Feature / Development plan

With the revised commissioning structure in place next month, a new HFMA programme aims to support the development of commissioning finance leaders


Most clinical commissioning group chief financial officers have been recruited and will now be gearing up for their 1 April launch. While they will be experienced finance professionals with strong technical abilities, the new commissioning landscape means they will need new skills. The HFMA is developing training to meet this need.

The training programme has two elements – a core module and a series of optional master classes (see box). In January, senior commissioning finance staff in the Wessex area were the first to benefit from the core module training (pictured). The day-long event included local and national updates from commissioners and providers together with workshop sessions looking at how commissioning would operate in Wessex and exploring how different bodies could collaborate.

Wessex Area finance director Mark Orchard says he has been developing the network among the nine CCGs (eight CFOs – one is a joint appointment) since his appointment last year. But this was the first time he had been able to get everyone together in one room with his newly formed area team senior appointments.

The CFO network will help deliver the training and professional development of commissioning finance staff, Mr Orchard says,? and he will be looking to the HFMA and others to assist with this.? Also, he will work with CCG accountable officers to agree the training required, some of which could be provided across the region – by bringing together individuals with similar development needs.

The Wessex CFOs are a mix of former PCT finance directors and deputy finance directors. ‘They are all experienced individuals having been finance directors or very senior and experienced deputies. Each will have individual development needs – after all, CCGs are brand new entities and very different to PCTs – and as a spin-off from this particular session we may look at how we do things like pairing up and mentoring,’ he says.

The CFO job will be very different from that of a PCT finance director, Mr Orchard says. They are new roles in new organisations that are clinically led. ‘I am impressed by the level of clinical engagement across the patch. CFOs will need different skill sets,’ he says. ‘They will need to be facilitators for change, consulting with the clinical body before making decisions, as opposed to the PCT finance director who needed more directive skills.’ Mr Orchard says that the number of executive posts on CCG governing bodies will be smaller generally than PCTs, which means only two or three board-level posts, including the CFO, may be driving the organisation forward on a day-to-day basis. This compares with five to seven executive posts in PCTs generally.? He adds that there has been a shift in exposure to financial risk, making the CFO post more demanding in terms of delivering financial balance. PCTs have a large commissioning portfolio allowing them to balance their financial risk in less predictable or difficult to manage areas, such as acute commissioning and continuing healthcare.

‘CCGs have more risky portfolios because they don't have the more predictable areas such as primary care and public health, allowing PCTs to balance their risks,’ says Mr Orchard. ‘However, CCGs still have acute commissioning and continuing healthcare, where it can be difficult to manage demand and cost.’

He describes the January event as ‘time out to agree how we do business’. As well as developing a narrative on training, it has strengthened connections between senior commissioning finance staff locally – both with each other and the area team. Senior members of his team were present and he sees them as an integral part of the relationship with the commissioning CFOs.

‘We are not always going to agree, but the relationships are there, so I am confident that we will be able to take things forward,’ he says. ‘I took a lot of pride and comfort from the day. I am in a privileged position that we have eight fantastically experienced and talented individuals as CCG CFOs – that came out clearly from the quality of discussion and debate.’