Government & Public Sector

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Healthcare | Infrastructure | Local Public Services | Central Government | Insights

We are dedicated to helping you through the unprecedented challenges currently facing healthcare systems around the world.

We work with clients to realise long-term goals, and have extensive experience, insight and the technical ability to provide the best solutions.

Our core team has a wealth of hands-on experience and includes a number of ex-clinicians. Our teams work together to offer our skill and knowledge, and we bring energy and innovation to help effect change.

Find out more about the services we offer:

In the face of rising patient demand, restricted resources, and an expectation of large efficiency gains, improving productivity is key.

By understanding your clinical services, we can shape a new strategy and help you transform your service delivery model. We can also bring sustained performance improvement to your operating model and help drive your organisation in the most productive and effective way, helping you achieve clinical and financial sustainability.

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Provider sustainability

Doctor holding medical notesThe NHS £20bn productivity challenge is in its third year, and rising patient demand means trusts face unprecedented challenges; testing even the most innovative and well managed organisations. Whatever stage you are at, through stabilising, optimising and transforming the provision of services, we can help you achieve clinical and financial sustainability 1.8Mb, December 2012.

The NHS in England needs to deliver £20 billion of efficiency savings by 2015. Many NHS organisations are struggling to become authorised as Foundation Trusts and there is an ongoing drive to offer more joined up patient services.

Facing these challenges, NHS organisations are considering integration and collaboration opportunities across a spectrum – from informal networks to mergers and acquisitions. We believe a new approach is needed if these projects are to succeed within the timeframes – an approach that considers the full spectrum of options available to partnering organisations and focuses on realising their clinical and financial benefits.

We have extensive experience helping organisations identify how their functions can work better together. We help find the best form of collaboration or integration, including the legal and contractual implications of different organisational models.

Our approach focuses on delivering benefits. We consider all organisational components to create an optimal design that maximises strengths, reduces costs and improves productivity across the transaction lifecycle.

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Integration and collaboration in the NHS

Doctor and patient looking at computer monitor The NHS needs to deliver £20 billion of efficiency savings by 2015, and a new approach is needed to achieve this. Learn more about how we can help 1.8Mb, November 2012.

The new landscape for NHS commissioning puts clinicians at the heart of decision-making. We believe aligning clinically-led commissioning decisions to robust management processes creates huge potential for service improvement and greater productivity.

The creation of new GP-led Clinical Commissioning Groups (CCGs) will provide new opportunities to accelerate service improvement across health systems. While many core activities remain the same, the style of commissioning is likely to change radically as wider service provision reforms take effect.

Clinical commissioners have the potential to deliver sustainable productivity improvement, accelerate pathway redesign and stimulate health system reform. While the potential is enormous, the transition will be complex, and we need a multi-faceted approach to deliver change. To secure potential benefits, it is essential lessons are learned from previous models, so that strengths are maintained and weaknesses designed out.

New commissioners will need to develop improvement strategies using the right combination of ‘buy, share and build’ so that they have the capacity and competencies to:

  • Detect when changes are needed in a local health system
  • Use tactical awareness to bring about change
  • Execute change confidently to demonstrate that intended outcomes have been achieved.

We are already working on CSS development at national, regional and local levels. Our team includes people who have built effective commissioning support service businesses in the NHS, and who bring the direct practical experience you need in order to set up and deliver a successful service.

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Achieving successful commissioning support services

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Getting your mind around clinical commissioning

Hands working with test tubesTrying to get your mind around commissioning? Check out our map explaining the world of commissioning (1.9Mb, December 2012), from change levers and improvement strategies, to maturity indicators and our tools and services to help with the challenges you face.

Succeeding in the world of clinical commissioning

Doctors and patient studying x-rayClinical Commissioning Groups will provide commissioners with the opportunity to deliver sustainable productivity improvement, accelerate pathway redesign, and stimulate health system reform. We work with commissioners to maximise their strengths, and translate good ideas into reality 4.9Mb, December 2012.

Restructuring an organisation doesn’t just involve structures and processes. All components need to be considered in order to enable the new organisation to maximise strength and reduce waste. We have expertise and experience in all aspects of health and social care integration, including:

  • Redesign of integrated care pathways
  • Early intervention and reablement
  • Change management that recognises the different cultures and agendas that health and local government have historically worked in
  • Organisational change, including supporting development of integrated care organisations.

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Integrating health and social care

Elderly couple's handsHealth and social care organisations are under pressure to make significant financial savings, while services are increasingly under pressure from increased public expectation and the needs of an aging population. Our integrated systems approach can help increase productivity (777K, November 2012), offer savings and service improvements through reduced admissions, and efficiency through reduced duplication.

Unprecedented change is occurring in the NHS, driven by fiscal pressures and rapidly changing demographics and technology. Major changes to the design of our healthcare service are needed if it is to continue delivering high quality, cost-effective clinical care wherever and whenever it is needed.

EY can help healthcare organisations face these challenges by making best use of their data assets and embracing disruptive technologies.

Through a suite of technical products and capabilities we combine deep healthcare experience with an understanding of healthcare data and technology.

We provide the NHS with the tools to make better decisions, run more efficient services, and drive the innovative, positive change needed to build tomorrow’s healthcare system.

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The NHS is facing the biggest financial challenge in its history. Constrained funding and significant projected growth in demand and other cost pressures mean it must deliver around £20bn in efficiency savings by 2013/14.

Most organisations will have to make significant changes to meet this challenge. We can help your finance function develop a clear vision for the future, to enable this. We also have significant experience of conducting foundation trust assessments for Monitor, and can help you prepare for an assessment.

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Finance at the forefront

Doctors walking in hospital corridorFinance departments should have the best understanding of their organisation’s financial position and play a central role in driving savings. Discover what a well run Finance function looks like 1.8Mb, December 2012.

As the NHS is gripped by change, real estate presents constantly evolving challenges.

We advise primary care trusts, acute trusts and foundation trusts on how to make the best use of their estate, drive through cost efficiencies, and provide fit for purpose space.

Critical to this is our health estate diagnostic review which identifies key estate issues and opportunities to release capital and achieve cost savings.

We advise on cost reduction and the use of strategic partnerships with the private sector to manage an estate. We also develop a low capital building solution that uses private sector expertise and finance to deliver fit for purpose buildings without the need to commit capital or sign a long head lease.

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Effective financial management should include pro-active tax management.

VAT and payroll taxes represent significant costs, as can corporation tax. Our team is dedicated to helping NHS clients with these issues. We work with trusts to comply with regulations and maximise available reliefs. Our comprehensive tax service includes:

  • VAT and payroll tax assurance programmes
  • Flexible benefits and the associated tax implications
  • Contract review and VAT efficient procurement, helping Trusts to utilise available reliefs
  • Advice on property transactions, including co-developments with charities, universities etc.
  • Restructuring advice, for example primary care trust provider carve out
  • Support with HM Revenue and Customs audits.

Doing the right deal right can make your business more competitive and profitable – and help it grow more quickly.

  • We provide lead and financial advice on a range of PPP and PFI projects within the NHS.
  • We help our clients engage in competitive or non-competitive acquisition or integration (including transforming community services).
  • We advise on a variety of mergers and acquisitions transactions, including bidding to acquire mental health NHS Trusts, mergers of community health services entities, acquisition of acute NHS trust by a foundation trust, and integration of community health services organisations with foundation trusts.
  • We also have significant experience of private sector mergers and acquisitions, including advising on healthcare transactions.


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EY - Survive, strive or thrive?

Survive, strive or thrive?

The financial sustainability of England’s small hospitals

Our report shows small NHS hospitals in England will face extreme financial difficulty next year, with all forecasting a deficit. Find out more.