Comment / Twin challenges

The NHS is now at the stage of bringing the 2021/22 financial year to a close, while looking forward to the clear challenges that await us in 2022/23.

The financial challenge ahead will continue to be influenced by Covid as the pandemic moves towards being endemic. Covid hospitalisations are expected to reduce, although the pace of this reduction is likely to be patchy across the UK. However, it is clear that the virus will continue to have an impact on direct costs – as a result of personal protective equipment and testing – and on performance, as a result of changes to pathways and flow to facilitate infection prevention and control.

So it is essential that we work to understand additional Covid-19 costs and how to ‘reset’ the system. How do we deliver efficiencies in a system where costs have significantly and permanently changed? And how do we manage service expectations, as all nations will be subject to much tighter finances?

In early February, the Department of Health and Social Care published a white paper on the integration of health and social care in England. Joining up care for people, places and populations sets out a vision to join up planning, commissioning and delivery across health and adult social care.

Its focus is on integrated working at a place level to encourage local planning to prioritise outcomes for local people through solutions developed across organisational boundaries.

The paper recognises the need for effective, and different, leadership within and across organisations, underpinned by clear accountability for delivery and financial responsibility.

The use of pooled and aligned budgets is expected to increase to facilitate integration across organisations.

This will be supported by investment and legislative change to encourage data sharing and shared digital approaches at system level.

There will also be greater flexibility in the sharing of the workforce and the transfer of staff between health and social care settings, with a focus on integrated workforce planning at a place level.

Each nation has taken a different approach to working more seamlessly across NHS settings and improving links with the social care sector.

There remain opportunities to learn from the different arrangements and the HFMA is planning to produce a short paper setting out how each of the four nations has approached integration across the NHS and social care.

The paper, which should be published in the early summer, will share learning and highlight the different methods employed.

The past two years have also created challenges for the association, particularly at the outset of the pandemic. These have now stabilised, thanks to the amazing work of our staff team and the support of branches. So now is the time for us to look to the future with a refresh of our strategy.

With this in mind, the trustees have agreed to look at our services and plans across a range of headings: membership; policy and research; education and training; and managing ourselves as a business.

We will particularly look at how the association can adapt its offering to meet the changing needs of our membership, following the provision of free membership to all band 2 to 6 finance staff from the beginning of 2022.

We are delighted with the response to date, with almost 1,200 new members as of February, and we are determined to meet the needs of our new members.

The refreshed strategy will be developed in the coming months, with publication planned for the summer.