Technical / Obituary: Paul Hughes

05 June 2023 Phil Foster

Login to access this content

He was diagnosed with a grade 4 brain tumour in 2013 and was given a prognosis of surviving 15 to 18 months with treatment. However, with four surgeries and multiple cycles of chemotherapy, he continued to defy the predictions and, as he put it, to ‘live beyond his sell-by date’. He returned to work and continued to contribute to his trust and to the association.

Paul Hughes_2016 awards_PORTRAIT

Paul started in the NHS back in June 1990, supporting Birmingham maternity hospital. I actually met him on his first day. He was employed as a grade 4 accounts assistant and then left in late 1992 to join the Birmingham Children’s Hospital (BCH) team as a budget manager support (terrible title, I know).

Paul then stayed with BCH through its various guises all the way through to his sad death. Given the merger of Birmingham Women’s Hospital and Birmingham Children’s Hospital back in 2017, this ultimately meant Paul spent the whole of his 32-year NHS career within the same organisation, which was a fantastic feat.

He was going through a process of ill-health retirement at the time, and two days after his death was awarded a BWC 30-years long service award. Paul was working his notice when he passed away.

In those intervening years, Paul continued to work within financial management, before taking the head of costing role in 2003. After a period of also undertaking the acting head of contracting role, he was appointed to the substantive role in 2007.

Following periods of illness, Paul subsequently became head of special projects within the organisation. It was while undertaking this and the head of contracting role that his knowledge and skills around understanding payment by results and the national tariff came to the fore.

His knowledge in this arena was incredible and he loved the release of any tariff updates so that he could test out just how our organisation, and more importantly paediatric services, would be affected. He was a die-hard advocate for appropriate funding for paediatric services and, irrespective of the situation, would be passionate in his vocal support for this.

Outside his immediate day job, Paul would throw himself into anything the organisation needed doing. At a time when the country was in lockdown, he would happily volunteer to be ‘on the door’ Covid marshalling at BCH and probably did more front-of-hospital shifts than anyone else – and with all his customary gusto.

On a personal level, I did a lot of these shifts with him and those were some of my fondest memories of Paul. A great doorman!

Paul is fondly remembered at BWC and mainly for the work he did at BCH. At the presentation of his 30-year long service award, chief medical officer Fiona Reynolds recalled the business case Paul helped drive forward, which resulted in BCH expanding up to 31 paediatric intensive care beds.

He was also a major contributor to national developments and the wider finance community, sitting on a number of national groups and committees that were closely involved with costing, healthcare resource group (HRG) currency development and the emerging payment system. These included the NHS Digital (formerly the Health and Social Care Information Board) Casemix Advisory Board and the Paediatric Expert Working Group, which oversaw the design of paediatric HRGs.

Paul was also a member of the HFMA’s Payment Systems and Specialised Services Committee (and its forerunners), as well as sitting on the association’s costing groups.

His contributions were recognised in 2016, when the association presented him with an honorary fellowship (pictured).

The legacy of Paul’s skills and knowledge are there for everybody to see on a daily basis and it is only when you step back you realise just what an influence he had on healthcare at BCH. He was more than just an accountant – and one who put people before finance. A lot of us already knew that, but his sad passing has enabled his influence to be shared once more.

Phil Foster is chief finance officer at Birmingham Women’s and Children’s NHS Foundation Trust. 


‘Paul had a depth of knowledge and a passion for his professional area that was hard to beat. He was a lively contributor to the HFMA committee and respected by all who attended. Over the years, it was also a pleasure to get to know the kind and generous man that he was, who will be much missed by his friends and colleagues.’ Madi Parmar, chief finance officer, Coventry and Warwickshire ICB

‘As a member of our Casemix Advisory Board and our Paediatric Expert Working Group, Paul was always a staunch supporter of the National Casemix Office and will forever be remembered for his insistent reminder that the NHS did not make Mars Bars, but rather treated people. As a true friend of casemix, Paul will be sorely missed.’ 
Paula Monteith, National Casemix Office

‘Paul was instrumental in helping me find my way around, physically and metaphorically, when I joined Birmingham Children’s Hospital in 2007 and I was grateful for his words of wisdom, but also his cheekiness and sense of humour, reminding me not to take life so seriously. He always put a smile on my face – especially when he asked the questions that we were all thinking but nobody else dared to say!’ 
Hayley Ringrose, HFMA policy and research manager