Covid-19 – a CFO perspective

by Hannah Witty

16 July 2020

On my seventh working day at Central and North West London NHS Foundation Trust (CNWL) as chief financial officer, NHS England declared a level 4 incident in response to the coronavirus pandemic. Within days, all the preparation I had done for the role was torn up and replaced with a gold command structure.

This saw the executive team grapple with many challenges. These included: prioritising and closing non-essential services and corporate functions; the redeployment of around 15% of staff; opening mental health emergency assessment centres; new palliative care wards; ramping up community rapid response and discharge to assess teams; and moving many services to non-face-to-face against the backdrop of around 15% of staff absent at the worst points.

When you start in a new role, people often talk about the first 100 days – these were 100 days for which nothing can really prepare you. Looking back now I realise that around the middle of March when we moved from paper-based evaluations to decisions about closing services and redeploying staff, my main feeling for a brief period was one of helplessness.

I had a limited understanding of what CNWL did and how it delivered things, so discussions and decisions at gold meeting felt very theoretical. Finance (rightly) wasn’t a priority; the safe delivery of the services most needed for our users and wider sector colleagues was our north star and the contribution I was able to make was limited. So, I took the proactive step of offering to jointly lead and manage the majority of corporate services and establish and chair a redeployment group.

At that point CNWL didn’t have a human resources director, so most of my time was spent ensuring the trust had a pandemic people policy (we shamelessly copied the Barts policy – never reinvent a wheel) and that we had systems and processes in place to support our staff and managers to redeploy at pace to keep essential services running.

This was in addition to the ‘day job’ of trying to ensure adequate personal protective equipment (PPE) supplies and maintaining financial control.

My key reflections from the period are neither revelatory or new. In order to retain motivation, I identified a role where I could use my transferable skills to add value. I grabbed the right people to advise me and listened to them. I took the time to communicate priorities and the rationale for decisions to my newly expanded team, and I empowered people to make things happen.

Were things perfect? No, they will never be when you are working in such a rapidly evolving period of uncertainty. Did they work well enough? Yes. In CNWL’s reflections on our experiences so far, the feedback on how corporate services stepped up and delivered at pace has been overwhelming.

The heads of teams have formed a bond that wasn’t there before. Oh, and there is nothing like sitting in a virtual room twice a day facing unenviable decisions that immediately makes you feel like part of a team in a new role.

So, what now? Thankfully, our director of people and organisational development joined at the start of April (I have never been more relieved to hand over a function!). Finance is once again a very live issue and I have a brilliant team working on the cost of our new services and modelling the challenges of unmet demand and the mental health surge created by the pandemic.

We are trying to work out, collectively, how to be a virtual team. I have grabbed some rest and am now looking forward to my belated induction to CNWL.

This blog was first published as part of the HFMA London Branch newsletter. Click here for more details on membership.