Comment / NHS finance: how the numbers add up

The English version was published last month. The census provides a comprehensive picture of the size of the whole UK finance function as at the end of June 2015. This is supplemented by a staff attitudes survey, carried out in the autumn and completed by 753 finance staff from across the four home nations. An infographic summarising the results has also been produced.

This is the first time that data has been collected on a consistent basis across all four countries. But while the data collected is consistent, the structure of the NHS and working practices differ in each country, which makes it difficult to compare the results across the four nations, but not impossible. Analysis of the data raises many questions, most often, why? 

There are 19,602 people working in the NHS finance function across the UK, with 83% working in England, 7% working in Scotland and 5% working in both Wales and Scotland. 

In the UK, 63% of NHS finance staff are female, but only 28% of finance directors are female and women only make up 50% of the finance workforce in agenda for change band 7 to the very senior manager band. This pattern is the same across England, Wales and Northern Ireland, but Scotland bucks the trend. In Scotland 63% of finance directors are female and 71% of all finance staff in Scotland are female. The reasons for this are not immediately obvious, but there may be lessons that could be learnt elsewhere. 

There is also a difference in the ratio of qualified to unqualified staff. Across the UK, 56% of finance staff have or are studying for a formal finance qualification. 29% have a CCAB/CIMA qualification and 11% are studying for one. 44% of finance staff in England are either qualified or studying for a CCAB/CIMA qualification, dropping to 35% in Wales, 21% in Northern Ireland and 20% in Scotland. Again the reasons for this are not clear and what the impact is, if indeed there is one. 

Time spent on the principal finance functions also differs. The census records finance roles in four high level categories: financial management; financial accounting; financial services; and admin and secretarial. In England, Wales and Scotland the highest proportion of people work in financial management roles, in Northern Ireland it is financial services. No doubt use of shared services and exploiting technology will have had an impact. 

While I’ve highlighted some interesting data from the census, the real question is what value are NHS finance staff adding? Across the UK, nearly nine out of ten respondents to our attitudes survey said their department added value to their organisation. But this ranged from 77% in Scotland to 95% in Wales (with Northern Ireland and England reporting 87% and 89% respectively). Those with concerns may be frustrated with a focus on central returns rather than local improvement, but there were some suggestions for how more value could be added. These included enhancing communication between finance and non-finance staff, improving finance staff knowledge of the business and boosting the financial literacy of non-finance staff. This was consistent across the UK.  

There is no doubt that as the budgets continue to be under significant pressure and the Carter report on productivity with its recommendations to cap corporate back office and operational costs begins to bite, that the cost of the finance function and the value it adds will come under increasing focus. 

Over the next few months we will also be thinking about our future work programme. This will include how we can make best use of the rich finance function data we have collected and how it can be used to support finance staff in demonstrating the value they add.

NHS finance function in 2015: UK
NHS finance function in 2015: England
NHS finance function in 2015: Northern Ireland
NHS finance function in 2015: Scotland
NHS finance function in 2015: Wales