A changed world

by Caroline Clarke

27 March 2020

Clinicians are the frontline of virus response, but there is big ask of finance teams too

I nearly didn’t write this month’s column because, like most of you reading, I have been totally immersed in trying to prepare my organisation for the Covid pandemic. I also gave away my laptop today to someone who needs it more (not only are we facing shortages of personal protective equipment (PPE), but also laptops!). And then my iPad froze in a really unexpected way, perhaps to remind me that I really can’t take anything for granted – as if I hadn’t learned that lesson already.

So, I’m going to take the opportunity to reflect about how quickly life has changed, in such a short period of time, and also to reflect upon the role of finance professionals in these times.

Just over a month ago, I was in Morocco for half term.  We knew that there was a danger posed by the Covid-19 virus, and we knew that travel might be curtailed.  I remember coming back to the UK and thinking how brilliant the NHS was because we had such a digital capability, in comparison to the Moroccan system, which was largely paper-based. 

At the beginning of March, my organisation started to realise the enormity of what could happen, but we hadn’t really digested it.  That first week in March saw an awful lot of pennies dropping in my part of the world, and it hasn’t really stopped since then.  I do realise that we are in overdrive, planning for a pandemic and trying to stay a few days ahead of the curve.  I also realise that London is seeing this happen earlier and more quickly than the rest of the country, who hopefully will be able to learn from what’s worked and what hasn’t.  And who hopefully won’t see the sheer volumes of patients that we are already seeing. 

While the current ask of the NHS is operational and clinical, there has also been a huge demand on finance teams too.  I’ve seen my chief finance officer Peter Ridley move mountains in order to get PPE, accommodation and new wards into the organisation.  What he doesn’t know about masks and fit testing isn’t worth knowing.  He and I have spent happy hours bending every rule we know in order to get stuff done to give our patients the best possible care, and to keep our staff safe, and the results have been extraordinary.

I am in awe of some of the things he and the finance team have made happen, and I’m sure that many of you will be doing similar things to support your clinical colleagues.

We’re now moving from that initial start-up phase where everything seems reactive and one-off to something that will hopefully feel a bit more systematic and sustainable. The skills of the finance team in making that happen have been fundamental.   And I don’t think we’ve lost financial control - we have some clear governance and accountability. 

We know who is in charge of making decisions, and who has the right of veto (if anyone).  Peter reminded me today of the work we did under the Future-Focused Finance programme around decision making. I would urge any of you in a leadership position to take a look at the Best Possible Value decision-making toolkit, which basically helps you do the right thing quickly. 

This is a time of huge anxiety for all our staff, clinical and non-clinical.  Everyone has loved ones and friends that they will be worried about.  But it’s also a time for us to do the right thing as NHS professionals. It’s a time when the NHS will be at its best, in the worst circumstances.  And finance professionals will be at the heart of it, ensuring that we keep the show on the road and that we have a path to recovery.

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