News / HFMA outlines top priorities as survey reveals FD concerns

The HFMA has called for a focus on five areas to ensure the NHS remains clinically, financially and operationally sustainable.

Publishing the results of its first financial health check, a survey of 188 finance directors from NHS organisations in England, the HFMA said savings were becoming harder to achieve and resources continued to be squeezed.

It was clear the determination of the service to at least maintain quality was manifesting itself as deficits in an increasing number of organisations, including some that had not experienced financial difficulties before. Taking into account the comments made by survey respondents, it suggested five areas of focus for the NHS:

• Making faster progress on large transformation schemes?
• Having an open and honest debate with the public and government about the financial challenges facing the NHS?
• Utilising the expertise and skills of NHS financial staff to support much needed change
• Creating solid foundations for the better care fund so that it achieves its aims?
• Focusing on obtaining the maximum value for every pound spent in the NHS.

Paul Briddock, director of policy at the HFMA (Pictured), said: ‘Resources are being stretched and although many NHS organisations have just got by, we have seen an increasing number of them report a deficit last year.

‘We are seeing financial problems materialise in organisations that have previously been financially stable. If all things stay equal, the financial outlook looks increasingly challenging, but despite this, it is encouraging to see that finance directors do not see quality deteriorating. In fact, many think quality will improve.’

The NHS Financial Temperature Check report said that, despite tight finances, 39% of finance directors believed the quality of services would improve over the next few years, while 53% expected it to be maintained at current levels.

Finance directors insisted the pace of transformation must pick up and called for an honest debate between the NHS, public and politicians about the need for change.

‘It is clear that the future success of the NHS depends on the clinically led transformation of services, with support from managers and finance staff.

‘Finance directors are clear that this transformation needs to happen faster and we all need to work together to make this happen effectively,’ Mr Briddock said.

The survey showed evidence of growing financial pressure. The number of organisations overspending or reporting a deficit has increased since the 2012/13 financial year and more organisations than planned reported an actual deficit at the beginning of the current financial year.

While more than a third (36%) of provider directors were confident of hitting financial targets for 2014/15, 20% were not confident and 44% said it was too early to say.

Chief finance officers in CCGs were more positive – 54% were confident of meeting their financial targets, 21% were not confident and 25% said it was too early to say.

However, directors were worried about 2015/16 and there was concern about the impact of the better care fund. Just 12% of provider trusts and 25% of CCGs are confident their financial targets will be achieved in that year.

Siva Anandaciva, the Foundation Trust Network head of analysis, said more providers were in deficit and the aggregate deficit was growing as trusts meet the costs of increasing demand for services and additional staffing.

‘It is unsustainable for NHS providers to keep absorbing cost pressures by going into deficit or by cutting surpluses that would otherwise be used to improve patient services,’ he said. ‘If we are to avoid the sector falling further into deficit at the end of 2014/15 we need a funding and payment strategy that better matches the reality of what providers are being asked to deliver.’