Discuss the decision

Anna Cox | Founder and Director

I’m Anna Cox, founder of
Questant Insight Partners.

I have spent more than 15 years working across healthcare consulting, NHS transformation and strategic commissioning.

For the last decade I worked across Hampshire and the Isle of Wight’s health and care system, leading and advising on commissioning, intermediate care, hospital discharge, community services, demand and capacity, Better Care Fund planning and major investment decisions.

Much of that work happened where the answer was not obvious. NHS, local authority and provider partners could be looking at the same pressure from very different positions. Finance, operational performance, clinical evidence and patient need did not always point neatly in the same direction.

My role was often to establish what the evidence was actually telling us, make the trade-offs visible and help senior leaders decide what to do next.

Questant Insight Partners grew from that experience.

I had seen well-designed programmes deliver what they were asked to deliver without always changing the pressure they had been funded to solve. More beds could open. Services could expand. New pathways could launch. The activity was real, but the expected system impact did not always follow.

That taught me to look earlier in the decision. Before asking how to deliver the proposed solution, I want to know whether the explanation behind it holds up and whether the intervention is aimed at something the system can actually change.

I founded Questant Insight Partners to bring that judgement, analysis and independent challenge to organisations before another expensive commitment is made.

Experience

Experience across the decisions
that shape care.

My work has moved through healthcare consulting, provider transformation and strategic commissioning. The common thread has been working where strategy, evidence and operational reality have to meet.

2016–2026

Strategic commissioning and system transformation

NHS Hampshire & Isle of Wight

Experience details

Ten years working across complex NHS and local authority commissioning, including intermediate care, discharge, community services, Better Care Fund, demand and capacity, pathway redesign and investment decisions.

I advised executive leaders, developed business cases and options appraisals, designed demand and capacity models and worked across NHS, local authority and provider boundaries where priorities, statutory responsibilities and financial pressures did not always align.

2013–2015

NHS provider transformation

Southern Health NHS Foundation Trust

Experience details

Technology-enabled transformation, service development and implementation across a large multi-site community provider.

The work included workflow redesign, digital transformation, commercial development, mobilisation and aligning clinical, operational and technical teams around changes that could actually be delivered.

2010–2013

Healthcare consulting

GenesisCare Australia

Experience details

Operational and commercial consulting across a multi-site private healthcare network, including business cases, service review, process improvement and cost optimisation.

This is where I developed an early understanding of how operational choices, commercial pressures and investment decisions interact in healthcare.

What connects all three?

Working at the point where strategy has to survive contact with operational reality.

BScEcon Business & Management with Law | Lean Practitioner | PRINCE2 Practitioner | ITIL Foundation

EVIDENCE FROM THE WORK

Four times the evidence
changed the question.

40%

Missing demand.

Reported demand was incomplete. Reconciliation identified that approximately 40% of relevant discharge activity was absent from the reported position and materially changed the investment discussion.

Six-figure proposal

Temporary relief.
Not sustainable flow.

Modelling showed that additional beds would provide short-term operational relief but would not sustain improved access while turnover and onward-flow constraints remained. Subsequent performance reflected the forecast.

11 organisations

One system-wide model.

Demand, capacity and flow modelling across eleven health and care organisations helped leaders distinguish genuine capacity shortfall from productivity, pathway and operating-model constraints.

Competing investments

Scarce resources.
Clearer choices.

Marginal benefit, delivery risk and opportunity cost were used to compare investment options and make the trade-offs between them more defensible.

The evidence changed the questions I ask.
WHAT EXPERIENCE CHANGED

Four things
I had to
unlearn.

The useful lessons came when reasonable answers did not produce the expected result.

I stopped trusting averages.

Average demand rarely exists. Variation, pathway mix, geography and dependency usually explain more than averages ever can.

I stopped treating activity as proof.

Paying for more activity can produce exactly that: more activity. The real test is whether it improves outcomes, flow or value, rather than simply increasing the cost of the existing system.

I stopped assuming capacity was usable.

Commissioned capacity and usable capacity are rarely the same thing. How that capacity is distributed and used can produce a very different result from the one the plan assumed.

See it for yourself
I became interested in assumptions.

Every proposal tells you what is expected to happen. I want to know what has to be true for that result to happen, and whether that uncertainty was clear when the decision was made.

Comfortable where the answer is contested.

I am comfortable working where views differ and the evidence is contested. I do not arrive assuming one organisation has misunderstood the problem and another has the answer.

Usually, each part of the system can see something the others cannot.

My job is to understand those different positions, test them against the evidence and help establish which routes stand up operationally, financially and clinically.

That sometimes means asking uncomfortable questions.

It also means being willing to find that the original proposal was right.

Independent challenge is only useful if people can do something with it.

In other people's words

What colleagues and partners
say about working with me.

Analytical judgment
“Over the years, as service requirements and performance evolved and fluctuated, Anna used data to cut through often emotive arguments about what was and was not needed to support the community and deliver flow.”
Hospital Service Manager
1 / 7
Next

The experience matters.
So does how it is applied.

Questant brings together commissioning judgement, operational evidence and analytical modelling to test what is really driving a decision before further resources are committed.

See how I work Discuss the decision
No finished brief required. Start with the decision, pressure or proposal that does not quite add up.