Comment / A fine balance

Surely everyone in the country is now aware of the severe financial challenges facing the NHS. Even so the sheer scale of the year-to-date provider deficit revealed by the Q1 figures sent the media into a frenzy. Providers’ plans had always indicated a sizeable deficit by this point, but actual performance was even more severe with the £930m provider deficit already more than the figure for the whole of last year.

We’ll soon publish our NHS financial temperature check survey, which provides the most in-depth assessment of how finance directors view this year’s performance, opportunities and risks. It is certainly the most difficult financial situation the NHS has faced in the 15 years I have been doing this job.

Most people would sign up to an overall ambition to see the UK’s deficit coming down. We simply can’t keep taking out IOUs for our children to repay. Different political parties have their own ideas about how to realise this – ranging from austerity measures to invest-to- grow policies. But whatever approach is taken, we need to ensure the impact on the NHS is fully understood. The danger is that the service could become even more of a political football than it normally is, with political parties blaming each other and government blaming local services for pressures being felt across the globe.

Striking the right balance between funding to meet these pressures and central pressure to improve productivity will be absolutely key.

There seem to be increasing doubts that the promised extra £8bn will be sufficient to cover future requirements on the back of fairly heroic efficiency assumptions – especially as central demands for service improvements continue apace. See seven-day services as an example.

What we need more than ever is realism about funding and pace of change. This month’s spending review needs to set the tone in both areas. Improvements can be made – the vanguards are really important in helping the service test and learn about new models – but they can’t be made overnight.

Failure to tackle these issues head on will inevitably lead to speculation about other solutions – such as rationing and co-payments. But surely with a health service that is envied across the world, such options need to remain off the table or at the margins of our activities.

Turning to HFMA matters, we have launched a new jobs board, which we hope will feature all the finance jobs in the NHS. It is a paid service, but you’ll pay a relatively modest fee for exposure to our market, the most focused place for finance roles in the NHS. I urge you to go to the HFMA website (www.hfma.org.uk) to take a look.

We are also approaching the end game for our annual conference bookings – by the time you read this it will be just over a month to the opening presentations. We will be making some announcements soon about our programme, so look out for those as well as other information.

That also means we will be at the end of our year of ‘Stronger together,’ Sue Lorimer’s theme for the year. However, the theme remains just as relevant into 2016 and beyond.

As a function and as a national health service, there can be no doubt that we are stronger when we work with a shared purpose, join our talents together and learn from each other.