Comment / World stage

It’s been a bit of an international month for the association. In mid-June, the HFMA hosted a study programme for colleagues from Australia – the return leg after a visit from some UK members in November last year, led by Tony Whitfield, HFMA’s president at the time. A big thank you to all the UK members up and down the country who helped the Australians feel so at home. We were pleased they learned so much and, in turn, this has helped us shape our plans for a further trip to Australia in November. If you would like more details, please get in touch.

I’m writing this column from the HFMA USA’s annual national institute meeting in Las Vegas – HFMA USA’s equivalent of our annual conference – where I’m accompanying Andy Hardy representing the UK. We may not have been doing too well in the football – I was getting some considerable stick from my US colleagues – but in the serious business of healthcare, we can claim to be doing somewhat better.

A recent report for the Commonwealth Fund puts the UK first in eight out of 11 measures and first overall. This may be a very high-level assessment, but the US’s last place on efficiency is hard to argue against. But what you realise in the US is that its health service incorporates systems that demonstrate a huge range in performance and approaches. At its best is the HFMA US’s recognition of the value agenda, which we have been following over the past four years.

The most interesting presentation this week has been from Harvard professor Dr Atul Gwande, who talked about the delicate balance between improving quality, managing risk, measuring performance and managing cost. To an audience of not unalloyed fans of the Affordable Care Act or Obamacare, he asserted: ‘The debate about whether to provide coverage for healthcare needs is over.’ I’m not certain that is true, talking to US colleagues, but perhaps they are moving more towards the idea of universal healthcare. Certainly in the UK, that link between healthcare and ability to pay has not been an issue since 1948 – one of the most decent things this country has ever done.

Dr Gwande also talked about the US delivery system being broken and the need for change. His main contention was that focusing on the sickest will produce the best benefits. We know it’s the frequent users of accident and emergency units who need joined- up, top-quality interventions to give them the right care and keep them out of the system.

His final point was on strength of data and how organisations need to be data-driven to enable trends to be identified and to track patients through the system in a more personalised way. I don’t think anyone in the UK system(s) would disagree with this – it is at the heart of many organisations’ strategies to increase quality and reduce expenditure.

We have a lot in common with our US cousins and a lot to learn from each other as we face common challenges. So, 50 years after Reginald Stacey (chair 1962/63) first addressed the American conference in June 1964, it is great to see Andy Hardy continuing the tradition by updating US finance professionals on our progress. We may not be very good at football, but we have a lot to be proud of with our NHS. And I’m glad we have the opportunity to share this on an international stage.