Making the money work in the health and care system

PwC and HFMA

01 June 2018


The HFMA has worked in conjunction with PwC to explore how financial flows could be redesigned to find a better way to make money work in the health and care system. The research sets out why change is necessary and proposes a number of radical financial reforms so that benefits to patients are maximised and resources are put to their most effective use.

The report sets out why the current complex system of funding flows do not support the proposed new models of more integrated care introduced in the Five-year forward view and therefore need to change. In a survey carried out to support the research, some 76% of HFMA members think that the current financial structures in the NHS are not fit for purpose.

The report sets out why the way the money flows around the NHS needs to change and proposes that:

  • Financial flows should be aligned with the emerging place based architecture
  • Systems should be provided with more clarity through longer-term funding
  • Money should be focused towards achieving better outcomes.

A number of detailed recommendations are made covering both long and short term, including the restructuring of debt, system-wide control totals, the capital regime, certainty over long-term funding and outcome based payment systems.


Making the money work in the health and care system

June 2018 (PDF 1407KB)