Coming together

by Owen Harkin

Healthcare Finance comment, 06 December 2021


New HFMA president Owen Harkin says the UK nations have much to learn from each other.

I am immensely proud to become only the second person from Northern Ireland to be HFMA national president. Though I know the Northern Irish system best, I am keen to be the leader of finance colleagues from across the UK.Owen_Harkin comment L

We are all in different positions. While England is preparing to embark on closer integration in April, in Northern Ireland we are nearly 50 years down the road of bringing health and social care together, with integrated services, integrated organisations and health and social care trusts. Though we have years of integration under our belts here in Northern Ireland, no-one would claim it is perfect.

However, like England, we are embarking on a period of reform, led by our Department of Health. Our commissioner, the Health and Social Care Board, is due to close on 31 March 2022 and its staff will move to the Department of Health to create a Regional Group, which will provide oversight, co-ordination and accountability functions.

This will be underpinned by the creation of area integrated partnership boards (AIPBs), including membership from the local trust, primary care, local government, and the community and voluntary sector, These five AIPBs will be accountable to the Regional Group.

Trusts will still exist under this new integrated care model, but questions remain over how wide the powers of the AIPBs will be, and whether the new system will be underpinned by the same performance management mechanism.

There is also recognition of the cultural change required across the full range of constituent partners to ensure the success of the model, with the expectation that a better understanding of the roles and responsibilities of each partner will be vital in constructive collaborative working. I hope we can all build on the co-operation we saw during the pandemic.

I am aware that the whole of health and social services in Northern Ireland is equivalent in size to one large integrated care system in England. But we still face common issues, including the immediate challenges of winter. This is shaping up to be the most challenging ever faced by the NHS, placing enormous strain on our hospital and critical care capacity, and the need to maintain flow through our emergency departments and into social care settings.

But there are many other common questions. How can we make our services more sustainable, embrace the digital agenda, address workforce shortfalls and, broadly speaking, make the most of our cumulative resources to ensure we provide the best outcomes for the populations we serve? All this while addressing the major health inequalities so visibly exacerbated by the pandemic.

I think there is much we can do by bringing the nations together to share ideas and experiences.

In November, we had the first meeting of our new HFMA Devolved Nations Group, which included branch chairs and senior finance leaders from each nation. We talked about what we can do in terms of collaborative research, and joint publications, webinars or podcasts over the next 12 months. We could all contribute to these, and include input from the NHS in England as well.

My theme for my year as president is Reimagining the future, and it will have three parts – the short-term recovery of the NHS from the Covid pandemic; longer-term changes to the NHS; and the future of the HFMA.

I am looking forward to discussing and developing the theme with HFMA members over the coming months. I’ve always said the members are the most important element of the association, and I want to meet and talk with as many members as I can. I can’t wait to get out there.