Business and value

by Bill Gregory

28 February 2019


Finance teams are focused on the year-end, but they must also make progress with the value agenda

Value the opportunity

The ‘business end’ of the financial year is now in full swing. That’s a well-used phrase by football managers, but nicely sums up how the efforts put in by NHS finance teams up and down the country throughout the year come together at this time of year. In particular, this reflects the process of preparing statutory accounts for the current year and making sure our plans are well developed for next year.

The dust has begun to settle on the planning guidance, particularly as some of the missing parts of the jigsaw puzzle have been published – namely detailed tariff arrangements and control totals. The challenge next year still looks significant for many of us. However, we shouldn’t forget that the budget increase for health is relatively generous compared with other public spending budgets.

During the past month, I was able to join the Yorkshire and Humber Branch for its annual conference. It was really pleasing to see such a strong and vibrant branch in action, with a well-supported conference. It was also a great reminder that the HFMA is made up of branches and the devolved nations. I look forward to being able to join many more similar branch events across the country during the year.

While the HFMA’s national profile is important for our profession, its core purpose is to serve the interests of its branches and members. This year, we will be revisiting the HFMA strategic aims to make sure they remain relevant to both the branches and its members, with a focus on the membership offer. If you have any views on what the association should be taking into account during this review, please let me or your local branch know.

Last month, I had the opportunity to attend New York State’s delivery system reform incentive payment (DSRIP) learning event in Saratoga. This programme has a prime goal of reducing avoidable hospital use by 25% over five years and is about to enter its fifth year in April. The programme is a little bit similar to the new blended payment system for urgent care being introduced in England in 2019/20. However, significantly, it incentivises providers to address issues across the whole care pathway and to consider the impact of wider social issues that affect individual health needs.

The keynote presentation was delivered by Don Berwick, a celebrated healthcare improvement expert and founding chief executive of the Institute for Healthcare Improvement. His work with the NHS has already been acknowledged with an honorary knighthood. Some of you may have been lucky enough to hear Don speak at a number of HFMA events over the last few years (see below).

Don provided us with a salutary reminder of how big an influence social inequality is on life expectancy. He referenced the work of Michael Marmot (The health gap), which provided many examples of this relationship. 

Perhaps the most striking of these was the progressive reduction in life expectancy as you take a bus from the West End of Glasgow to Easterhouse.

This was also a useful reminder that health value can be improved by using financial and outcome data to critically review how we provide care and prevent illness. These are concepts that our own HFMA Healthcare Costing for Value Institute is looking to explore further as part of its work programme for the year.

In particular, the institute’s value summit on 22 May will showcase real-life examples of clinical and financial teams working together to create more sustainable approaches to healthcare and wellness.

I hope to see many of you at the summit or at your own branch conferences during the course of the year.


This blog first appeared as a comment in the March issue of Healthcare Finance

Don Berwick at the HFMA

Quality response, Healthcare Finance February 2013

Triple vision, Healthcare Finance, February 2015

Find out more about the work of the HFMA Healthcare Costing for Value Institute