Summary of the HFMA’s system working material

by Lisa Robertson

15 June 2021

The establishment of integrated care systems (ICSs) creates real opportunities to deliver more joined up care and improve population health. However, there is a lot to do to ensure appropriate governance and financial arrangements are in place at a system level. Over the last 12 months, the HFMA has produced a number of resources to support members as they move to greater system working. These are summarised below.

The Department of Health and Social Care published their legislative proposals for the NHS on 11 February 2021, building on the NHS long term plan and the subsequent NHS’s recommendations to Government and Parliament for an NHS bill. HFMA’s Summary of Integration and innovation: working together to improve health and social care for all sets out the key proposals for legislative change in the NHS.

To support systems as they formalise and develop their own finance and governance arrangements, Developing system finance and governance arrangements: key considerations for 2021/22 explores the system approach; the financial framework and system governance. The key principles that should form the foundation for a system framework, as well as the behaviours that also need to be in place across systems if the new structure is to achieve its goals were also discussed at a roundtable, summarised in The missing linkthat brought together chief finance officers and finance directors from across the UK  .

The HFMA’s summary report, Developing system working through changes to the NHS financial regime sets out the key changes that are needed to support the continued development of effective system working and is published alongside the longer briefing, The future NHS financial regime in England: recommendations which gives greater detail on the recommendations and also includes feedback from the surveys. 

The HFMA has submitted an number of responses to support national planning including: The HFMA’s response to the consultation on the system oversight framework 2021/22The HFMA’s response to the Health and Social Care Committee’s inquiry into the white paper on health and social care; and The HFMA’s response to the NHS provider selection regime consultation

As the NHS moves to a more integrated approach to delivering care, understanding how resources are currently used is an essential first step in improving population health. The case study, Understanding resource consumption across a system shares experiences from the Derbyshire system as they set out to develop a map of resource consumption across the system. This was also explored by one of our MBA in healthcare finance learners: High utilisation patients in Derbyshire sustainability and transformation partnership. Another of the MBA learners focussed their project on the finance skills required to transition to an integrated care system: Strategic finance leadership skills required to transition to an integrated care system

System working has also been a feature within a number of HFMA’s articles, blogs and events over the past year including:

ICSs will continue to be an area of focus for the HFMA over the coming 12 months. Recognising the amount of work finance teams will need to do to set up arrangements, the HFMA is launching a ‘system exchange’ for members of the HFMA Hub. This will be a monthly opportunity to meet colleagues virtually to share thoughts and experiences as integrated care systems evolve. These networking calls will be held on MS Teams with no set agenda, allowing Hub members to join colleagues to discuss current system finance and governance issues, share experiences and feed into the HFMA work programme. The first exchange will be held on 6 July at 9am. If you are interested in joining the call, please contact
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