The HFMA began life back in 1950 as the Association of Chief Financial Officers in the Hospital Service in England and Wales. The NHS itself was still finding its feet and it was just two years since article 25 of the NHS (hospital accounts and financial provisions) regulations 1948 had firmly established a core role for the finance function.
But finance officers were not universally seen as key players in the management of the service, in some cases attending finance and policy meetings merely to present financial figures, then leaving while other chief officers discussed the implications. Many of the senior accountants in the new health service had a background in local government and felt strongly that NHS finance officers needed a higher status.
Reports in association journals over the years suggest that the association was born out of two parallel initiatives in the north and the south and it was decided to form the association. A constitution was drafted and branches set up to cover all regions of England and Wales.
The association's purpose
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.
Though the association was to stand the test of time, its name did not. 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 role of finance was growing and in 1974 the service underwent major reorganisation. Ninety 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. The association also went through major change. Its name was no longer appropriate, so it became the Association of Health Service Treasurers (AHST); membership was extended to treasurers and finance officers in Scotland. Even more fundamentally, the association ‘merged’ with CIPFA, with association’s council becoming the institute’s health executive.
By 1978 AHST membership had reached 500. But concerns were growing over the exclusion of non-chief finance officers from health service finance activities at a national level. A postal ballot run by the association in 1981 led to a narrow vote in favour of maintaining the existing membership criteria, perhaps reflecting concerns among some members that changing the rules would dilute the association’s influence with the then Department of Health and Social Security.
Opening up the membership
However in 1986, the AHST threw open its doors to a wider financial community and the Healthcare Financial Management Association emerged. With plans to enlarge membership and achieve a higher profile, a full-time secretariat was set up at CIPFA’s headquarters in London, serving the HFMA and representing CIPFA in health. 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.
A fully independent organisation
In 2000 a decision was made to sever links with CIPFA and set up the HFMA as a fully independent organisation.
From the beginning of 2001, for the first time the HFMA had its own independent, free-standing secretariat and support team. Subsequently the association has gone from strength to strength. Membership has increased from 1,640 to over 22,000. The association is now financially stable and now owns a conference centre in London and its headquarter building in Bristol.
In 2025 the HFMA will celebrate its 75th anniversary.