Improving financial and clinical collaboration

by Catherine Mitchell

27 August 2020

It’s time to turn the spotlight back onto the value agenda as the NHS begins to restore its services

At a HFMA webinar in June, attendees were asked about the level of engagement in their organisation between finance and clinicians. Half the delegates indicated that finance and clinicians only worked together because they had to comply or obey. What needs to happen to turn this around?

It has been great to read the HFMA #DoingOurBit stories over the last few months and discover how finance staff have stepped up to support their clinical colleagues during the Covid-19 pandemic – cleaning wards or creating a stock management system for PPE, for example.

With the number of new Covid-19 cases reducing, now is the time to consider how clinicians and finance staff need to work together to build the new NHS post Covid. While the value agenda may have paused at the height of the Covid-19 pandemic, its relevance continues to be significant in supporting the NHS to provide high-quality care sustainably in the future. Transforming services and improving value – ensuring that resources are used well and effectively – is only possible where there is good collaborative working between clinicians and finance.

Finance staff talking about budget statements is not the way to get clinical teams engaged. Jointly discussing how to best use the resources available to provide high-quality care, and presenting data in a way which is clinically meaningful is more likely to get everyone on board.

The HFMA briefing Exploring the role of the finance business partner states that finance business partners ‘have a critical role in supporting the decision-making of the clinicians and operational managers with whom they work’. How can finance staff in this relatively new role maximise the use of finance data to support improvements in value?

Patient-level costing (PLICS) provides clinical teams with a rich source of information to help them understand their patients and services. Linking patient-level costs with outcomes allows services to promote value for the patient. The Healthcare Costing for Value Institute PLICS toolkits provide tips on how PLICS data can be presented in a way that will attract clinicians’ interest.   

The institute and Future-Focused Finance Engagement Value Outcome (EVO) pilots have shown that bringing local teams of clinicians and finance staff together to explore PLICS data for a specific service promotes closer working relationships and greater understanding of the challenges facing each group. By getting the right people in the room, value-based decisions start to happen. You can read the experiences of three trusts here.

Improving financial and clinical collaboration requires sustained effort. The case study of HFMA 2018 Costing Award winners, Wrightington, Wigan and Leigh NHS Foundation Trust, describes some of the initiatives that they have found to be successful in increasing the quality of engagement between clinicians and the trust’s finance and informatics teams. This includes working closely with quality improvement teams and involving clinicians in the design of dashboards.

There are good examples of finance working more closely with clinicians in mental health services too. The institute case study  Using PLICS to drive value in mental health services explains how North Staffordshire Combined NHS Trust’s costing team has developed an information dashboard that clinical teams are using to identify opportunities for service improvement. Recent developments include mapping service user pathways, and linking these to patient outcomes.

At the HFMA and FMLM webinar Harnessing the power of clinical and financial collaboration to deliver value, 12% of attendees felt either ‘creative excitement’ or ‘heartfelt commitment’ about working together; and a further 38% described current engagement as ‘cheerful co-operation’. The Covid-19 pandemic has fundamentally changed the way the NHS operates. Now is the moment for the other 50% to seize the opportunity to improve financial and clinical collaboration, and rebuild the NHS using the value agenda as the building block for change.

Find out more about HFMA’s Healthcare Costing for Value Institute here