HfMA

History of HFMA

 
Past Chairman of the HFMA

1950	HFMA formed as the Association of Chief Financial Officers in the Service in England and Wales. Many of the senior accountants within the newly formed National Health Service had a background in local government and they felt strongly that financial officers needed a higher status. This led to a handful of likeminded officers meeting in London, and the Association was born. Invitations to join were sent out to all finance officers of the hospital management committees and the boards of governors of teaching hospitals and the new Association set about providing a professional, national forum for the service’s finance leaders. The Association’s objectives have not changed drastically over the years. It aimed then, as it does now, to promote high standards of financial management, to inform the health department and the service on financial matters and to provide opportunities for discussion and research. While the Association was to stand the test of time, its name did not.
1964	In 1964, a postal ballot led to a new moniker – the Association of Hospital Treasurers (AHT), a name that also reflected the new titles being adopted by the service’s senior finance officers. The same year also saw the Association rules change to allow for the appointment of a president instead of a chairman and an offer of a president’s badge by the Leeds branch was accepted by the AHT Council. HFMA’s own journal, Hospital Service Finance, launched early in the 1950s, had established something of an international reputation, with health service accountants from as far away as Australia and the Middle East keen to read its articles.
1974	In this year the NHS underwent major reorganisation. Some 90 area health authorities and 200 districts were created to administer hospitals. In Scotland and Wales, the regional tier was also abolished. The changes boosted the profile of NHS finance managers as a move to consensus management threw the treasurer into the spotlight. During this time the association also went through major change. For a start its name was no longer deemed appropriate and so it became the Association of Health Service Treasurers. Membership became extended to treasurers and finance officers in Scotland. But even more fundamentally, the Association ‘merged’ with CIPFA, with the association’s council also becoming the institute’s health executive. In its first 25 years HFMA had grown into a body that commanded respect. By this time, the association’s annual conference and luncheon had grown into a flagship event with an address from the incumbent health secretary becoming a regular event. The likes of Enoch Powell, Richard Crossman, Keith Joseph and Barbara Castle all took to the platform. But the conference did not only attract politicians, as senior civil servants, representatives from other professional bodies and the national press all saw the conference as an event not to be missed.
1976	The introduction of cash limits and the arrival of a new resource allocation formula (based on the work of the resource allocation working party – RAWP) put increasing pressure on finance departments. And the Association continued to flourish. The Association was proud of its relationship with the national health department. Regular quarterly meetings between key finance leaders and civil servants had long been established providing a direct route into the corridors of power.
1978	By this time membership of the AHST had reached over 500. There was however some concern over the exclusion of non-chief finance officers from health service finance activities at a national level. (The AHST was undeniably an influential body.
1985	At this point, 40% of members were participating in 45 national committees and working parties and its research committee was held in very high regard). However the issue of opening up the association to a wider membership did not go away as further organisational changes in the NHS made the move seem increasingly inevitable. In 1982 the area tier of administration was abolished and districts were upgraded to district health authorities. Then soon after consensus management was abolished in favour of a general management model. The NHS Management Board was established with a national director of finance. And the creation of general and finance managers in every unit management team led to an explosion of senior finance staff in the service. The AHST and its predecessors had been created when there were few qualified accountants in the service apart from chief officers. But the number of qualified accountants had trebled since the 1974 reorganisation.

1986	Early in 1986 the AHST threw open its doors to a wider financial community and the newly named Healthcare Financial Management Association (HFMA) emerged. With plans to enlarge membership and achieve a higher profile, the HFMA set up a full-time secretariat at the CIPFA headquarters in London. Writing at the time, Gerry Cinderby, the new HFMA’s first chairman said: ‘Many qualified accountants have been transferred to unit management accountant positions with managerial accountability to unit general managers. Current thinking at the top suggests that an additional 600 qualified accountants need to be recruited to the NHS over the next five years if the general management initiative is to succeed and many of these will be appointed to posts which are not on the treasurer’s establishment. In such circumstances the need for a professional group capable of promoting sound financial management and harnessing the support of all qualified accountants employed in health services becomes self-evident.’ Former members of the AHST and CCAB qualified accountants engaged in the NHS were automatically entitled to join the new HFMA. The HFMA Council could also grant membership to other individuals engaged in healthcare finance such as civil servants, lecturers, management consultants and private healthcare staff. Branches were also encouraged to enrol anyone with a special interest in healthcare finance.
1989	The White Paper entitled Working For Patients proposed the creation of an internal market, separating purchasers of healthcare from providers. The following year’s NHS and community care act put those proposals into effect. The introduction of capital charges, GP fundholding, contracting and free-standing NHS trusts again led to a major expansion of the finance function. The 11,000 finance staff in 1989 would reach over 16,000 within just a few years. The Association took over the successful Fincare programme from the NHS Management Executive. The HFMA Newsletter was also launched, the forerunner to today’s Healthcare Finance magazine. And the Introductory guide to NHS finance, soon to be re-issued in its ninth version, was published for the first time.
2000-Present	Following a review of management arrangements, the HFMA appoints its first full time chief executive (Mark Knight) at the end of 2000. His first task is to oversee a separation from CIPFA and establish independent headquarters for the Association. This takes place early in 2001 with the Association making its new administrative home in Bristol. At the beginning of 2002 the Association launches a redesigned Healthcare Finance monthly magazine. The Association is now widely seen as the representative body for accountants working in health and also attracts an increasing number of non-executives and chief executives as members. It continues to provide a range of high quality events, briefings and publications to support the development of financial management and financial managers and has developed a new e-Learning product to bring the NHS finance classroom to the desktop. It provides increasing sector specific support for members and organisations for instance working in foundation trusts or mental health. A national Policy Forum also provides a formal platform for the Association to debate the key issues in healthcare finance.