Prioritising prevention

by Bill Gregory

28 June 2019


Health systems across the world are trying to shift the focus onto prevention

One of the privileges that comes with being HFMA president is the opportunity to represent the association internationally. And at the end of June I attended the HFMA USA annual conference in Orlando.

It’s now 55 years since an HFMA UK chairman first addressed the US conference, and it’s great to have been part of this long tradition. I am also grateful it only took me a mere nine hours on the plane, compared to the three days it took Reginald Stacey to get to here in 1964.

I was asked to give a UK perspective on the social determinants of health inequalities.  I based a lot of what I said on the work Sir Michael Marmot did for the UK government – Fair society, healthy lives. This provides evidence to underpin many of the wider social policies we have adopted in the UK, such as the focus on ‘place’ in the NHS long-term plan to create sustainable communities for healthy living.  

I sensed more than a touch of jealousy from the American audience when my fellow US president, Mike Allen shared a slide that showed how far the US is behind the UK when it comes to spending resources on prevention.  

However, they seem to be struggling with exactly the same problem – how do we create the incentives for organisations and individuals to focus more on prevention? The UK system definitely has the edge here, as we rightly see money as an enabler for healthcare improvement, rather than a way of earning profits, with much more flexibility for change as a result.

Before I left Orlando, I invited Mike Allen to our national conference in December and I look forward to meeting him again in London and hearing more about his ‘I dare you to move’ challenge. He wants finance professionals to step outside their comfort zone to address current challenges.

Before travelling out to the USA, I also had the chance to meet with our new national chief financial officer, Julian Kelly. This was a great opportunity to welcome Julian in his new role and explain how the HFMA supports the finance profession in the NHS.  

I was struck by how quickly Julian has acquainted himself with intricacies of the health service and also the value he places on personal development and talent management. I wouldn’t be surprised to hear more about this over the coming months from Julian.

I’ve written before about how important it is for the HFMA to influence the design of the future financial regime and, in particular, how we work ourselves out of the issues created by the current financial architecture of control totals, sustainability funding and provider liquidity.  

The current challenges around capital are now well understood, and the more we can do as a profession to help Julian and his team work through these problems, the quicker we are likely to get to a better place especially as we enter the next phase of spending reviews. 

Julian, who will make his first major speech to the finance profession at this month’s HFMA summer conference, will also be speaking at the December national conference, which will be a great opportunity for more of us to welcome him.


The HFMA summer conference takes place in Bristol on 4-5 July.  Follow the conference on twitter #HFMASummerConf or see news reports on the HFMA website.