Comment / Poll position

The expected 2015 general election is just 13 months way.  Normally, the year preceding an election is a time of inactivity in terms of major decision-making about the NHS. This can mean a period of frustrating inactivity within the service. However, I think this time will have to be different and indeed will be different. And we, as NHS finance professionals, must play our part in making this happen.

The current context makes change imperative.

We are all aware that a number of provider trusts are currently under ‘special measures’ and that the health secretary is driving forward the potential ‘solutions’ to these challenged organisations. 

Once these solutions have been identified, I would not be surprised to see finance professionals and other colleagues challenged – along with the political players – to ensure that the election doesn’t introduce damaging delays to necessary change.

What we need to remember is that the changes – both in very challenged organisations and across all health economies – are about doing the right thing for patients.

Finance professionals need to take a leading role in identifying potential solutions and then in supporting implementation. We can help assess the options, including current service provision, and help examine the relative value (based on outcomes and costs) of different approaches. Then we can help ensure that costs and benefits are tracked and projects and programmes stay on budget and deliver.

The fact that we approach this general election with a coalition administration also puts a different slant on the run-in. We will see members from different sides of the coalition – as well as the opposition parties – start to identify their differing positions in relation to the NHS. 

The association’s role is not to take sides. Its members are likely to reflect the make-up of the electorate in general and share differing views about the current and future direction of the service. But the association can play a part in helping to ensure the debate is well informed and remains fact-based.

It can also help to keep the focus on how we meet the challenges. These challenges – meeting the demands of an ageing population with higher prevalence of long-term conditions – face all health systems across the developed world. All political parties need to set out how they will meet them, rather than simply protecting the status quo.

The next 12 months will also, I am sure, see an inevitable debate around the size of NHS funding in the future. The finance profession and the HFMA are, I believe, in a unique position to be able to contribute to that debate. It is imperative that we do so on behalf of our members. After all, finance staff know better than most just how financially demanding the challenges could be.

We know what a flat settlement means for budgets, we are very aware of acute pressures that could materialise with the better care fund and we are also well placed to understand the realistic potential for efficiency improvement, both from traditional productivity gains and from service redesign.

The countdown to the election cannot be a period of standstill for the NHS. Equally, it needs to be a period where finance professionals come to the fore. It will inevitably add to uncertainty and probably make change more difficult. But we need to rise to the challenge, pick up the additional workload and demonstrate that we really can ‘Lead by numbers’.