Comment / Raising the temperature

The HFMA’s NHS financial temperature check, our biannual survey of NHS finance directors in England, gives an insight into the challenges healthcare finance is facing, but also into the solutions that healthcare finance professionals can, with all our colleagues, help drive.

I want to draw your attention to just three headlines from the survey that demonstrate the financial pressure the NHS in England is under, and then how finance directors’ responses show we can respond to these pressures. I encourage you to read the full briefing, to see the overall picture.

Firstly, our ambition for driving efficiency savings is higher still in 2017/18 even than it has been in recent years, with NHS providers and commissioners planning to achieve levels averaging 4.5% and 3.9% of income respectively compared with 3.7% and 2.6% last year. Provider finance directors have identified the need for agency, procurement and estates savings to help meet this requirement, aligning with the recommendations of the Lord Carter review and with clear support and direction from NHS Improvement. Commissioners have identified the need for a reduction in unnecessary clinical variation, which was also picked out by providers, as well as the need for redesign of acute pathways, to see a reduction in interventions of limited clinical value and to speed up the adoption of new care models. The survey certainly shows that finance directors embrace the need for efficiency.

Secondly, there is a clear alignment behind sustainability and transformation partnerships (STPs) to enable whole health economies to work together. However, at the same time there is a lack of confidence among finance directors that STPs will be able to deliver at the necessary pace to close the funding gap by 2021. One area of particular concern across almost all of the finance directors we asked related to the availability of capital and related investment funds to support the required transformation.

Finally, it is encouraging to note that almost three quarters of finance directors believe quality will stay the same or get better over the next twelve months. This is a testament to the work of the staff in the NHS. There is however a perceived threat to waiting times across both A&E and elective care.

I hope that this time next year we will be reflecting on a year where we have all helped drive the change that is needed and that the collective healthcare financial position is stronger and more resilient in return. Let’s not underestimate the amount of work this is going to take from healthcare finance professionals, and indeed all staff working in the NHS, but I know that the energy and expertise that we have will continue to be an asset to the service during this period.