Feature / Number crunch

The HFMA and FSD have combined again to undertake a census of NHS finance staff. Steve Brown trawls through the headline figures

The latest NHS finance function census shows that finance has made a contribution to running cost reductions, with a nearly 7% fall in staff within the core NHS since the last census was conducted in 2009. It also reveals a slight move towards a more senior skill mix across the function and a reduction in the numbers studying for accountancy qualifications.

The census is undertaken as a collaboration between the HFMA and NHS Finance Skills Development. While FSD has undertaken surveys of staff numbers for a number of years, in 2009 a joint initiative was set up to expand the census to provide a breakdown of staff by Agenda for Change pay band.

The 2011 census, which counts staff in post at the end of June 2011, is the second time this more granular examination has been run.

Strong response

Mirroring the almost comprehensive response from NHS bodies last time around, the 2011 census covers more than 99% of NHS bodies.

A total of 443 organisations took part, 414 from the ‘core’ NHS – which includes foundation trusts, NHS trusts, commissioners and strategic health authorities. The census recorded a headcount of 16,368 staff. Some 15,670 of these worked in the core NHS, with the remainder spread across a range of audit, shared services and other bodies.

However, the new census counts two groups of staff excluded from the previous census – namely finance secretaries and agency/interim staff on long-term placements or running projects. When these groups are excluded from the new headcount (to enable like-for-like comparisons with 2009), the figures indicate a fall in core NHS staff of 1,082 or 7% of the 2009 core staff headcount.

The census provides a breakdown of NHS finance staff according to where they work – regionally and by type of organisation/sector. Some 75% of staff now work in the provider sector, with 42% working in the FT community and 33% in NHS trusts. Just under one in five – or 19% – of staff were working in primary care trusts. These percentages represent an increase in the proportion of provider finance staff and a reduction in the proportion working in commissioning organisations.

To a large extent they reflect the transfer of staff under Transforming community services  initiatives, which have moved community services to new hosts in the acute, mental health and social enterprise sectors.

Looking at the provider sector in a different way, 13% of staff work in the mental health sector, while 58% work in acute. (Many acute and mental health organisations will now be integrated with community services following Transforming community services changes). Another 4% work in ambulance trusts or stand-alone

community trusts.

The report underlines that crude averages for staffing levels need to be read with care. For a start, turnover is a major driver of staffing levels. But different approaches to in-house and outsourced services, or the provision of services to other organisations, also make a difference to staff numbers.

However, the report suggests averages can provide a very rough guide to organisational differences. For example, FTs have 51 staff on average, trusts (including community) have 47, PCT clusters 63 and SHAs 27.

A breakdown of staff by Agenda for Change band shows a slight drift towards a more senior skill mix, with small percentage increases in bands 8a upwards compensated for by more significant reductions in bands 1-3.

The census shows that 47% of staff work in financial management, 29% in financial accounting and 20% in financial services, with the balance identified as having a purely administrative role. Financial management makes up an increasingly large proportion of each band moving up from bands 1 to 8d.

Gender split

Just under two-thirds of the finance function are women – virtually no change from 2009. However, the male/female split is not constant throughout all levels of the function. At band 6 and below, nearly three-quarters of the function are women, compared with 48% at band 7 or above. Women account for nearly one in four of all directors in the census – a slight increase in proportion since 2009.

The census shows 4,396 staff are CCAB qualified, with 2,217 studying (CCAB is defined as a CCAB qualification or equivalent). The number studying for CCAB (not including those on the national training scheme) has fallen 173 since 2009 – averaging 17 per SHA economy.

The HFMA and FSD plan to re-run the census in the summer of 2013.

Download the NHS finance function census 2011