Comment / Leading question

Speaking at the HFMA annual conference last December, Department of Health director general of NHS?finance, performance and operations, David Flory made it clear he was concerned about the sometimes small numbers of people coming forward for the most senior finance jobs in the NHS.

And he is not the only one with an interest as an HFMA survey showed during May. A massive 450 finance professionals – including more than 160 finance directors and deputies – took the opportunity to make their views known. It was not just the reponse to the multiple choice questions that impressed me, but the time taken to comment and suggest improvements.

A significant issue is clearly work/life balance (see pages 8-9 for full analysis). But I want to explore some of the other points you raised: the perceived risk involved with director jobs; levels of pay; and an alleged lack of fairness in the recruitment system.

It was clear that many people had changed jobs in the recent past. And the negative impact of reorganisations was a recurrent observation. While reducing the organisation numbers was bound to create unrest among managers directly affected, perhaps what was not factored in was how the changes would impact on the perception of risk in taking a director level position.

Directors’ remuneration was often tied to the risk issue. One interesting comment suggested that exit strategies, akin to those of football managers, should be agreed in advance. Who would be Chelsea’s manager without such a package?

A particular concern for me was the feeling that the recruitment process was unfair. There were suggestions that it relied too heavily on head-hunters and cronyism and that appointments often appeared to have been decided prior to interview.

These comments may be negative, but they are important if we are to understand and effectively improve the situation. There were also some helpful and positive suggestions for improvement. Development programmes with support packages, increasing competition for top jobs by opening them up more readily to the private sector, better retention of those trained and qualified in the NHS and more exposure to operating at the top level – all excellent proposals.

But what also came through at times, regrettably, was a lack of ambition. Many people currently below director level simply do not aspire to the top finance jobs.

One of the more difficult parts of any director’s job is managing risk. To manage risk, you have to be prepared to take risks, albeit they have to be evaluated, managed and mitigated. You have to be prepared to stand by your decisions and judgements.

So maybe what we need is a different approach to how senior finance staff are exposed to risk and responsibility while they are developing during their careers. The gap between senior finance staff and the director in terms of responsibility, risks and rewards would then seem capable of being bridged.

Having been at finance director level for nearly 18 years, I have experienced the risks and rewards, the reorganisations, the good and bad years. I still believe that I can make a difference. If you believe that you can make a difference then perhaps it is time to step up. The view is much better than I suspect many of you imagine.