Mixed response

by Caroline Clarke

28 February 2020


Reaction to the planning guidance for 2020/21 will depend on local context

So the operational guidance arrived at the end of January, setting out operational and financial requirements for the year ahead, and the notion of ‘system by default’.  I’ve been testing reactions to the guidance and I think it’s fair to say that they are mixed, and that context is everything. 

If you’re in a more developed, financially stable system, you’ll be thinking about how the guidance can genuinely help improve system performance.  If you are in a financially challenged economy, you’ll be wondering how on earth you can make the whole thing stack up. And if you’re in a hospital you may be wondering about how you run at 92% capacity, while welcoming the increased investment into community, primary care and mental health services.  And everyone is probably wondering what on earth is going on with social care funding. 

There’s promise of a detailed people plan in the spring – and if you want to hear more, do sign up for our webinar with Julian Kelly and Prerana Issar on 10 March.

Personally, I’m pleased to see more emphasis on population health and sustainability, although whether we are being tough enough as a sector in either area remains to be seen. I think that as finance professionals, we have a head start in measuring. And we should definitely have carbon measurement firmly in our sights.  If your organisation doesn’t produce regular carbon statements, why not start?    After all, if we don’t reduce our carbon usage, we are, as they say, toast….

Meanwhile the latest data on workforce equality standards has been published and it’s a mixed picture. There’s a bit of progress overall, but way too much variation, and too many of our colleagues and staff still experience bullying and harassment. And it’s significantly worse if you aren’t white.

That is not OK. It never was OK and it isn’t OK for the future. We’ve got a long way to go, and I hope that we can get the finance profession to really lead the way – we point to some of the actions we need to take in the document NHS finance: designing our future.  If we want the NHS finance function to be a career destination of choice for young people, we need to step up and take pride in our work and our diversity. We’ll explore more on these themes at a series of events in 2020 (4 June and 8 October) with key policymakers. 

In other news….the spread of the Covid-19 coronavirus globally continues to attract comparisons with the 1918 flu pandemic. We still don’t know what the course of the disease will eventually be. However, the response of the NHS has been brilliant in comparison to many other countries that simply don’t have the same basic infrastructure as us. 

For all the short term operational and financial pressures, our ability to track patients, contain the virus and repatriate people has been globally admired.  It may not be enough, but it made me proud of our national health service and our ability to respond as a single system.  That is something to keep hold of when the chips are down.


This blog also appears in the March issue of Healthcare Finance