Time to hear the finance voice

by Emma Knowles

22 September 2017

Lots of media space and time is dedicated to NHS staffing issues. Can we recruit the right numbers? Is pay at the right level? Are work pressures increasing? And what is the overall impact on morale and levels of job satisfaction? Almost exclusively the attention is on front line staff – but finance staff along with other key support services face many of the same pressures and challenges – and the HFMA wants to hear about them.

It is perhaps understandable that the national media ignores the back office – or sees it only as an overhead to be minimised. After all, the NHS is about delivering healthcare and improving health, isn’t it? And anyway the 20,000 NHS finance staff across the UK (based on the HFMA’s last finance staff census) hardly register compared with a total UK workforce – estimated to be around 1.7 million.

In reality, finance staff have a massive part to play in meeting the current challenges facing the NHS. They may not be wielding the scalpels, administering the drugs or delivering the therapy to patients. But they have a crucial enabling role. High quality care can only be delivered on a foundation of good financial management.

More specifically, in such a difficult financial environment, finance staff are fundamental to improving productivity and efficiency, releasing resources for better or more care. And finance staff working alongside clinicians hold the key to the transformation programme that the NHS – and all healthcare systems – needs to go through.

In short, ensuring we have the right staff in finance departments – properly motivated and with good career paths – will also have an impact on the delivery of frontline healthcare.

So that’s why the HFMA undertakes it biennial finance staff attitudes survey – to build a comprehensive picture of the training and development, career path, values and perceptions of NHS finance staff.

Previous surveys were carried out in 2013 and 2015 with results reported alongside the regular census of NHS finance staff that we undertake with Finance Skills Development. We are keen to see how things have changed in what has been an undeniably tough time for the service as a whole.

Demand for NHS services is increasing with the population ageing and growing levels of people with long-term conditions. The NHS is experiencing lower levels of funding growth than previously. And pressure continues to rise to deliver ambitious efficiency targets – including a specific requirement to reduce corporate costs – while transforming care at the same time.

Alongside this many finance staff have been moved into shared service arrangements or into different working set-ups as new system-wide models are developed. This can provide new development opportunities, but it can also be unsettling for those who move and those who are left behind. Finance staff, along with their broader NHS staff colleagues, have continued to be affected by the 1% cap on NHS pay, and while there may be more public sympathy for nurses and doctors, NHS finance staff have not had it easy.

In our last survey, completed during October 2015, we asked respondents to score job satisfaction from 1 to 10 and in England the mean score was 6.7. This itself was slightly down on the previous survey. Job satisfaction tended to increase the higher the pay band, not necessarily derived from the higher pay alone, but more likely because there is greater scope for people to manage their own workload and pursue more interesting aspects of their job.

We also asked finance staff how they felt their job satisfaction might change over the next 12 months. Nearly one in five expected it to get worse, although a more optimistic 30% predicted an improvement after temporary pressures were relieved. Given all the current challenges – and the extreme pressure in the last two years to meet financial targets – it perhaps would not be surprising if we see a further drop in job satisfaction in 2017. But we’ll see.

We’ll also be looking at how finance staff are managing their work/life balance. Last time out, one in four told us that they ‘always’ worked longer than contracted hours. Nearly the same number again said they did this at least three times a week.

What is clear from previous surveys is that many people are motivated to work specifically in the NHS and enjoy the complex and challenging nature it offers. But they do have their gripes – from limited career development opportunities to how they are valued. The survey provides us an opportunity to understand what you’d want to fix.

The NHS desperately needs to keep NHS finance staff motivated and focused on the task ahead. And the survey is one way of helping to achieve this. We want to know how you feel about your roles and your careers. That way we can feed this back to system leaders in our regular discussions. And it will also help inform the association’s ongoing work programme.

You can complete the survey here.