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A year ago, Zircadian Consulting Ltd (ZCL) was just a twinkle in the eyes of the Executive Directors, Dr Henry Carlton, Dr Angus MacDougall, Matthew Bluck and Dr Deborah Kendall. Today, the fledgling clinical workforce consultancy is already growing rapidly. The consulting team has brought forward its recruitment plans to respond to its expanding portfolio of clients and the new business opportunities that our service offering has opened up. To meet the demand, Lianne Ryan arrived five months ago as Business Manager and now I have just been appointed as Head of Global Health.

 

So, clear evidence that ZCL is already providing a service that fills a gap in the traditional healthcare consultancy market, a service that our clients really need and appreciate. We are now proceeding to consolidate and expand our UK business, but that is not enough to satisfy our ambitions. We are already planning ahead. We are going global. Health problems are global and they need access to global solutions. My job is to lead the development of our international programme. Hopefully, the 30+ years of my clinical and consultancy career to date enables me to do exactly that, otherwise I am in deep trouble!

I was an NHS consultant general / GI surgeon & Honorary Senior Lecturer in Edinburgh for 15 years. It was an exciting time, with rapid developments in cancer surgery, keyhole surgery, therapeutic upper and lower GI endoscopy, and with the launch of the Edinburgh Surgical Audit system to stimulate improvement in the quality of our surgical outcomes. The system was one of the precursors to the National Confidential Enquiry into Patient Outcomes and Deaths (NCEPOD) programme.

We launched a laparoscopic choleystectomy service, great for our patients, dreadful for our surgery and theatre managers’ budgets. Our use of resources exploded. Overnight, we went from using one bed for 5 days for one postoperative patient, to using that same one bed for 5 patients over the same 5 days. Overnight, I learnt about the central role that consultants need to take on in order to help our hard working managers to direct the resources more effectively, and to change clinical and organisational practices. All consultants, as the major generators of healthcare costs, need to be more involved and responsible. I went back to school to do an MBA on Health Economics.
Inundated with requests for keyhole surgery training, we set up a ‘hands on’ laparoscopic cholecystectomy clinical training course. Over the next two years, we put some three hundred surgeons through their paces, in the UK and overseas. The travelogue covered fourteen countries. We went overnight from 48°C in Abu Dhabi to -20°C in Reykjavik. We braved the troubles in Northern Ireland. We made the main evening news in Istanbul. We made many friends. Unintentionally, we also energized the private surgical sector!

At my first career crossroads, I took the road less travelled by most doctors, moving into senior management. I became an acute hospital Medical Director, firstly in Abu Dhabi for two years and then for a further three years in the NHS. Operating at the executive level is altogether a fascinating, but also isolating vocational training experience. You quickly learn what is achievable and, perhaps more importantly, what is not achievable.

At my next career crossroads, I took the road least travelled, certainly by doctors! For the last 10 years I have operated in the world of healthcare consultancy, with spells in KPMG and Teamwork Management Services Ltd, taken over two years ago by Mott MacDonald Ltd. To date, I have provided expert clinical strategic and operational input to over thirty major UK and international projects. I am comfortable operating in different cultures and health systems, and across all health sector levels, stretching from the front line service through to regional, supra-regional and national programmes.

My surgical passion for quality and clinical excellence was the forerunner of my consultancy passion for advising clients to international best practice standards and helping them prepare as thoroughly as possible for the next step, ‘making it happen’. There is nothing more frustrating to me than presenting a client with a set of excellent recommendations that promptly get shelved, going nowhere fast, seen as too difficult to implement.

So, between my clinical and consultancy careers, I have been fortunate indeed to have amassed a considerable wealth of strategic, operational and medico-political knowledge and expertise. Now I need to prove that I can make ZCL the latest beneficiary of my own good fortune!

 

Zircadian Consulting Ltd is a clinician-led healthcare consultancy specialising in clinical workforce and service re-design. Dr John Saunders and all other members of the Zircadian Consulting team can be reached by calling 0161 242 1234 or by emailing info@zircadian.com