HFMA 2017: Medical directors should lead on value

Paul Buss, medical director of Aneurin Bevan University Health Board in Wales, said there was an urgent need to move to value-based healthcare across the NHS. This meant taking decisions based on, and informed by, outcomes that mattered to patients and an understanding of the costs.

Dr Buss, who was named HFMA Working with Finance – Clinician of the Year at an awards ceremony during the conference, said the move would help accelerate the adoption of value principles.

'My prescription for a healthy NHS would be to have a chief value officer in every foundation trust and integrated health board,' he told the conference. He said appointing medical directors to these roles would be 'symbolic', but was also 'vital' in changing clinical behaviours.

He said that clinicians had traditionally seen finance and costs as 'someone else's responsibility' and this had to change.

Patient-level cost data and time driven activity-based costs provided ways of analysing clinical activity and showing the financial implications of clinical variation. 'When you look at costing data, you see patterns of clinical practice. How? Why? What kit are you using?'

He said that clinicians' professional fear of being scrutinised by data would need to be overcome. 'But this is where we need to go to obtain value,' he said.

Aneurin Bevan is a leader in value-based approaches within the UK health service and has collected outcome data in multiple areas to inform decision making alongside detailed cost data.