried to get involved again, suggesting we employ Picker, or another outside company, to evaluate the scheme. We suggested asking patients – which wouldn’t cost anything – but surprisingly this wasn’t acceptable (could it be they didn’t get commission? Surely not).


As a member of the public, this has been an eye-opener in how the Dept. Health wastes NHS money. We all cringed at garbled PowerPoint presentations full of jargon, crammed slides, money wasted on paying for unsuitable meeting rooms – and when we discovered an Uber driver ripping off the company, their Management Consultant was furious when we Patient Reps stepped in to argue and save the NHS money!  She had her purse out ready to pay him.

But reassuringly Kaiser Permanente (another American company)  evaluated the scheme before it was even up and running.  They were full of praise, even though no official patient had actually made use of the scheme (perhaps someone wheeled in rent-a-crowd – more cost?).

Luckily for the scheme’s success, the first NHS manager who was appointed came in and changed all the things we Patient Reps.had objected to – back to what we had suggested. Patients were very satisfied!  Shortly after she left to go on to better things – but if she had been appointed to start with, the NHS could have saved all those Consultancy fees.

For the Future, Take Heart.  Speak up and we can over-rule crazy ideas proposed by Consultant firms.   PEOPLE POWER works!


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