Strategy category winner Richard Lewis/Ernst & Young

Richard Lewis “has got the T-shirt” when it comes to offering advice on healthcare strategy, according to one of the MCA award judges.

Lewis, 47, who has a PhD in health policy, spent ten years as an NHS manager, followed by another ten specialising in policy and system reform for the King’s Fund healthcare think-tank.

He then worked in the Prime Minister’s Delivery Unit during the transition period from Tony Blair to Gordon Brown, before joining Ernst & Young two years ago as a director in the company’s health advisory practice. His client list includes primary care trusts, strategic health authorities and the Department of Health.

Lewis offers strategic advice at the highest level; he spent 18 months working on the Department of Health’s Vision for Primary and Community Care report as part of Lord Darzi’s NHS Next Stage Review. He is now advising the department on the care of long-term conditions.

He has no doubt that having practical, academic and strategic experience is a key advantage when advising clients on dealing with the NHS reforms. “It gives me an extra dimension that I have worked both within the NHS and on the academic side. It helps to understand the relationship between the academic theory and the ability to put it into practice.”

It also helps that he remains acutely aware of the need to tread delicately when dealing with healthcare staff, many of whom remain uncertain of the reforms.

“For instance, if you want to motivate doctors it takes more than money,” he notes. “You need to focus on intrinsic professional incentives as well as financial incentives.”

Lewis’s solid credibility helps on the occasions when he has to deliver unpopular recommendations, although he emphasises the need to persuade the decision makers through the strength of evidence.

“Clients do want a consultant who can take a dispassionate view and who is able to challenge the cosy consensus,” he says. “At the same time, if you just march in with a hypercritical review and march out again, then that review is probably not going to go very far. You need to be able to build the case so that the solutions become apparent to the board.

That is where it becomes important to have a good grasp of the evidence. Lewis’s “evidence-based” approach to consulting dovetails neatly with the patient-centred direction in which the NHS has moved in recent years.

Indeed, he is keen to ensure that policy initiatives are not only accepted at managerial level but also implemented on the front line of patient care. “One of the biggest mistakes you can make is to keep the strategy in the boardroom,” he says. “One of the developments in strategic consulting in recent years is an increasing emphasis on implementation.

“Obviously you do not want your consultant procuring the paperclips, but you do need to take an interest in what is going on beyond the top-tier management. After all, a strategy that cannot be implemented is no strategy at all.”

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