Comment / Finance voice needed in NHS funding debate

It is no secret that the NHS has been coping with unprecedented operational and financial challenges. Missed access targets and significant deficits have never been far from the headlines. And rising demand, staffing pressures and patient flow are common themes for all health systems.

NHS bodies have done their best to minimise the impact on services, but the higher levels of demand and bed occupancy have taken their toll on performance against access targets as well as budgets. There have been other important consequences as well, including impacts on the ability to plan for the future and the whole transformation agenda.

How many decisions are being taken to meet a short-term budget control, when a different approach would deliver a greater long-term benefit? And how many transformation programmes are treading water, deprived of the staff time or financial support to make faster progress?

Transformation – working as systems to develop new models of care that will better meet the needs of a growing and ageing population in a more proactive way – remains the key to delivering sustainable services.

The prime minister has promised a long-term funding plan for the NHS and we expect to hear more details around the 70^th birthday celebrations for the NHS in July. While everyone connected with the service will have breathed a huge sigh of relief at this news, we remain in the dark about the details.

Inevitably, it will not address all the service’s problems overnight. The challenge of delivering sustainable services will continue to be significant – but hopefully it will be much closer to achievable than with the current set of numbers.

As we move towards this vital moment for the NHS, the finance voice must be heard in the mix. This surely is the opportunity to put the NHS on the right track and make the transformation agenda a realistic goal. And who is better placed than finance professionals to understand the current financial gap and what is needed to bridge it?

That’s why the HFMA’s NHS financial temperature check remains so important (see previous report here). Not only does it provide an in-depth analysis of the separately published financial figures from NHS England and NHS Improvement. But it also drills down into the challenges and issues that the headline figures don’t reveal.

We know that time is tight – and the HFMA has listened to members in making the Temperature check­ a much tighter, more focused exercise, with a shorter survey sticking to the key questions and topical issues. For example, the latest survey, which has just been issued, again tests finance directors’ levels of confidence. But it also drills down into how organisations are making progress with efficiency initiatives such as Getting it right first time, the Model Hospital and NHS RightCare.

These initiatives should help to provide the focus and some of the tools for organisations to deliver better value, but we are keen to understand how they are playing out at the local level.

The Temperature check continues to form the basis for HFMA discussions with finance leaders at NHS Improvement, NHS England and the Department of Health. And the more of you we hear from, the more informed those discussions can be.