Responding to Covid-19

by Emma Knowles

20 March 2020


NHS finance staff have a major role in supporting the frontline clinical response to the coronavirus outbreak

Words seem inadequate to articulate the seriousness of the challenge we are facing with the Covid-19 coronavirus. The response from all NHS staff has already been amazing. They deserve the public’s thanks and respect and we will need their continued commitment and skills as the challenge intensifies in the coming weeks.

Earlier this week NHS England and NHS Improvement issued next steps guidance in response to Covid-19. The HFMA has summarised the key points here. The guidance makes fundamental changes to the financial regime and the impact for finance teams is significant. 

Clinical staff will be under intense pressure in the weeks and months ahead and the role of finance staff and others is to support these heroic frontline efforts. At its simplest that means ensuring core functions such as payroll, ordering supplies, paying suppliers and payroll are maintained.

The way we do things will inevitably change, particularly as the number of finance staff is itself likely to reduce either because of illness, self-isolation or because people have been transferred to support other business critical functions.

The HFMA is considering the detail of the new guidance and looking at how we can best support our members and the NHS finance function. Earlier this week we asked members of all of the HFMA’s committees and groups where we should focus our efforts over the short-term. This feedback has been really helpful as we reprioritise our policy and technical work programme to provide support as best we can. We have decided to postpone any work that is not directly relevant to the current situation we are facing.

We know that finance staff already have many questions and this will increase. We will be collating the questions you have and doing our best to answer them. On our own, we won’t know all the answers, but collectively we might. Finance departments will be developing their own solutions and we will be happy to facilitate the sharing of them.

We will be providing timely guidance to you and are already working on a summary of the finance and governance implications of Covid-19. This will be updated on a regular basis and also include information on the annual accounts and audit process, which is one of the most frequent concerns raised with us.

Guidance is clear that financial constraints ‘must not and will not stand in the way of taking immediate and necessary action’. The measures put in place by NHS England and NHS Improvement, including the move to block contracts and for further cost reimbursements, aim to put this into practice. And the finance function will have a major role in ensuring the essential back office activity runs smoothly. These tasks include the careful recording and reporting of costs incurred in responding to the outbreak and the estimating of expected costs. As the guidance underlines, the maintenance of financial control and stewardship of public funds will remain critical.

We will also be doing our best to support finance colleagues at NHS England and NHS Improvement. We have already provided them with a summary of the issues raised with us and offered our assistance. We will continue to liaise closely with them, raising your concerns and supporting where we can.

Many finance staff will now be working from home and this will almost certainly be the case for the foreseeable future. We understand that the ability for finance staff to access ledgers and systems remotely differs across the country. For some organisations, the simple logistics of enabling finance departments to operate remotely will have been a key first step. But even with the basics in place, working from home can feel very different from sitting in a busy finance department.

All members of HFMA’s policy and technical team are home-based and we have put together a list of top tips based on our experiences. You can find them here. We are considering how we can help finance staff who may be feeling isolated and are looking into setting up a discussion board so that we can support each other in the weeks ahead.

We will also be working on beefing up our webinar offering, to enable finance staff to feel connected. Maintaining a sense of community – while working in a more isolated way – will be really important to maintaining morale.

Two important points. First, any HFMA policy and technical outputs that are related to Covid-19 will be freely available to all NHS finance staff, not just HFMA members. This includes briefings, Healthcare Finance articles and webinars. We will also relax access controls on all our policy and technical briefings published in the last year. Please let your colleagues know about this if they are not HFMA members.

Second, we want to know if there is more we can do to support you. Any feedback on what we are proposing would be valuable. Email us at policy@hfma.org.uk. You can also email us with any questions you may have or any good practice/tips we can share with the NHS finance community.

Finally, these are undoubtedly difficult times, but if we stay focused and support each other we will get through it. Colleagues from other NHS professions often state that they are envious of the finance networks that exist. This is a time when we should use the strength of this network to help us deliver to the best of our abilities.