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Ken MacNeill

A CIPFA-qualified accountant with over 40 years’ experience in public sector finance, Ken specialises in financial strategy, operational efficiency, bid management and service transformation for NHS bodies, local authorities and commercial providers delivering public sector contracts.

Ken MacNeill is a founding director of At Scale Limited, bringing extensive experience working with public and private sector providers bidding for and delivering public sector contracts. He understands the financial and commercial imperatives providers face whilst navigating NHS and local government commissioning requirements. His career began in local government finance before moving into consultancy with both Big 4 and medium-sized firms.

Ken’s approach combines technical financial expertise with practical operational understanding. He works alongside clients to implement sustainable financial management systems rather than simply providing recommendations. His work includes supporting external providers navigate NHS procurement processes, develop partnerships between NHS commissioners and providers, establish financial governance frameworks for public sector contract delivery, and manage the financial implications of operational challenges when delivering services under NHS contracts.

Ken’s expertise centres on:

  • Strategic Leadership: Financial strategy development for NHS Trusts, Primary Care Networks and local authorities, building financially sustainable operating models
  • Efficiency and Transformation: Operational reviews delivering measurable improvements in efficiency and service quality, including financial management reviews and process improvements
  • Workforce and Skills: International training on public financial management, accounting standards, corporate governance and public private partnerships
  • Commercial and Negotiations: Business case development, investment appraisal, bid management and contract evaluation for NHS and local government contracts

Key achievements include:

  • Developed robust financial strategies for NHS Trusts, PCN Clinical Directors and federation management teams, building financially sustainable operating models ensuring regulatory compliance
  • Prepared business cases for major capital projects including primary care building extensions and urgent care service expansions, with detailed investment appraisals and scenario modelling
  • Supported GP federation in developing business case securing funding for new clinical hub, navigating complex approval processes and demonstrating value for money
  • Conducted financial management reviews and efficiency programmes delivering measurable improvements across diverse NHS and local government organisations
  • Developed strategies for Primary Care Networks across North and East London, supporting financial planning, business case development and service expansion
  • Worked with social enterprise providers of clinical services to improve governance, secure new contracts and develop robust financial models for activity, resources and costs
  • Delivered customised training programmes to government delegates in Botswana, Lithuania, Jamaica and Kenya on public financial management, international accounting standards and governance

What distinguishes Ken’s work with private sector clients is his ability to translate between commercial financial imperatives and public sector financial expectations. He understands commercial requirements around margin, cash flow, risk and return on investment whilst also understanding public sector expectations around transparency, value for money, financial governance and regulatory compliance.

Ken holds a B.Com in Business Studies and Accounting from the University of Edinburgh and is a CIPFA Member. He sits on CIPFA’s Assessment Approval Panel and works throughout the UK and internationally, remaining passionate about supporting effective public services through sound financial management.

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