Our clients ask, how do we...

  • Deliver better patient outcomes?
  • Make sure our services achieve the latest standards?
  • Manage the risks involved in change?
  • Gain the support of a diverse set of stakeholders?
  • Build evidence that we are making the right decision?
  • Achieve a world-leading service?

Every day, academics, practitioners, and industry innovate. Organising clinical services is about delivering innovations. A key challenge that our clients face is gaining the support of professionals, politicians and the public who can be resistant to change and concerned about how it will impact on them.

We take a whole system approach, establishing the full impact of any potential service change to ensure it can be managed safely and effectively, and guiding teams and organisations to new ways of working. We help people across the whole health and care system, including local residents to:

  • Understand the detail of the local context, including the population’s needs
  • Articulate a compelling, evidence-based narrative for the need to change
  • Build on best practice clinical models, harnessing learnings from around the world
  • Design the optimum set-up to deliver a world-leading service
  • Align system leadership and resources around delivering change in a way that is sustainable.

Our support enables people to think beyond the “obvious” solutions and consider alternative care models based on internationally evidenced best practice. We help to build clinical consensus around these, driving innovation across the health and care system. We help our clients to understand complex regulatory processes to ensure any proposals developed are robust and legally watertight.

  • Developing a compelling case for change - Combining our cutting-edge analytical capabilities with skilled narrative crafting
  • Innovative care model design - Drawing on our international evidence library and supporting engagement with clinicians to develop world-leading clinical models
  • Impact modelling - Building models across finance, activity, workforce, estates and travel times
  • Business case development - Providing guidance through the development and assessment of options, enablers planning and development of public-facing materials
  • Navigation through assurance processes - Garnering support and momentum for change with key stakeholders and assisting with public consultation
  • Expert system leadership support - Provided by individuals with first-hand experience of leading change that has saved hundreds of lives
  • Programme planning - Planning that covers governance design and resourcing plans

Speak to one of our specialists for advice


CF is a refreshingly different form of consultancy, using a range of very skilled professionals who have worked within and across real services. They are responsive to feedback, deliver to tight timescales and provide great quality, ensuring an overall outstanding experience. Most importantly, there is compassion and a real understanding of why services need to change and improve. The philosophy is about facilitation, evidence, challenge and most of all support and appreciation of the staff delivering the change and respect and inclusion of the public voice. The attention to detail and expertise has been pivotal, alongside the very real passion to land the best services for the Kent and Medway community.

Patricia Davies
Director of Acute Strategy, Kent and Medway STP

Reviewing alternative models for urgent and emergency care in small hospitals

CF was asked to undertake an independent review of the temporary changes made to a small, rural hospital’s urgent and emergency care services, to determine whether alternative options should be explored.

The hospital’s Board had taken the decision to temporarily close the accident and emergency (A&E) department. The hospital had the smallest A&E department in England, serving a rural population of around 144,000 people and faced increasing workforce challenges, notably clinical vacancies. The temporary closure was undertaken on the basis that the hospital was no longer able to staff the A&E service safely.

To assess the appropriateness of this decision and test the benefits of the alternative model of care that had been put in place, we reviewed:

  • the wider regional, national and international context for urgent and emergency care services
  • the case for change
  • whether the new model addressed the issues highlighted in the case for change
  • the robustness of assumptions made
  • whether risks had been adequately assessed

We researched learnings from other hospitals that had faced similar challenges, establishing opportunities to enhance or maximise the new care model based on best practice elsewhere.

Our review concluded that the hospital had articulated a clear case for change and made reasonable attempts to resolve staffing issues to meet the required standards, ensure patient safety and avoid unplanned emergency closure. We also found that the model of care also delivered safer care in the context of the current workforce challenges.

In addition, we determined that the assumptions underpinning the model of care were robust, although we made several recommendations to enhance the successful implementation of the new model.

Our work also drew attention to a set of recommendations to shape policy at a national level to support sustainable urgent and emergency care in small and rural hospitals.

The local MP who commissioned the review recognised our report as comprehensive, compelling and clear, while the deputy CEO of the hospital commended our thorough research and clear and appropriate recommendations.

Our report can be found here