One starting point. Follow-on only where the evidence justifies it.

Which pressure is most elevated, benchmarked against peers, and the decisions it should change.

How engagements are scoped

The Workforce Structural Review is one product with variable scope. The standard single-organisation Review is £15,000. A first-engagement or case-study Review has an £11,000 minimum only where case-study rights or equivalent commercial learning are secured.

Smaller requirements are quoted only after the analytical and delivery workload is explicitly reduced. Multi-organisation requirements are quoted from the actual number of organisations, peer groups and delivery effort. They are scope variations of the same Structural Review, not separate product tiers.

Who it is for

Chief People Officers, Directors of Workforce, Chief Operating Officers and Chief Finance Officers facing a workforce decision with money attached and no independent evidence to point at. Also Integrated Care Boards reviewing a provider portfolio.

The problems it solves

• You have an agency reduction target and no independent view of whether it will hold.
• Your workforce dashboards disagree with each other and no one can say which one to act on.
• The board has asked for assurance on workforce risk and internal reporting cannot provide an outside comparison.
• A programme is being proposed and you cannot tell whether it addresses the pressure that is actually most elevated in your organisation, or someone else’s.
• You need evidence a board, a regulator and a union will all accept for a decision that is already contested.

What we do

Build your position on three independent measures from published data, benchmark against up to 203 peer trusts over 2021 to 2024, identify which is most elevated, and translate that into the specific decisions it changes.

What you receive

• Board-ready report, written to be read by non-specialists rather than analysts.
• Your three-axis position with peer benchmark and percentile placement.
• Cost translation: what comparable trusts recorded when they made this decision.
• A “do not do” list specific to your position.
• One testable hypothesis you can check against your own internal data inside 30 days.
• Ninety-minute board or executive session.
• Full data provenance appendix, every figure traceable to source.

Outcomes

A named candidate binding constraint instead of a list of concerns, with the specific test that would confirm or rule it out in your own operational data. A decision you can defend in a board paper with an independent source. An early answer on whether a planned programme is aimed at the right thing. A hypothesis your own team can test, which is where the internal conversation is designed to shift.

The structural intervention, designed and sequenced, including the redesign that has to come before any reduction target.

Who it is for

Executive teams that have accepted the structural diagnosis and need the intervention designed. It follows only where a Structural Review produces a Redesign-candidate outcome and the entry conditions for a Redesign programme are met.

The problems it solves

• You believe agency dependence is the constraint, and you have seen that in comparable trusts a reduction was followed by higher permanent-staff sickness absence.
• A previous workforce programme delivered a saving that has since unwound, or you cannot tell whether it held.
• Rota, skill-mix and establishment decisions are being made in separate places with no shared structural logic.
• You need a sequence, because doing the right things in the wrong order is why the last attempt failed.

What we do

Design the structural intervention and, critically, sequence it. Escapes from the heaviest agency quartile hold 77.8% of the time, against a 91.1% base rate for trusts that were never there: most hold, and relapse runs 13.3 percentage points higher. That gap is why we build the programme with the redesign before the reduction target. Whether sequencing it that way changes the outcome is not something our published analysis establishes.

What you receive

• Structural intervention design, tied to the specific mechanism identified in review.
• Sequencing plan, including explicitly what must not be attempted first.
• Rota, skill-mix and establishment redesign for the services in scope, worked inside the engagement on your own roster and establishment data. This is the one part of our work that cannot be done from published data, because NHS public data does not carry shift patterns, tenure, pay band or skill-mix.
• Financial model of the intervention, reporting the cash saving and the associated absence separately, with the pay-bill-equivalent value of that absence stated as a valuation rather than a cost.
• Board and executive engagement throughout.
• Handover pack so the design survives the people who commissioned it.

Outcomes

An intervention aimed at the mechanism rather than the symptom. A defensible sequence. A financial case that treats the figure as a valuation of lost time, not a cash saving. A design your own team owns at the end.

Your position re-cut on the same method every year, with the measures that move tracked quarterly.

Who it is for

Organisations that have had a review or a redesign and need to know whether the position moved. Integrated Care Boards monitoring a provider portfolio. Boards that have committed to a workforce programme and owe themselves evidence about whether it worked.

The problems it solves

• A programme completed and nobody can say whether the structural position actually changed.
• The board asks “are we better than last year” and the honest answer is “our internal metrics moved, we do not know if our position did.”
• An Integrated Care Board needs a consistent view across providers that each provider’s own reporting cannot give.
• Structural drift is slow, and annual reporting cycles are too coarse to catch it while it is cheap to fix.

What you receive

• Annual three-axis position with peer benchmark, re-cut when the Staff Survey lands.
• Movement report: what changed, what did not, what is within normal variation.
• Quarterly movement tracking on the measures that are published monthly.
• Named analyst contact.
• Annual review session.

Questions people ask before they buy

If it is all public data, what am I actually paying for?

The comparison and the testing, not the data. The data is public. What you are paying for is the panel already assembled across 244 NHS organisations and four years, and the seventy-nine pre-specified tests already run against it, which found that fifty of the obvious explanations were wrong.

What happens if your analysis says we are fine?

Then we say so, and there is no programme to sell you. That happens, and it is a legitimate result. It is also the reason the review is priced as a standalone piece of work rather than as a loss-leader for a larger programme.

Who else sees our data and our results?

Nothing you give us is used, because we do not ask for anything. The analysis is built from data your organisation already publishes, so there is no information governance process to clear and no system access to grant. Your report is yours. We do not publish client positions and we do not name organisations in our public content without permission.

You have not done this for a paying client yet, have you?

No. The Labour Prefect has not yet delivered a commissioned review. What exists is a full review built on a large acute trust that did not commission it, from published data, which you can read before deciding anything. Every figure in it is traceable to a public source, so you can check the work rather than take a reference on trust. Being early is reflected in how the work is priced.