News / News analysis: Development room

Secondments, job shadowing and talent programmes should play a role in developing finance managers for the most senior roles in their health economies and nationally. But senior jobs need to be made more attractive, with ‘heroic’ working hours and salary differentials seen as specific obstacles that must be tackled.

These were some of the conclusions of an HFMA Policy Forum held in July to examine the issue of recruitment to senior NHS finance positions. The gathering followed an HFMA survey prompted by concerns – highlighted by David Flory, director general of finance, performance and operations at the Department of Health, at last December’s HFMA annual conference – about the lack of competition for senior finance roles.

The survey involved some 450 finance managers (including 60 finance directors and 100 deputies) and suggested there were reasons to be concerned (see box below). Perhaps of greatest concern was the 40% of deputy finance directors with no aspirations to take on a director-level position. Work/life balance was also a major theme throughout the survey with 60% of finance managers keen to improve current work/life balance.

July’s Policy Forum aimed to build on the survey and identify practical, workable recommendations for change that might both improve the attractiveness of senior roles and ensure any unhelpful obstacles to progression are removed.

Salary differentials cropped up time and again in the discussions. The lower rewards on offer at director level in PCTs was a key issue. The difference between the top of band 8D (under Agenda for Change) – typical for a deputy finance director – and salaries for PCT directors of finance (under the Very Senior Managers’ Pay framework) was seen as too narrow in many cases – providing little additional reward for the extra board level responsibilities and the perceived extra risk.

But the Forum stressed that the problems were not all connected to financial rewards. There were also concerns about what is involved in director roles and the development given to staff during their careers to prepare them for the most senior roles.

Talking up the job

Although finance directors report high levels of job satisfaction (as indicated by numerous HFMA finance director surveys), there can be a tendency for directors publically to focus on the pressures, stresses and challenges. The Forum said that the finance function in general and finance directors in particular needed to project a more balanced image, talking up the role rather than talking it down.

But it was not just about image. Real changes were also needed to address concerns that a director level position equated to a reduction in work/life balance. The Forum acknowledged that longer working hours could be a major deterrent to taking on a more senior role. It said boards had a ‘responsibility in setting the tone for not working “heroic” hours and breaking the culture where long hours are seen as evidence of commitment and success’. The Forum believed that more flexible working practices would encourage more people to step up.

The over-riding message was the need for greater development of finance managers throughout their careers to help prepare them for  working at the most senior level.

The Forum called on organisations to provide opportunities for deputy finance directors to ‘practice in a safe environment’. This could involve presenting reports to the board – something that might require support for the deputy and the acceptance of the board. Different structures could also be considered. For instance the Forum said that the service tended not to make best use of staff nearing retirement. Pension issues often worked against directors reducing hours, but moving a deputy to an associate director role alongside a part-time director could ‘provide an opportunity to gain significant experience while still retaining substantial support’.

All strategic health authorities should introduce talent programmes for finance managers, similar to those that exist in the West Midlands and North West. And secondments and job shadowing were also backed as ways to broaden managers’ experience. These approaches could be used within finance departments, enabling managers to gain a different perspective of the function’s role, or between organisations. In this latter case secondment or shadowing arrangement could additionally help encourage greater movement across the provider-commissioner divide – an issue the Forum acknowledged needed to be addressed (see recruiters’ perspective).

It said trust managers in particular were often reluctant to move into commissioning. This was partly down to a perception of reduced job security in commissioning, resulting from years of restructuring. But there was also a feeling among trust staff that there were more attractions in provision – being closer to the frontline and operating in a more commercial framework (including patient-level costing, service line management and the foundation trust system).

The Forum agreed this view did not reflect the current reality where the move to world class commissioning and use of practice-based commissioning to shape patient pathways were arguably the key challenges in the health service. The Forum said more could be done to improve understanding of the different parts of the NHS. While organisations themselves had some responsibility for supporting this broader understanding, it said there were roles for the Department and bodies such as the HFMA.

Organisations also had a part to play in stimulating greater traffic between commissioners and providers. The Forum said trusts often wanted managers, particularly at director and deputy level, with specific provider experience. Similarly primary care trusts wanted candidates to have direct commissioning experience. While organisations understandably wanted new recruits to ‘hit the ground running’, Chris Calkin, HFMA chairman, who led the Forum, said that the focus should instead be on the competencies needed to be a finance director, which are largely non-sector specific. Mr Calkin added that in fact candidates with a broad range of experience – rather than simply on one side of the purchaser-provider split – should really be at an advantage.

The HFMA plans to publish a more comprehensive report of the Forum’s discussions soon, together with key recommendations for change.

Survey Highlights

• 60% of finance managers (excluding director level) have no aspiration to become finance directors
• 40% of deputies do not want to move on to finance director roles
• 60% of all finance managers want to improve work/life balance, rising to 70% for deputies and 73% for directors
• A third of all finance managers said that professional satisfaction was their number one priority when looking for a new job
• But two-thirds said that longer working hours and reduced work/life balance might prevent them taking a higher profile role
• More than 40% said that pay at the next level was often not enough for the additional responsibilities
• 70% of finance managers saw lack of sector specific skills as a barrier to moving across the purchaser-provider divide
• There is an even greater reluctance to recruit at senior level from the private sector
• 76% of managers backed formal programme of secondments to improve movement between different organisations
• 30% of managers identified a need for greater pay equity between commissioning and provider organisations

Recruiters’ perspective

Sheila Tunstall, director of consultancy services at HFMA Parkhill Placements, said organisations that restrict themselves to only appointing candidates with direct experience in the same type of organisation are being short-sighted and missing out on benefits for the organisation and for the wider NHS. ‘There has to be something to learn in the job or there is no incentive for many people to take it on. You need to create space for people to grow and develop,’ she said. She added that a trust appointing a director with PCT experience will not only benefit the NHS, providing a finance function with greater breadth of experience, but benefit the trust by giving it a greater insight into commissioning, which holds the key to future trust funding.

It is not just movement between commissioners and providers that could improve, but the private sector could also be a greater source for recruiting senior NHS finance managers. According to recruitment consultancy Hays Public Services, changing this picture will require the NHS to focus more on generic skills as well as improved marketing of the NHS as an evolving and commercially minded employer, happy to appoint from outside. The consultancy has seen a gradual increase in NHS clients’ readiness to recruit from outside the NHS, but believes there is still room for substantial improvement. ‘There should be a focus on competencies and skills, rather than the background a candidate comes from,’ said Jonathan Crosser, senior business manager at Hays. ‘This will help ensure finance directors have varied experience and gravitas to influence cultural and strategic change.’

Candidates also need to be more prepared to move around the NHS. Neil Fineberg, executive director at recruitment consultants Fine Green Associates, said some of the reluctance to move from trust to PCT is because commissioning is in transition. ‘There can be some confusion over what world class commissioning means and what it means for [the finance practitioner’s] role,’ he said. However he added traffic between the two sectors will increase as the commissioning programme finds its feet and commissioning action plans are published. And he adds that the lack of experience in PCT commissioning teams will make high quality finance staff vital.