Comment / Summer blues

Long gone are the days when the summer brought a well-earned respite in the intensity of workload. With the accounts filed and costing returns out of the way, summer was often an opportunity to regroup.

But the finance agenda and the endless deadlines have meant there’s been no time to catch our breath.

If anything, the workload has increased, with finance teams being pushed to the maximum. The ‘reset’, unveiled at the end of July, looks suspiciously like a further step back towards command and control. The centre is taking an unprecedented interest in the detail of our operations.

The scrutiny on providers’ waiting list payments is the latest example in a list of areas where the regulator is casting an inquisitive eye.This is both regrettable and understandable. The desire to get a grip on the finances is clear and the Department of Health cannot afford to steer as close to the expenditure limit as it did in 2015/16.

But the problem cannot be micromanaged, with unrelenting requests for data and permission having to be sought for the smallest decisions. The service needs the space and time to deliver.

The challenge facing many providers is stark. If they don’t stay on their set financial trajectories and meet their access targets, they will not receive the sustainability funding fundamental to achieving their ambitious control totals. They are not only caught between a rock and a hard place, but the gap is being narrowed and they are in danger of being crushed.

Perhaps the silver lining of the reset is that it brings all the requirements on the NHS into one place – and makes it clear commissioners and providers share the responsibility for delivery.

For some footprint areas, it has taken this strong push to finally get parties in the same room – although there are still issues in some places.

The ‘quieter’ summer period also saw system leaders present tariff proposals for 2017/18 and, crucially, 2018/19. Understanding the implications of these proposals is key. With earlier deadlines for financial planning, contract negotiating and identifying savings and the need to work through STP plans, it is clear we are going to be truly tested from September.

I hope that, where members have managed a short summer break, they have come back completely refreshed as they will need all their energy and ability.

And we should not forget another ‘ask’ in relation to sharing back-office services including finance. There can be no special treatment for any services. If activities can be delivered as well or better for less, that is what should happen. However, corporate functions such as finance and human resources are already hard pressed – and Carter and transformation will only increase the workload on these key professions.

This isn’t to say we won’t or shouldn’t look into this. But we just need to ensure we get the priorities right and keep our eyes on the bigger prize.We need to be clear shared back-office services can deliver quality services and financial savings, and that those savings are worth distracting our teams away from a vital broader agenda.

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