Comment / On the case

It’s been a hectic few weeks with the white paper Equity and excellence being considered right across the association’s committee infrastructure. You may recall I wrote to members in August to let them know what we are doing at this time. Part of that has been the response which, as we go to press, is nearly complete.

The overwhelming feeling from the committees is that while we are all for engaging clinicians, this document is the greenest white paper in history. It is full of laudable ambition, but short on the detail that will need to be addressed if the new structures and systems are to be successful. Notwithstanding the fact that it is not even clear whether enough GPs want to come out and play the great and complex art of commissioning, we don’t even know the precise nature of consortia and their ‘organisational style’.

The HFMA stands ready to support the transition process and help fill in the detail within the broad outline that has been sketched. Most of our focus has been on the crucial areas of governance, financial control and accounting. On each of these fronts we have concerns – not insurmountable, but which will need to be addressed.

We have a particular concern over the potential to lose much needed talent from the NHS finance function. Finance is a core responsibility and NHS finance costs already compare favourably with other parts of the public and private sectors. Our joint statement with the Academy of Medical Royal Colleges and the NHS Confederation (published at the end of September) called for an end to the simplistic division of frontline and back office. We all serve the same purpose – delivering high-quality, patient-centred care within available resources – and sometimes the vital contribution by managerial and administrative staff is undervalued.

We risk a brain drain at a time when finance skills – in closing down organisations, setting up new statutory bodies and continuing the productivity push – will be desperately needed.

We are grateful to all our members who have helped Anna Green, our technical editor, draft the association’s response. We strongly believe the HFMA has a major role to play in raising awareness of issues around finance, governance and accountability in the primary care community.

This is not new territory; some GPs have already undertaken our e-learning modules. But we recognise that the association is not widely known within the GP community.

I have met primary care leaders and representative bodies and we have produced a briefing, Finance and accountability for GP consortia, aimed at GPs and their practice managers. This provides a sketch of funding flows within the NHS and looks at how accountability is built in at every step. And with our popular guides to NHS finance and governance and our suite of e-learning, we stand ready to help.

Finally we are planning the first events of our support programme for finance managers, spearheaded by Suzanne Tracey, who becomes our president in December. Two half-day personal development workshops in November will give members the tools to control their situation.

So, we remain on the case. And if you feel there are areas we should move into, drop me a line.