News / Policy Forum calls for renewed effort on clinical engagement

Finance managers are being urged to prioritise clinical engagement, making it part of day-to-day business and recognising the importance of engaging all clinical staff – not simply focusing on medics.

The HFMA’s Policy Forum met at the end of April to discuss clinical engagement –  a key theme for HFMA chairman Chris Calkin in his year in office. Mr Calkin led the Forum in developing guidelines and practical ideas to enhance clinical engagement across the NHS. ‘Accountants and clinicians can view the world differently,’ he said, ‘but it is the same world we are viewing.’

The Forum emphasised that clinical engagement was a two-way street. The Forum agreed that finance and general managers also had to understand clinical issues, values and language and have a grasp of the broader ‘health business’. This should go beyond an organisation’s own boundaries and involve the whole health economy, factoring in public health and illness prevention as well as healthcare delivery.

The Forum stressed the importance of taking clinical engagement beyond the consultant community. Resources are committed by a far wider clinical group including nurses, therapists and ward and budget managers. Focusing on senior doctors would limit benefits and potentially alienate key parts of the clinical team.

Increasing awareness among this wider clinical team of NHS financial systems and about the resource implications of their actions would have a financial pay off. However the Forum called for finance managers to be clear that the main purpose of greater clinical engagement was to improve patient health and healthcare. It stressed the importance of transparency  – for instance the approach to central reserves – in establishing trust.

Mr Calkin said good financial management was a prerequisite for good clinical care. Focusing solely on financial goals or treating clinical engagement as an initiative were unlikely to be successful.

Information plays a major role in clinical engagement and needs to be robust. However, the Forum also said that concerns about data should not be used as an excuse for inactivity. Trends and ball park figures could still be useful and if there were concerns about costing data accuracy, clinicians should be engaged in improving the validity, for instance by informing apportionment decisions.

Presentation of data is also important. Sue Jacques, finance director at County Durham and Darlington NHS Foundation Trust, briefed the forum on how her trust had set about engaging clinicians as part of a move to service line management (SLM). She said that clinicians had liked simple graphical overviews of key metrics with the ability to drill down. She added that clinicians had really embraced SLM. ‘We looked at costs per clinician and the consultants wanted it to be named,’ she said. ‘This was really powerful in changing behaviour even if no specific actions were agreed.’

The Forum backed existing plans to develop a curriculum that includes financial training for doctors. However it suggested that NHS managers could take up less formal opportunities to brief trainees from all disciplines while on placements.

One-to-one relationships between managers and clinicians were seen as the foundation for good clinical engagement. And ‘walking the patch’ was seen as vital for all senior finance managers. The Forum also backed the use of events, such as away days for consultants or ward managers.

The HFMA plans to publish a list of guidelines and ideas, based on the Forum’s discussions, during May.


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