President’s tour: Wales

by Mark Orchard

29 September 2017


For as long as I can remember, HFMA Wales has been renowned as a branch built on solid foundations and enabling a strong professional network to thrive for the benefit of the nation it serves.

The Wales Branch was my entry point into the association almost two decades ago when I first joined the health service as an Association of Chartered Certified Accountants (ACCA) trainee. It is significant for me, therefore, that the Welsh annual conference is now a joint affair between both HFMA and ACCA Wales.

This year’s conference boasted nearly 250 delegates – a remarkable attendance given that the most recent joint Finance Academy Wales and HFMA staff census showed that there are only 1,018 NHS finance staff in Wales in total.

As well as a full range of professional development updates spread over two days, innovation sharing and motivational sessions, this year’s event included a key note address from Vaughan Gething, Welsh Assembly member and cabinet secretary for health, well-being and sport. That demonstrates the weight of importance given to NHS finance in Wales by the Welsh Assembly government.

For my part, I was pleased to be able to return to a venue that played home to the first five and a half years of my NHS career and to offer a personal reflection on the common challenges we face across the UK. Indeed, despite updating myself on the latest population, activity and finance numbers for Wales ahead of the event, my broad conclusion was that despite the now very different organisation and governance models, our challenges are remarkably consistent.

Indeed, many of the population and economic observations drawn by the Health Foundation within last year’s publication – The path to sustainability: funding projections for the NHS in Wales to 2019/20 and 2030/31 – could equally have been made for England.

‘Looking out, reflecting back’ – the conference theme – summed up the mood in the room perfectly. Wales is clearly listening and actively learning from the health and care journeys unfolding in the other three UK nations. But at the same time the NHS in Wales is quietly leading the way on several fronts from which the rest of us could usefully take a lead.

The ‘Once for Wales’ approach has tangibly shaped the way support services are now provided at scale, further reducing non-clinical overhead cost even below the levels achieved following the abolition of the NHS internal market in Wales.

And on health integration, the seven local health boards would appear to be closer to achieving ‘accountable care’ having brought together primary, community, secondary and mental health – both the population planning and operational delivery functions – under one single leadership team for each of their seven footprints. Only Public Health Wales, the Welsh Ambulance Service and specialist trust Velindre sit outside of this model. Together, the ten NHS bodies have a direct and, therefore, seamless interface with the Welsh government.

The inevitable next step on the Welsh journey will be embracing social care – perhaps learning from experiences in Scotland and Northern Ireland, but in a way that no doubt works for this nation and the population it serves.

For now the NHS in Wales will continue to serve my family and loved ones well, and I will continue to watch with interest.


President's tour: Scotland
President's tour: Eastern
President's tour: Kent, Surrey and Sussex 
President's tour: South West
President's tour: North West
President's tour: London
President's tour Yorkshire and Humber
President’s tour: West Midlands
Presidents's tour: South Central