Comment / Food for thought

Recent news coverage focused on standards of hospital food. Slow news day or a real hot potato? The hospital food debate is as old as the NHS itself, but it was good to see that County Durham and Darlington NHS Foundation Trust, whose chief executive is last year’s HFMA president, Sue Jacques, was being held up as an organisation that can get the quality and choice right for patients, delivered reliably and at economic cost.

In the report I saw, County Durham and Darlington staff explained the need to deliver food three times a day, seven days a week and the challenges that brings. And catering staff in all hospitals will know that if you get it wrong, patients notice very quickly and are quite happy to say so.

It is interesting to contrast that report with stories earlier in August relating to seven-day services. Coverage about that seemed to suggest that patients worry less about the seniority of clinical staff on duty each day to provide care. 

The high-level aspiration for seven-day services – providing a uniformly high-quality service whenever a patient is admitted or treated – is universally accepted. But the potential implications are less well understood. Seven-day services may well require different business models in some settings – greater concentration of services in specialist centres, for example. There is a disconnect here – in a way that doesn’t exist with hospital food – and the onus is on clinical and managerial leaders to provide the compelling arguments for why we need these new ways of working. Failure to do so will result in more than cold or mediocre food.

The finance community has a major part to play in the transformation agenda. The challenge is better services within a defined budget. Better services are what drive us, but understanding the costs and the cost benefits are also crucial to getting the reforms right. And we have a major role in ensuring the mechanics support the overarching goal.

That means robust costing and payment systems that support better outcomes. It also means providing our expert input to allocation reforms and governance changes.

However, simple statements about the need for transformation tend to mask the fact that reform will need complex solutions and detailed planning. What data do we need to collect? How do we collect it? How do ensure consistency across the service?

We also need to get better at sharing. Many health systems have created innovative local arrangements to address local challenges. We now need to bring these approaches out into the open and examine their wider applicability.

The HFMA, which has strong and trusted links with the key stakeholders, gives us the perfect channel to do this. Equally, we need to help identify where things aren’t working. If you believe you have something the system needs to know about, then let me know about it. 

And perhaps most important, we need to become expert at explaining the need and rationale for system changes. We all agree that patients need to be at the heart of reformed services, but they also need to be the focus for our communication strategies too.

You will have seen elsewhere in this magazine the appointment of Paul Briddock as the association’s new director of policy. Paul, currently at Chesterfield Royal NHS Foundation Trust, is a highly experienced finance director and his appointment is key, given the significant role for finance in the current agenda.