Briefing / Improving NHS financial sustainability: are you getting the basics right?

Since March 2020, NHS organisations have been focused on the operational management of the Covid-19 pandemic. This, coupled with the temporary financial regime and additional funding, meant efficiency requirements were put on hold. Now there is a renewed focus on improving financial sustainability and a need to regain financial grip, while still balancing the competing priorities from operational activity, workforce demands and recovery from Covid-19.  

This self-assessment is intended to help finance teams to think about the core elements that should be in place to support board assurance over an NHS organisation’s financial sustainability. 

This assessment is divided into two parts.

1. Initial self-assessment - a small number of statements to prompt thinking about how arrangements work, or should work, in practice. It is intended to provide a quick assessment of the relative maturity of the organisation’s arrangements for financial sustainability and provide an indication of where further work is required. 
2. Detailed checklist – a more detailed list of questions linked to the initial self-assessment. It is not a comprehensive list of all the factors that need considering - it focuses on those areas most likely to have an impact on financial sustainability.  

The checklist is not designed to be a simple ’tick-box’ exercise, but rather for consideration of the question; both in terms of whether the arrangement is in place, but also if that arrangement is working effectively.  

It is intended to prompt an honest assessment of the arrangements as they stand and provide a focus for further work. It is for each organisation to decide how they will use it. 

The document is also available in Microsoft Word and Microsoft Excel formats.