Comment / Finding the right balance

The pandemic has left a permanent mark on the country, changing how people live their lives and interact socially. For many, it has also changed their working lives.

In September, a BBC poll found that four out of five business leaders thought it was likely that people will never return to offices in the same numbers as before. This also appears to be the case within NHS finance departments, according to a new HFMA survey of finance directors.

Last year, finance teams switched to home working almost overnight. IT and connectivity problems were rapidly sorted, enabling finance teams to keep to their duties, including preparing annual reports and accounts. It was a lesson in what can be achieved when the pressure is on.

The survey underlines this overnight change. Finance directors say their teams went from being broadly in the office for 90% of the time to only averaging around 10% of their time in the office. Directors estimate teams now spend about 25% of their time in the office – although the picture varies from organisation to organisation.

But there is a clear feeling that the eventual steady state will be a hybrid model, with staff splitting their time between office and home. People cited different possible models – three days in and two days at home, or vice versa, for example.

There are clearly pros and cons. There were differing views on whether productivity was better or worse when working at home. But there was a consensus on the benefits of reducing commuting time and improving work-life balance, albeit recognising that working from home can make it difficult to separate work and home life. And some people simply do not have a suitable ‘home office’ environment to work from.

One of the clear challenges of working from home is the reduced opportunity to interact with colleagues and clinical teams – the loss of ‘corridor conversations’ or being on hand to support clinical teams.

There have been calls for finance staff to improve their knowledge of the ‘business’ of healthcare. How can they do that if they are one step further removed from the frontline?

Clinical-financial engagement is already vital – from budgetary control, to the delivery of efficiencies, the development of business cases and establishing robust patient-level costs. This will become even more important as a greater level of financial control is exerted while the service looks to meet high levels of emergency demand and address an intimidating elective backlog.

So the new hybrid model of working will have to find ways to retain this engagement. In fact, engagement will need to increase.

The move to population health management and the need to address health inequalities will also put a focus on data. Finance practitioners will be relied on to help clinicians understand where the opportunities for improvement lie, and the costs and value associated with different plans of action.

Online meetings have been a revelation, helping to keep teams together and, according to some reports, enhancing team spirit. But they do not work in all circumstances.

The One NHS Finance team, through the Future-Focused Finance programme, is leading work around hybrid working models. This is important – sharing experience and good practice  will be vital as NHS finance teams look to find the right balance.