A changed world

by Caroline Clarke

Healthcare Finance comment, 27 March 2020


Clinicians are the frontline of virus response, but there is a big ask of finance teams too, insists HFMA president Caroline Clarke

Caroline ClarkeI nearly didn’t write this month’s column because, like most of you reading, I have been totally immersed in trying to prepare my organisation for the Covid pandemic.

I also gave away my laptop today to someone who needs it more – not only are we facing shortages of personal protective equipment (PPE), but also laptops. And then my iPad froze in a really unexpected way, perhaps to remind me I really can’t take anything for granted – as if I hadn’t learned that lesson already.

So, I’m going to take the opportunity to reflect about how quickly life has changed, in such a short period of time, and to reflect upon the role of finance professionals in these times.

Just over a month ago, I was in Morocco for half-term. We knew there was a danger posed by the Covid-19 virus and travel might be curtailed.

I remember coming back to the UK and thinking how brilliant the NHS was because we had such a digital capability compared with the Moroccan system, which was largely paper-based. 

At the start of March, my organisation started to realise the enormity of what could happen, but we hadn’t really digested it.

That first week in March saw an awful lot of pennies dropping, and it hasn’t really stopped since. 

I do realise that we are in overdrive, planning for a pandemic and trying to stay a few days ahead of the curve. I also realise that London is seeing this happen earlier and more quickly than the rest of the country, who we hope will be able to learn from what’s worked and what hasn’t. And who hopefully won’t see the sheer volumes of patients we are already seeing. 

While the current ask of the NHS is operational and clinical, there has also been a huge demand on finance teams too. I’ve seen my chief finance officer, Peter Ridley, move mountains to get PPE, accommodation and new wards into the organisation.  What he doesn’t know about masks and fit testing isn’t worth knowing.

He and I have spent hours bending every rule we know in order to get stuff done to give our patients the best possible care, and to keep our staff safe, and the results have been extraordinary.

I am in awe of some of the things he and the finance team have made happen, and I’m sure that many of you will be doing similar things to support your clinical colleagues.

We’re now moving from that initial start-up phase, where everything seems reactive and one-off, to something that will hopefully feel a bit more systematic and sustainable.

The skills of the finance team in making that happen have been fundamental.   And I don’t think we’ve lost financial control – we have some clear governance and accountability. We know who’s in charge of making decisions and who has the right of veto (if anyone). 

Peter reminded me of the work we did under Future-Focused Finance around decision-making – I urge any of you in a leadership position to take a look at the Best Possible Value decision-making toolkit, which helps you do the right thing quickly. 

This is a time of huge anxiety for all our staff, clinical and non-clinical.  Everyone has loved ones and friends that they will be worried about. But it’s also a time for us to do the right thing as NHS professionals.

It’s a time when the NHS will be at its best, in the worst circumstances. And finance professionals will be at the heart of it, ensuring that we keep the show on the road and that we have a path to recovery.

Contact the president on president@hfma.org.uk

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