Comment / Shaping our support

Many current plans to transform NHS services are built around moving healthcare into community-based settings and reducing the amount of care delivered in hospitals. While there are clear patient benefits, there is only a partial understanding of the impacts of such changes on the cost of service delivery. Potential new research from the HFMA could help to fill this knowledge gap – if members choose to prioritise this work stream in the association’s work programme for the year ahead.

The value delivered by transformation programmes has been a key area of contention. There is plenty of emerging anecdotal evidence that new models of care – often involving multidisciplinary community teams – are starting to have an impact on hospital attendances and acute admissions. But there has been little assessment of how any savings compare to the cost of investing in these new ways of working – especially when you recognise that there will be some stranded costs in acute facilities even if activity reduces.

In many cases, if not all, these new models of care will be the right thing to do regardless of cost – with better outcomes for patients equating to overall better value. But the service needs to plan for these changes with a better knowledge of the financial impact. The presumption has been that transferring services to the community will also reduce overall costs – but this needs to be fully tested.

This is just one possible project that the HFMA has proposed for its 2018/19 work programme. And now we want members to help us refine the proposals by completing a survey. There are a number of projects that the association’s policy and technical team will definitely take forward.

These include updates to some of the HFMA introductory guides and the continued expansion of the popular HFMA/NHS Improvement NHS efficiency map. The association will also continue to survey NHS finance directors as part of its six-monthly NHS financial temperature check and will undertake some research specifically for each of the Northern Ireland, Scotland and Wales branches.

But beyond that, we want members to have their say on what research and briefings would be of most relevance to them and of most value to the finance function and the service more generally. We’ve identified some 37 projects across the following themes:

• Transformation and integration
• Supporting the finance function
• Efficiency and value
• Payment systems
• Financial management
• Governance, audit and oversight

Other possible work projects within transformation include an exploration of the functions that currently sit with commissioning organisations that will need to transfer for provider bodies or integrated care systems.  Within the proposed finance function workstream, you might decide that the financial restructuring of deficit organisations is of direct relevance to you, while a refresh of the example charitable fund accounts may be less so – or vice versa. We don’t have the capacity to do all the projects, so it is really important you help us to narrow down our scope.

Our long-list of projects has been compiled with input from the HFMA’s committees and groups, including the new Out-of-Hospital Care Special Interest Group. Branches have also fed into the process. But the final say is down to members.

We are planning to produce 35 briefings and publications in the 12 months from July – that’s more than we’ve planned in previous years, but in line with what we’ve actually produced. Help us to make sure that work is as relevant to you as possible.

Take the survey here