Comment / Time to step up

You may have heard by now – or read elsewhere in this issue – that my theme for the year is ‘step up’. This call to action is aimed at the centre, local NHS bodies and the finance function collectively and also at individual members of finance teams.

This in no way undermines the valuable contribution that finance staff have made to date. Far from it – finance has played a significant role in recent years in setting up new commissioning organisations and meeting heroic efficiency requirements built into tariff and non-tariff contracts.

But the NHS continues to face unprecedented challenges. The new money announced as a result of the spending review – and the sensible decision to frontload this and to target those early resources on sorting out provider deficits – is to be applauded. But no-one is pretending these steps have dissolved the challenge facing the NHS.

The only way we will meet this challenge is if we do things radically differently, including redesigning services to meet the needs of an ageing population with a growing level of long-term conditions.

It can’t be the ‘same old same old’. If we are to stand any chance of success, we will need the finance function to play a leading role. It is easy to say this, I know, but it is nonetheless true. Finance professionals have the skills – an understanding of the clinical and financial sides of healthcare, a reliance on evidence-based decision-making, problem-solving capabilities and attention to detail – that will be vital if we are to transform services.

We need to see this leading role as an opportunity and an obligation – making a lasting contribution to the delivery of sustainable healthcare services for the future.

Of course this would be challenging at the best of times. But the here and now demands our attention too. I doubt the current planning round – even with the extra resources – could be any more demanding. The timescales are shorter than ever – planning guidance was only released at the end of December and we still don’t have the official section 118 consultation document on the new tariff or the 2016/17 national contract, even if we basically know the core details.

Trying to produce a one-year plan and a five-year system plan within a few months is going to be daunting, given that organisations are still shuffling for places within their system footprint and trying to understand what that really means.

But the reality is that we simply have to find the time to support these contract and planning deadlines – producing meaningful long-term and operational plans. We have to continue to manage the day job – ensuring the smooth running of the financial engine room and delivering the agreed bottom line that will be statutorily reported. But somehow we also have to find time to raise our eyes to the horizon.

That means getting involved with transformation projects, bringing ideas to the table and brokering patient-focused transformation across organisational boundaries whatever the implications for individual organisations. It means getting our cost data and financial modelling fit for purpose so they can be the drivers for change.

And it means working right alongside our clinical colleagues – supporting them and challenging them – to really help understand clinical variation and where standardisation of practice can deliver better value.

Within this challenging context of balancing the money and the quality, the NHS needs us more than ever. Are you ready to step up? Somehow I already know you are.

Contact the president on [email protected]