Comment / Costing: the new face of finance

Costing teams have evolved over the past decade. Gone are the individuals sat in darkened corners of finance, gently rocking as they complete the yearly national cost return. Instead they have become the face of finance, driving change and service improvement through the use of costing information.

This is what makes them not only one of the most important parts of finance, but central to service transformation.

However, on 12 April, many of our costing professionals were nowhere to be seen in organisations. And neither were they at home polishing off Easter eggs! Over 180 of these professionals were in London at the annual HFMA costing conference*.

The conference is the flagship event in the Healthcare Costing for Value Institute calendar and, as current chair of the institute council, it is my pleasure to chair the day that aims to inspire and challenge practitioners back in their own organisations.

After three years of online events, it was fantastic to finally be back in the room and to see and hear the buzz throughout the day as delegates had those conversations that just don’t happen in a virtual space. It was also good to see delegates engaging with sponsors and exhibitors in the breaks.

Throughout the day, delegates heard from a wide range of presenters about the importance of costing data, and costing professionals, in supporting organisations and wider systems to understand and address many of the financial and operational challenges they are facing. We heard about national and local projects that aim to ensure value for the patient, wider population and taxpayer remain core to decision making.

The Getting It Right First Time (GIRFT) team highlighted a project based on high-volume, low-cost orthopaedic procedures, which supplements model hospital data with patient-level costs. This allows for enhanced analytics to demonstrate if variation can be explained by casemix and demographics and, if not, helps to highlight the elements of a patient pathway to focus on for maximum effect. As GIRFT already has the attention of medical professionals, this is a fantastic opportunity to put the costing data front and centre.

But local engagement with this data is equally important and we saw that demonstrated by presentations from two organisations who were shortlisted for the 2022 HFMA costing award. The costing team at Warrington and Halton Hospitals NHS Foundation Trust has been on a journey but continued to build momentum throughout the pandemic including using benchmarking to support its medical director with a project to reduce medical staffing costs.

And on the subject of clinical engagement, there is no better advert than seeing Professor Finbar Cotter, a consultant haemato-oncologist at Barts Health NHS Trust, waxing lyrical for 30 minutes about the reporting platform that the trust has developed and it has been key to understanding the health needs of the population. He said that he ‘doesn’t do finance’, I beg to differ.

What stood out in the presentations from both Warrington and Halton Hospitals and Barts Health was the involvement of clinicians in recognising and driving value using the information set before them. Successful costing teams need to engage with the wider organisation and engagement is a two-way process.

We saw some excellent demonstrations of dashboards throughout the day. But if a costing team is producing patient-level costs on an annual, quarterly or even monthly basis without ensuring that people know the power of what is available, then their organisations are missing out on a gold mine of information.

Our final presentation of the day brought us back full circle to addressing the challenges that are keeping many senior leaders awake at night. How do you invest limited resources wisely within a health system in a way that maximises value while addressing health inequalities and un-met need?

Wes Baker, director of strategy analytics at Mersey Care NHS Foundation Trust demonstrated how system-wide cost and activity data is underpinning the trust’s approach to preventative, predictive, precise healthcare that addresses the needs of population, patient, and person. I wonder why it’s called System P!

He told delegates that costing accountants were becoming as, if not more, important as traditional management accountants. What a way to end the day.

What are my overriding reflections from the day? First, an overwhelming pride in costing teams across the country. If you work in costing thank you and keep going – the rewards are there for the taking. If you don’t work in costing, go and talk to your costing colleagues and find out what information they have at their fingertips and what they can do to help you. Perhaps even think about joining them and you could be there at the 2024 costing conference.

Second, engagement is everything. We all need to identify the Professor Cotter in our own organisations – he or she is bound to be out there, you may just need to knock on a few doors before you find them. But the rewards will be worth the effort!

And finally, the institute is fast approaching 150 member organisations. If your organisation is not already a member then this would be a great time to join as HFMA is offering the chance to win 2023/24 membership for free if you join by 30 June. You can find more details about member benefits on the institute homepage or by contacting Alex Chapman, [email protected] for more information.

Su Rollason is chief finance officer at University Hospitals Coventry and Warwickshire NHS Trust.

Members of the HFMA Healthcare Costing for Value Institute can access presentations from the annual costing conference (as well as conference delegates).