Holmgate
Consulting
Complex systems. Sustained improvement.

Health & Public Sector Advisory

When performance
cannot wait.

Holmgate Consulting supports NHS trusts, independent providers, and social care organisations to navigate regulatory pressure, lead complex transformation, and build the capability to sustain improvement.

Get in touch Our services
3
CQC enforcement engagements led to exit from regulatory intervention
2,500+
NHS leaders reached through national improvement programmes
143
NHS organisations engaged at national scale
20+
Years spanning clinical practice to national advisory roles

About Holmgate

Built inside the system.
Operating independently.

Holmgate Consulting was established by Simon Bristow following more than seven years as a Senior Consultant Adviser with NHS England's GIRFT Mental Health team and Mental Health Intensive Support Team (MHIST), and over two decades working inside the NHS across clinical, operational, and national advisory roles.

The practice focuses on the problems that matter most — organisations under regulatory scrutiny, leadership teams navigating complex transformation, and systems where standard improvement approaches have not delivered the change required.

We combine clinical credibility, analytical rigour, and hands-on delivery at board level and with frontline teams. Every engagement is designed to build internal capability alongside delivering immediate results — because improvement that disappears when the adviser leaves is not improvement.

Simon Bristow
RMN  ·  MSc  ·  CMI Level 7  ·  PRINCE2

Registered Mental Health Nurse. MSc Mental Health Services and Population Research, King's College London. CMI Level 7 Leadership Coaching. PRINCE2 Practitioner.

Regulatory intervention expertise
Three major ~18-month engagements with providers under CQC enforcement action — all resulting in exit from intervention. Multi-workstream, board to frontline.
National programme leadership
Designed and delivered a national Lean-based improvement programme reaching 84% of all NHS mental health providers, and a COVID demand modelling programme reaching 900+ participants.
Clinical foundation
RMN and former Head of Nursing — clinical credibility and operational authority that most improvement consultants do not carry.
Analytical depth
Power BI, STATA, and epidemiological modelling — quantitative rigour alongside qualitative advisory, grounded in a published research background.

Core services

Complex problems.
Clear capabilities.

Holmgate Consulting operates across six service areas, each grounded in direct experience.

01
Performance diagnostics
Rapid, structured assessment of operational and governance failures — producing clear findings and a prioritised improvement plan for board and executive audiences.
02
Regulatory response & recovery
Leading improvement delivery in organisations under CQC enforcement action — multi-workstream, multi-discipline, with a sustained track record of enabling exit from intervention.
03
Transformation leadership
Embedded or advisory leadership of complex, multi-workstream programmes — access and flow, clinical capacity, patient safety systems, and pathway redesign.
04
Quality governance & safety
Review and redesign of governance structures, reporting frameworks, and oversight systems — ensuring boards have the right information to meet regulatory expectations.
05
Leadership capability building
Bespoke improvement leadership programmes — from trust-level interventions to national-scale programmes. Grounded in Lean principles, CMI Level 7 coaching methodology, and real-world delivery experience.
06
Associate & embedded consulting
Senior NHS advisory capacity for consulting firms on a flexible associate basis — health and social care transformation, CQC regulatory response, and complex performance diagnostics.

Engagement model

Three ways to
work together.

Engagements are structured to match the nature and urgency of the challenge. All three models are available to NHS, independent sector, and social care clients.

Embedded advisory
Intensive, on-site advisory support working directly alongside your leadership team — diagnosing, planning, and leading improvement delivery over a defined period. Best suited to organisations under regulatory pressure or in active transformation.
Programme oversight
Senior leadership of a defined improvement programme — strategic direction, workstream coordination, and board-level reporting across a multi-month engagement. Suited to complex, multi-discipline transformation programmes.
Diagnostic review
A focused, time-limited assessment of a specific performance challenge — producing clear findings, prioritised recommendations, and an actionable improvement plan. Delivered at pace, with board-level rigour.

Get in touch

Let's have
a conversation.

If you are navigating something complex — or know someone who is — get in touch directly.

Location
London, UK

Holmgate Consulting is available for direct client engagements and as a senior associate to consulting firms. A capabilities document is available on request.

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