Comment / Better budgeting means better care

Clinicians have a responsibility to ensure the best use of limited resources, but finance managers cannot simply leave them to sink or swim, says Carol Black 

Thoughtful clinicians have always known that there is a direct relationship between good financial management in the NHS and their ability to deliver improved patient care. Thanks in large part to the excellent work of Andy McKeon and his team at the Audit Commission, that message is now reaching a wider audience.

It is just over a year since the Audit Commission published A prescription for partnership: engaging clinicians in financial management. Using examples drawn from a cross-section of medical specialties, health communities and hospital departments, the report outlined some of the startling improvements to care achieved when clinicians and finance managers put an end to the ‘them and us’ culture too often found in our hospitals. It showed too that when doctors, nurses and finance managers do work together – viewing budgets as a facility rather than an obstacle – better patient care will naturally follow.

That is why I was delighted when the Academy of Medical Royal Colleges along with the Royal College of Nursing, the Healthcare Financial Management Association and the Department of Health, were invited by the Audit Commission to produce a joint statement that set out the benefits of getting clinicians involved in the business side of the NHS.

As the statement makes clear, no one is asking clinicians to become instant accountants, but I believe we all have a duty to at least understand not just a basic budget but also why that budget matters and what it means for the way we can care for our patients.

As the men and women responsible for the way services are delivered, surely we should understand too our responsibility to use those resources as effectively as possible, mindful of the implications for the organisation as a whole. We all have to manage our household and personal budgets, why then should we neglect that responsibility when we arrive at work? Coming to grips with the financial consequences of decisions we make as clinicians is about taking responsibility to ensure the best and fairest use of the necessarily limited resources available to us. 

I was also pleased that the statement recognised that finance managers and staff have an essential role to play here too. The joint statement says clinicians have a right to expect prompt, reliable information presented in a way that they understand, which is useful to them and well-supported by IT, and for their involvement to be wider than simply handing out a budget. The recognition that we cannot simply be left to sink or swim when it comes to managing the money will, I believe, be a crucial factor in the success of this initiative.

Finances are always under scrutiny but as the full effects of the economic downturn begin to filter through to the wards and the operating theatres, it could be argued that there has never been a better time or greater need to begin this process of getting doctors and nurses engaged in the numbers. We will undoubtedly need to stretch resources further as demands upon us increase and we can only do that if clinicians and finance professionals take collective responsibility for spending wisely and well.