News / News analysis: Top attractions?

Where are tomorrow’s finance leaders going to come from? How can the NHS ensure it gets the right people into its senior finance roles? These are questions that have been exercising the Department of Health. And a major survey by the HFMA suggests the Department has every right to be concerned.

Speaking to the HFMA annual conference in December, Department of Health director general of NHS finance, performance and operations, David Flory spelt out the problem. He said a recent attempt to recruit a finance director to a high profile finance director job had produced a shortlist of one and he said he understood that similar problems were being experienced locally. Instead he said he wanted to get to a position where job adverts were attracting a full shortlist of strong appplications. ‘Then the employing body would [be] confident there were a number of appoint-able candidates and could pick the person with the right fit for the organisation,’ he said.

He suggested this was a ‘much different’ scenario to current experience and that without a change, the NHS ‘won’t achieve its objective of having the best people in those most challenging jobs’. He added he was keen to involve the profession in a dialogue about how to address this issue.

Last month the HFMA began this dialogue when it surveyed finance directors and their teams about recruitment to senior posts. Some 450 finance managers responded, including around 20% of the CCAB qualified NHS workforce. Their views, including those of 160 finance directors and deputies, provide an insight into why shortlists for senior roles may be getting too short.

Work/life balance concerns
For some, promotion is seen as requiring too great a sacrifice in terms of work/life balance. However managers also identified an urgent need for greater development of finance managers throughout their careers to prepare them for the most senior roles.

Some 60% of finance managers (excluding those already at director level) have no aspiration to become finance directors. And four out of 10 deputies – the most obvious candidates for future director roles – also declare themselves uninterested in the ultimate step up.

A lot of deputies simply said they preferred the hands-on nature of being second in command or that they were put off by the politics involved at director level. However many cited concerns over the impact on their work/life balance. For instance one deputy commented: ‘The additional rewards of being a finance director do not justify the additional risks/stress of the role. This partly reflects unreasonable expectations upon directors to deliver regardless of the context in which they operate and the wider organisational capacity and competence. The work/life balance of the finance director is not appealing as it currently stands.’

Another said simply: ‘I am not sure that the rewards available warrant the impact on work/life balance or the degree of pressure involved.’ Others pointed to a lack of support and training at deputy level to prepare for the next stage.

Work/life balance emerged as a major theme for the survey. Some 60% of finance managers said they would like to improve work/life balance in their current job. Among deputies the numbers prioritising an improvement in work/life balance rose to 70%; among directors this rose again to 73%.

Job satisfaction
Work/life balance is not finance managers’ biggest priority in looking for a new job. More finance managers (33%) chose professional satisfaction as their number one priority when looking for a new move. Smaller numbers selected being in commutable range (19%), work/life balance (18%), family considerations (17%) and pay (13%).

But reduced work/life balance was a clear deal breaker for many. Two-thirds of all finance managers said longer working hours and reduced work/life balance might prevent them taking a higher profile role. With finance managers already working long hours (see box), many are not prepared to commit to a role that will involve more time at the office.

Some 60% of finance managers also highlighted a perceived increase in stress as a potential deterrent. More than 40% also said pay was often not enough for the additional responsibilities. And pay was a bigger issue for existing finance directors, with nearly half indicating that insufficient financial rewards for new roles could keep them in their current posts.

A rounded understanding of the whole health service was seen as good preparation for senior roles. However pay differentials between different parts of the NHS were highlighted as a problem in encouraging movement between organisations.  There was a clear feeling among many respondents that trusts and foundation trusts pay better and that the very senior managers’ pay framework needs to be revised so that PCT finance directors’ pay is on a par with their provider colleagues.

Pay was not the only obstacle to better movement across the purchaser-provider divide – 70% of finance managers identified the lack of sector specific skills as a barrier. ‘Trusts seem to think that they must have finance directors with acute experience,’ said one. ‘What they really need are director and business skills and these are transferable.’

Others highlighted personal experience of not making shortlists because of lack of practical experience in the sector. Some highlighted an even greater reluctance to recruit from the private sector, particularly at very senior level.

Managers also raised concerns about interviewing candidates when someone was already earmarked for the job. Some 40% said that the perception this was the case would put them off applying for a higher profile role. One manager complained that placing adverts in the interests of appearing ‘equitable’ when the job was effectively filled was a waste of applicants’ time. ‘I know of people who have been deterred from pursuing a career in the NHS because they’ve wasted too much time on interviews for jobs which had already been sewn up,’ he said. The message was only advertise ‘real’ vacancies and then advertise widely.

Many managers raised concerns about the lack of preparation for senior roles. Some suggested more tiers were needed in finance departments, so the jump between levels was not as great. One pointed out that ‘three bands (implying three jobs between qualification and being a deputy) is insufficient’. More trainees and better in-career development were frequently proposed as ways to improve competition for senior roles. But the most frequent suggestion was to introduce much greater opportunities for secondment and for secondments to be seen as a positive, not a negative, move.

Tha anomous results have been shared with Mr Flory. The Department said it would work with the HFMA and finance leaders to address the findings.

Putting in the hours
Four out of 10 finance managers in the NHS are working 45 hours or more each week, with more than one in 10 clocking up 50 hours plus.

At deputy level, the burden increases with nearly six out of 10 working 45 hours or more and one in five averaging more than 10 hours per working day.

Meanwhile, at the top level, long hours are the norm. Nearly eight out of 10 finance directors are working more than 45 hours a week with four out of 10 recording 50 hours plus in an average week. Many respondents referred to seasonal variations, with accounts closure and reorganisations demanding the most extreme weekly commitments. However others said that long hours, including extra hours in the evenings and weekends, were typical.


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