The pressure of reorganisation and the challenge of finding £30bn in savings have prompted an initiative to preserve the unity of NHS finance professionals
When the first NHS trusts were introduced in the early 1990s many commentators argued that the resultant purchaser/provider split would encourage the health service in general, and its finance profession in particular, to split along tribal lines, with the trusts in one camp and health authorities in the other.
In the 20 years since Kenneth Clarke piloted the move towards semi-autonomous providers, NHS finance professionals have worked hard to stay united across organisational boundaries. The strong personal and professional relationships between senior finance colleagues have frequently been the key factor in resolving tricky contractual wrangles in local health economies.
When the coalition government’s Health and Social Care Act came into force last April and hundreds of primary care trusts and strategic health authorities were swept away to be replaced by clinical commissioning groups, commissioning support units, NHS England, Health Education England and numerous other bodies, the prospect of the finance function’s hard-won unity being lost became very real.
Added to the pressure created by the reorganisation is the need for the NHS to meet the Nicholson challenge and find £30bn of savings by 2015. One of the very real dangers of the efficiency drive is that organisations will balance their books by passing costs on to other parts of the NHS, thus driving finance colleagues apart.
In the light of the above pressures, the six national heads of the NHS finance profession came together late last year to initiate a programme known as Future-Focused Finance.
The detail of the programme is still being developed, with people from across the NHS encouraged to give feedback on whether the strategic themes and associated action areas identified so far resonate with them. Those themes and action areas cover a wide range of issues, from ‘Securing Excellence’ in financial processes, through ‘Knowing the Business’ – ensuring that finance staff understand the NHS and have the skills to deliver its requirements – to ‘Fulfilling our Potential’ by ensuring that every employee has the opportunity to be the best that they can be.
There are two elements to Future-Focused Finance that ensure it will be different to previous initiatives. At its heart is a desire to ensure that every member of the NHS finance function, and as many non-finance colleagues as are interested, can contribute to the programme’s success.
Ten workshops took place in March, attended by a range of finance staff, from new recruits to finance directors. By the time it is formally launched, close to 1,000 people will have been involved in the programme’s design.
Second, the need for finance to engage with colleagues from across the NHS is integral to Future-Focused Finance. This latter point is exemplified by one of the action areas being led by Dr Sanjay Agrawal, a consultant in respiratory and intensive care medicine at University Hospitals of Leicester NHS Trust.
It is obvious that finance in the NHS can only be truly successful if it is fully engaged with colleagues throughout the service. From the work completed to date it is equally obvious that clinicians and managerial professionals want finance to be fully integrated into service delivery, not sitting in remote offices commenting from afar.
If Future-Focused Finance is as successful over the next five years as it has been in the last five months, the programme will deliver the transformation in finance services that is required to help create a health service of which everyone will continue to be proud.
David Ellcock is the programme manager for Future-Focused Finance. He can be contacted on [email protected]
This opinion piece was first published in the April edition of Public Finance magazine
