Feature / Stepping up

The NHS is looking to transform healthcare services so that they remain sustainable within finite resources in the years and decades to come. But it also needs to deliver service and financial targets in the short term. Taken together, these challenges make finance director roles some of the most important to the continuing success of the NHS.

There have been concerns in recent years about shortages of candidates for some finance director roles – particularly in some of the more challenged health economies – or about the shortage of experience among candidates. So what is the finance function doing to ensure it has the right people ready to step into these roles as the opportunities arise?

Enter the Future-Focused Finance initiative. As part of its ‘Great place to work’ work stream, it is looking specifically at succession planning in NHS finance and in particular how it can ensure staff arrive at their first finance director position armed with the right skills and experience to do the job – and give their employer confidence they will be able to do it.

Karen Berry (right), director of finance and information at Lincolnshire Partnership NHS Foundation Trust (right), is examining how the function can do more to enable mobility for finance staff as they navigate their careers. There has been a long-held perception that finance staff can get stuck in sector-specific tracks – certainly in England.

So someone working in commissioning finance will stay in commissioning finance – partly because providers might be looking for provider specific experience to appoint at any senior level, let alone finance director. But finance staff can also get stuck in tracks within their sector – so a costing accountant won’t be exposed to a broader financial management role, for example. Secondments are one way to fix this.
As long ago as 2009, in an HFMA survey of aspiring leaders, deputy finance directors were calling for secondments to fill a perceived experience gap – both to gain experience of different sectors and to gain a more strategic focus. But secondments that do take place seem to do so on an ad hoc basis.

As part of its work on succession management, FFF has looked at how it might support and encourage secondments. But it has had to refocus from its original target – deputy finance directors – to slightly less senior staff. ‘We’ve found that directors can be reluctant to let deputies go on a secondment – nervous about the impact of losing such a key member of staff temporarily, or perhaps even permanently, and of who they might get as backfill for the position,’ says Ms Berry. She believes organisations can manage their staff development so that they don’t become so dependent on individuals.

At the Lincolnshire trust, for example, there has been a deliberate attempt to make no-one indispensable. This has involved shadowing of roles and detailed descriptions of each role and tasks undertaken. This makes it easier to fill vacancies as they arise and tackles concerns about how a role might be filled if someone did leave or take a secondment.

Ms Berry also believes recent developments in the NHS have created a more secondment-friendly environment. ‘While in principle we support secondments as an excellent way to develop staff, in the past there might have been suspicion about a provider taking in someone from its main commissioner or vice versa,’ she says.

This could mean they get ‘inside knowledge’ of local costs, for example, which might lead to additional pressure in local contract negotiation. ‘However the sustainability and transformation planning process is changing this,’ she says. ‘All the place-based systems of care work is pushing people to work together and across organisations. In Lincolnshire, for example, we have a system-wide approach including open book accounting that’s helping to reduce those barriers, so it removes any suspicion that people might have about one side hiding something from another. We need to take this opportunity.’

FFF has supported a secondment pilot in Yorkshire and is aiming to start a further pilot supporting more junior staff, with shadowing and buddying opportunities across Yorkshire and the North East. This second pilot will provide a taster of different roles and functions.

Having spoken to all finance directors across the county about the secondment work, and realising it would be difficult to get off the ground at the deputy level, the focus moved more to facilitating movement for finance staff around the band 7 to 8b level.

Secondment support

Cathy Kennedy (right), deputy chief executive and chief financial officer at North East Lincolnshire Clinical Commissioning Group, has led the FFF ‘Great place to work’ work stream since its inception (see p32).  ‘It wasn’t straightforward identifying the opportunities or the candidates,’ she says. ‘But with the help of Finance Skills Development, we were able to put together five secondment opportunities and identify a further four that were already underway.’ These opportunities were to fill vacancies, to cover for maternity leave and for a couple of fixed term projects.

FFF has asked CIPFA to review the pilot but says the anecdotal assessment is that the pilot has gone well. ‘We have had a project manager supporting us and we have stayed in contact with the secondees – and the response has been positive,’ says Ms Kennedy. ‘Now we want to look at it in more detail.’

She acknowledges that the releasing organisations may feel they get the least out of secondments. She recognises that a secondment may lead to someone actually leaving an organisation or accelerating their departure, but she says many also see the advantages.

‘Some organisations are keen,’ she says, ‘because they recognise they have a static workforce. They can see the benefits for the individual in seeing other aspects of the system and when they do come back they often come back with new ideas that will benefit their own organisation.

‘There have to be benefits to these experiences,’ she adds. ‘Increasingly we need finance directors to be system leaders and it has to be harder for them to do this – or for others to believe they are capable of doing this – if they have only worked in one sector.’

Ms Kennedy is also keen to provide support directly to deputies. ‘Often the deputy role faces internally so it can be unusual at that point to gain good system exposure. Yet we then expect these same candidates to move into roles where a system focus is one of prime requirements.’

This view is backed up by a new survey by the HFMA on behalf of FFF. Early results from this work reinforce the idea that it is the broader competencies needed to be a director – not technical skills – that most aspiring finance directors think they do not pick up automatically as part of their progression through finance. There are clear concerns about the relative lack of system leadership opportunities. And more than 60% of aspiring directors see this gap in their competencies as having a significant impact on their career progression.

The survey also underlines that respondents see secondments and shadowing – alongside coaching and mentoring – as having the most potential to help them fill this gap. FFF is currently analysing the findings of this further research before deciding its next steps.