Systems: beyond the theory?

The beginning of May finds the NHS well into the audit season – and auditors and final accounts will soon be long forgotten. But before we move on, we shouldn’t forget the professionalism of NHS finance teams, which largely produce their statutory accounts within three weeks of the year end.  I doubt there are many £150bn concerns that can do that.

In recent weeks, the control total system, and some of its perverse incentives, has rightly come in for a bit of criticism. 

However, it doesn’t take a genius to work out that the control system is flawed in the long term. It was merely an expedient short-term measure that is now being phased out.  The move to system-based control totals – sitting across sustainability and transformation partnerships or integrated care systems – is a more useful concept. But, of course, a number in a spreadsheet does not itself change behaviours. 

Successful management of system finances will need to be accompanied by effective mechanisms to ensure all parts of the system play their part in solving problems and improving care for our patients.

The escalating borrowing requirement of many providers is a by-product of the challenging financial environment they have operated in over the last five years. The idea of trusts borrowing money to pay interest and balance sheets with negative net assets are difficult for our profession to comprehend never mind the public. Tackling these issues will need to form part of the financial architecture as we move forward.

The HFMA has been similarly busy supporting us during a busy time of year, with accounts planning sessions and a costing conference helping prepare practitioners for the upcoming cost collection.

We have the Healthcare Costing for Value Institute’s value summit during May, which will focus on showcasing examples of collaboration between clinicians and finance teams across the country.

You may have also seen the announcement of plans to launch HFMA apprenticeships that combine the first stages of a professional accountancy qualification with our health sector-tailored HFMA education material. 

Look out for more information shortly about this exciting development, which will allow our finance teams to access the apprenticeship levy for personal development.

My comments last month about the timing of Brexit were a bit tongue in cheek, but we are not much clearer on when or if Brexit will happen. 

I suspect that there will be a big push to avoid the need for European elections with yet another Parliamentary vote on the deal.

But I wouldn’t be surprised if there is more mileage in this saga yet that will keep us entertained over the summer months ahead.

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