Feature / Support plans
We address those topics through a range of different outputs, including our traditional briefings, consultation responses, webinars and conferences, blogs and articles – and the most recent addition to our portfolio of activities – the HFMAtalk podcast.
We recognise that the volume of relevant guidance issued by NHS England and NHS Improvement, the accountancy institutes and the thinktanks is vast and that our briefings contribute to the length of your reading lists. Our overall aim is to produce short and timely outputs in a range of formats that summarise topical financial and governance issues and provide practical guidance for members.
When considering the topics for our work programme, there are a few things we keep in mind, including whether it meets the needs of members or would benefit from joint work with a partner organisation.
During the year ahead there will be no shortage of areas for us to focus on. As usual, we will keep some flexibility within the programme, but summarised here are the areas that are already top of the list to tackle.
Post-pandemic
Reset, restore and recovery are three words being used to describe what needs to happen to the NHS as a result of the Covid-19 pandemic. Whatever your preferred r word, there is a role for finance staff.
From an NHS finance perspective, there have been huge temporary changes to the financial regime. In some ways, the pandemic gave a welcome break from traditional concerns about the financial position, but that won’t last. As we move back to more traditional financial flows, we must continue to keep what worked well – for example, a simpler financial regime, increased collaboration and faster pace of change. We will look at how we can best help members to support their organisations to restore services in the months and years ahead, and learn from what has been working well.
Integrated care systems
At the same time as post-pandemic recovery, the NHS faces structural change. Assuming legislation progresses as planned, in April 2022 we will see the demise of clinical commissioning groups, with integrated care systems (ICSs) established as statutory bodies.
There is a lot to do to set up appropriate governance and financial arrangements at system and place level. While some systems are quite advanced in their thinking, others have a way to go. The statutory ICSs will be complex organisations, with a statutory ICS NHS body taking on overall system leadership, supported by an ICS health and care partnership (perhaps in the form of a statutory committee). With the support of the HFMA’s System Finance Special Interest Group, we will provide guidance to members on the transition to these bodies and share good practice to avoid reinventing the wheel. We’ll be thinking about the role of provider collaboratives, primary care networks and local authorities – all key to supporting proper integration.
And we will also be looking to support CCG finance colleagues as they transition into new roles. We have delayed our biennial report, The NHS finance function, until next year, with the Skills Development Network census being carried out at the end of June 2022.
This will give us a timely view of the impact of the structural changes on the shape of the finance function just a few months after their creation. While there will be a delay in the production of our provider diversity metrics, during 2021/22 we will continue our work on diversity and inclusion, most notably with a new HFMA award (see news, page 5). And we will continue our sector-specific work on mental health and community services.
Health inequalities, prevention and population health
For many years we have talked about health inequalities and preventing ill health. Covid-19 has brought these issues into sharp relief. The role of finance staff in determining the benefits of investing in prevention to tackle health inequalities will be a key focus for the HFMA during the year ahead. We’ll be looking at why these issues are important, how finance staff can help and making the case for investment.
Delivering value with digital
Even before the pandemic, the NHS was facing increasing demand. But Covid-19 has compounded the situation. One solution is increasing the use of digital healthcare, including digital medicine, genomics, artificial intelligence and robotics. These technologies can enable people to manage their own care, predict individual disease risk and personalise the management of long-term care. This can also reduce waste and improve value.
But there are challenges for finance staff. How do you make the case for investment and measure success? We will explore any financial barriers and how they can be overcome. Our work will begin with a short guide for finance on digital technology and the language used.
Financial reporting
We will continue to support members in the production of the annual report and accounts and monthly financial reports. During the summer, we will conduct a 2020/21 year-end survey to learn lessons for next year. And we will support members in meeting the requirements of the IFRS16 accounting standard on leases, which will finally come into effect from 1 April 2022.
We are also planning to focus on how to improve NHS board reporting – what financial information do boards need and how reports can be made easier to understand.
Governance and audit
Our prime governance focus will be on setting up the new statutory ICSs. But we will also continue to monitor the external audit market. Earlier this year, we raised concerns that some NHS organisations were struggling to appoint an external auditor, in part due to regulatory pressures in the auditing profession. Changes have since been proposed for managing local government audits and this will have an impact on NHS audits. We will ensure members’ audit market concerns are aired and explore practical options to ensure a smooth audit process.
Environmental sustainability
2020’s Delivering a net zero NHS report sets out initial thoughts on how to reach the targets of providing net-zero carbon care by 2040 and zero emissions across the entire NHS by 2045. This implies a rapid decarbonisation of NHS activities and we will explore how to embed sustainability within NHS decision-making, focusing on the role of the finance function.
Value and costing
Our work on value and efficiency will continue to form an important part of our programme. This year we will be focusing on the proposal to move to more frequent cost collection, why costing remains important in light of changes to the payment system and improving value at system level.
Communication is a key part of the success of our work and whether it has impact. Since the beginning of the pandemic, we have changed our offering to members. Healthcare Finance has turned into a quarterly printed publication with less of a focus on news stories. The Friday Healthcare Finance weekly email highlights enhanced online news coverage as well as the popular news alerts, while providing links to new briefings, podcasts and blogs.
Over the summer, we will be asking for your views on how we communicate with you and this will cover our emails, the myHFMAapp, the HFMA website as well as Healthcare Finance. We’d be really grateful if you could spare the time to complete it as it will help to shape some changes over the next few months.
As usual, there will be plenty to keep the HFMA policy and technical team occupied during the year ahead. We will continue to flex our work to best meet the needs of members, so do please get in contact with me if you have any views on our plans.
Contact: [email protected]
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We are excited to bring you a fun packed Eastern Branch Conference in 2025 over three days.
This event is for those that will benefit from an overview of costing in the NHS or those new to costing and will cover why we cost and the processes.