01 September 2000
While in opposition, Labour waged a vendetta against the health service's men in grey suits. So it is perhaps not surprising to find that the one clear message today is that in the future the NHS will need fewer finance staff.
However, employees need not hit the panic button and start planning for a change of career. Although the NHS Executive has now spelled out what a lot of people have known for a long time – that technology and modern business practices will fundamentally change the way the NHS does its financial business – this is not the bean- counter bashing of old.
With demand for finance staff currently outstripping supply, the last thing the NHS needs is an exodus of personnel.
In fact, in a remarkably proactive move, the NHS Executive is trying to stay a step ahead of the game and identify the skills that will make finance staff relevant to the NHS of tomorrow.
The NHS Executive's vision is spelled out in a consultation paper* that is due to land on finance directors' desks on September 1.
Its immediate purpose is to raise awareness about the likely changes ahead and the new skills that will be needed. The results of the consultation will feed into a revision of the finance staff development strategy at the end of the year.
The Executive is deliberately involving the finance function in shaping its own future – every staff member will receive an individual copy of the consultation paper. But the key decision, about whether to change or not, is non-negotiable.
Asked what happens if accountants don't change, James Birrell, director of finance and performance management of the NHS Executive's North West regional office, says: 'That is not an option. It will be a case of withering on the vine. The world is moving on and the impact will hit the NHS just as it hits the rest of the world.'
There are a number of influences making change inevitable. According to the vision document, written by the Executive's finance staff strategy group chaired by Birrell, these come from changes in business management practices, IT developments including the explosion of Internet-based technologies, and modernisation of the public sector in general and of the NHS in particular.
Perhaps the biggest change to affect NHS support functions is the shared services initiative. With payroll the first target, the Executive has been considering setting up a small number of centres providing basic financial services to large numbers of NHS bodies.
But even without shared services, technology will reduce paper flows. Orders, invoices, timesheets and expenses will be generated electronically by suppliers, customers and non-finance staff, removing the need for finance staff to process details of financial transactions.
The discussion paper predicts 'an overall reduction in the numbers of finance staff', but it is from these transaction-based areas that the most casualties are expected to come, rather than the roughly 4,000 qualified accountants and accounting students. But all finance staff will have to learn new skills.
In future, more responsibility will be devolved to clinicians and departmental managers. 'Finance information will be more available to non-finance people,' says Birrell.
The document says that a leaner, more professional finance workforce should emerge, with staff able to expand their roles and move away from routine tasks to concentrate on more 'added value' work.
In particular, performance management looks as if it will be the big growth area in the future. The NHS Plan is effectively directed at measuring everything that moves and finance staff are ideally placed to become involved in this area.
They are also expected to take on more generalised business roles, perhaps taking on responsibility for procurement, IT and certain personnel activities within a particular section.
Barry Elliott, chairman of the Healthcare Financial Management Association, has urged the NHS finance profession to embrace the changes.
'There will undoubtedly be some fundamental changes to the roles of finance professionals and we need to ensure that there are appropriate training and development programmes in place to enable staff to adapt,' he says.
'But we also have to recognise that while any period of change brings opportunities, it also brings casualties. And some people will be unable or unwilling to adapt. We need to ensure there is proper support in place.'
But the Executive is not dwelling on casualties. According to Birrell, the changes are an opportunity, not a threat, and offer finance staff a chance to widen their skills and experience. But he warns that it will be down to individuals to grasp the opportunity.
*Preparing finance staff for the modernised NHS
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