Comment / Going further and faster on health inequalities

When people talk about addressing health inequalities, they often identify finance as a barrier. They can see it as making it hard for them to start new initiatives, or to sustain and scale up projects that are working well. Delving into the detail, they usually mean that they would like there to be more funding available, or that they would like for funding to be given on a more certain and multi-year basis.  

It is rarely within the finance team’s gift to find such funding, particularly in times of financial constraint, no matter how committed they might be to the cause. There are, however, things that finance staff can do to help oil the wheels. Specifically, this is about:

• moving the money
• understanding the data
• showing it’s the right thing to do.

By ‘moving the money’, I mean allocating resources to the services that are best-placed to help address health inequalities. By ‘understanding the data’, I mean using financial and non-financial data to understand health inequalities and population health. And by ‘showing it’s the right thing to do’, I mean demonstrating the return on investment of specific interventions and including health inequalities in business cases.

The HFMA health inequalities finance fellows (HIFFs) are a group of NHS finance staff who recognise their power to influence in these ways. There are 47 HIFFs who work in mid-to-senior level management positions and come together to share ideas and spread best practice in tackling healthcare inequalities. There is a good representation from across England, with most integrated care systems and all NHS regions having at least one HIFF.

The HIFF programme was launched in November 2023, supported by colleagues in NHS England’s health inequalities team, who were also hearing that finance was a barrier. As part of this year-long programme, HIFFs attend monthly network events with external speakers, have access to training and resources from NHS England and the HFMA, and are supported to produce case studies on the work of their finance teams.  

HIFFs have been involved in some fascinating and impactful pieces of work on health inequalities. Nicci Briggs (now director of finance at Cambridgeshire and Peterborough Integrated Care Board) for instance was instrumental in developing a new primary care funding model to address health inequalities in Leicester, Leicestershire and Rutland. Jonathan Allsopp (costing and service line reporting accountant at Northern Care Alliance NHS Foundation Trust) is part of a costing team that combined patient-level costing data with the indices of multiple deprivation to better understand high intensity use of accident and emergency departments. And Emily Kirkpatrick (deputy director of finance at Alder Hey Children’s Hospital) used a cost-benefit analysis to compare the success of different interventions used by the Children’s Hospital Alliance to reduce the number of children not brought to their appointments.  

Every time we meet, I catch snippets on newer work that the HIFFs are doing on health inequalities. I look forward to learning more as the work progresses, and finding out the full detail as we reach the case study part of the programme. Here, the HIFFs will write about the projects they’ve been involved with so that they can share ideas and best practice with the wider NHS finance community. The HFMA plans to publish a selection of the case studies in autumn 2024.

Each of the HIFFs is at a different stage in their journey. Some are learning more about health inequalities as an area of personal interest, taking those first steps and recognising how to bring it into their day-to-day role. Others are taking stock of pre-existing projects, celebrating success and promoting what works. My hope is that the HIFF programme will embolden finance staff to go further and faster in their work to tackle health inequalities.

Supported by NHS England, the HFMA has produced a range of resources to help finance staff tackle health inequalities. This includes online bitesize courses, briefings and case studies, all of which are freely available to NHS staff. It is also running a health inequalities conference in Birmingham on 6 November 2024. Visit the HFMA health inequalities page to find out more.  

Healthcare Finance spoke to two of the HIFFs for a feature in the March 2024 issue of the magazine