Briefing / The role of the NHS chief finance officer

Draft statement

25 June 2024 Lisa Robertson Sarah Day
1 CPD hour

NHS chief finance officers (CFOs) are at the heart of organisations’ management structures.  With huge pressure on public finances, the CFO’s role is more challenging and demanding than ever.

The statement provides an analysis of what the role involves, covering the following key CFO attributes: values; qualifications, experience and practical skills; personal characteristics; and key roles.

Although it is written from the perspective of the NHS in England the principles set out apply equally to CFOs working in Northern Ireland, Scotland and Wales.

This draft statement supersedes the one that the HFMA issued in 2017, including a new section on the role of the CFO in partnership working, and takes account of other relevant guidance issued since then. The draft statement will be finalised at the end July 2024 and the HFMA welcomes any comments for consideration to be sent to [email protected].


In particular we welcome feedback on the following questions:  

  • Do you agree with the four essential key attributes: values; qualifications, experience and practical skills; personal characteristics; and key roles?
  • Do you have any comments on the six key roles outlined in the draft statement?
  • In your experience, does the new role 6: working with partners, accurately describe the role of the CFO in system working? 
  • Are there any further example activities to be included in appendix 2? 

Why we are issuing this statement 

NHS chief finance officers (CFOs) – also called finance directors or directors of finance – are at the heart of organisations’ management structures. CFOs play a key role in efficiently delivering safe, effective and economically sustainable services providing strategic focus, corporate management, decision-making and leadership. They also have responsibility for setting an organisation’s overall ‘financial tone’ and for establishing a culture that encourages partnership working, innovation, the achievement of quality and value for money while ensuring that public money is used wisely, safely and well. 

CFOs can have a real impact on patient care by ensuring that patients’ interests are at the centre of decision taking and developing innovative financial arrangements to support healthcare improvements, enabling swift and appropriate treatments that are right first time so that unnecessary admissions and re-admissions are avoided.

As well as being able to demonstrate strong leadership skills from a financial and corporate perspective, existing and potential CFOs must know their businesses thoroughly and understand the wider environment within which they operate. They must also be able to think strategically, communicate effectively with a wide variety of stakeholders and be prepared to work collaboratively across boundaries with a sound appreciation of the collective challenges and priorities that face them and their local health systems.

With huge pressure on public finances, the CFO’s role is currently even more challenging and demanding. To be successful he or she must possess excellent technical skills, the strength of character to stand by decisions and cope with heightened levels of regulator and media scrutiny and public interest. This requires an ability to remain clear headed and objective when making decisions about competing demands for scarce financial resources.

About this statement


This statement focuses on the skills and values that all CFOs working in the NHS should possess and the core activities that they carry out. It deliberately identifies generic tasks without reference (as far as possible) to ‘topical’ policies and processes. The principles of this statement are applicable to both CFOs holding board positions and those who do not work directly with an NHS board, for example, those who lead and form part of the arm’s length bodies’ finance teams.

The statement’s primary aim is to provide existing and aspiring CFOs with an authoritative but concise analysis of what the role involves, the skills and values they need and the part they play in ensuring the success of an NHS organisation while providing a world class finance service in a period of unprecedented challenge and change. Individuals can also use it to assess their personal development needs and influence the way that their role evolves.

The statement will also be helpful in informing others about the role – for example, it will help chairs, board members and other stakeholders to better understand what the CFO does and why they are critical to the success of an NHS organisation. Although it is written from the perspective of the NHS in England the principles set out apply equally to CFOs working in Northern Ireland, Scotland and Wales.


This draft statement supersedes the one that the HFMA issued in 2017 and takes account of other relevant guidance issued since then. The draft statement will be finalised at the end July 2024 and the HFMA welcomes any comments for consideration to be sent to [email protected]

We hope that the statement will remain relevant and helpful for some time to come but will keep it under review and update it as and when necessary. 

What being a chief finance officer involves

The CFO role has always been challenging and is becoming more so in the current financial climate. The introduction of system working and the management of system financial envelopes, has added an extra level of complexity into a role that was already multi-faceted. Responsibilities are varied, ranging from statutory duties relating to accountability, governance and probity; ‘traditional’ treasurer activities; corporate strategic management; day-to-day operational management; and stewardship of public sector resources. 

In many ways, the role of the NHS CFO mirrors that of CFOs in large commercial organisations – as well as fulfilling their traditional financial accounting and control role, they are expected to be effective board members. 

CFOs must ensure that finances are used well and are focused on delivering objectives; that investment plans are analysed thoroughly and properly and that the finance function adds value to the organisation. Of particular importance is the need to maintain financial viability and focus on delivering ever increasing value for patients via a financially sustainable local health system. In addition, best value for taxpayers must be delivered while meeting the overall objective of the NHS to deliver safe high-quality healthcare. As all members of the board are equally responsible for all aspects of performance, CFOs are also responsible for the quality of care provided.

The relative balance of activities within a particular CFO’s role will vary according to the size, type and structure of the organisation they work for and the skills and experiences of other members of the board and management team. The CFO often has a wide portfolio taking in areas outside their immediate technical expertise – for example, information technology or estates. Therefore, the range and depth of competencies required will depend on the specific circumstances and job content.

As well as local considerations, the role changes continually as new policies, services, organisational structures and processes are introduced. Change goes with the territory and inevitably affects the day-to-day activities of an NHS CFO. As a result, they must be:

  • effective leaders: playing a full, active and constructive part as a member of the board and executive/ management team and commanding respect across the organisation and the wider health and social care economy
  • resilient and clear headed: focusing on the statutory responsibility to safeguard public money while able to handle being in the spotlight. The CFO must always consider if something is actually affordable or whether better alternatives are available. There are times when the CFO simply has to say no, even when outvoted. It is vital to deliver an honest and true assessment of the financial position, even when this is not what anyone wants to hear - being ready and able to propose and implement tough actions, that may be unpopular within some parts of an organisation or the wider system. These qualities are particularly important given the ever-increasing politicisation of the service; the relentless attention of the media and heightened public and patient expectations
  • adaptable: able to anticipate and handle changes in circumstances and in the demands placed on them and assume other responsibilities as needed - for example, some CFOs may be leading service transformation programmes
  • far sighted: able to think long term and plan within and across organisational boundaries, supporting the wider system 
  • innovative: able to identify new and better ways of doing things for the benefit of the patient and being willing to take controlled and quantifiable risks without compromising quality
  • outward looking: receptive to new ways of working and able to develop and maintain good relationships with other organisations within the local health and care system
  • team players: able to see others’ perspectives and work with them for the good of the organisation or wider health economy while ensuring that colleagues understand the full financial implications of their plans and decisions
  • good role models: able to inspire loyalty and commitment amongst finance staff and others and establishing an environment in which staff can develop and achieve their full potential
  • highly motivated and passionate: even when delivering consistently difficult messages
  • technically competent: recognising the importance of maintaining and developing financial skills and competencies. In particular, being willing to acquire new skills and learn from others so that the finance function can meet challenges as they arise. 

Dealing with constant change while fulfilling a demanding role is challenging for anyone – however, the skills and experience of a typical CFO along with their values and personal attributes mean that he or she is well equipped to take things in their stride. 

Possessing the right values, skills and personal characteristics and being able to carry out the wide range of roles attached to the post are essential attributes for a good CFO. This statement therefore focuses on these four core areas: 

  • values
  • qualifications, experience and practical skills
  • personal characteristics
  • key roles.

Appendix 1 summarises the activities for each key role, with appendix 2 giving further details. 

Essential CFO attributes – values

Essential CFO attributes

First and foremost, the CFO must understand and support the principles and values of the NHS set out in the NHS constitution.Department of Health and Social Care, The NHS constitution for England, August 2023


  • the NHS provides a comprehensive service, available to all
  • access to NHS services is based on clinical need, not an individual’s ability to pay
  • the NHS aspires to the highest standards of excellence and professionalism
  • NHS services must reflect the needs and preferences of patients, their families and carers
  • the NHS works across organisational boundaries and in partnership with other organisations in the interests of patients, local communities and the wider population
  • the NHS is committed to providing best value for taxpayers’ money and the most effective, fair and sustainable use of finite resources
  • the NHS is accountable to the public, communities and patients that it serves.


  • working together for patients: Patients come first in everything we do. We fully involve patients, staff, families, carers, communities, and professionals inside and outside the NHS. We put the needs of patients and communities before organisational boundaries. We speak up when things go wrong.
  • respect and dignity: We value every person – whether patient, their families or carers, or staff – as an individual, respect their aspirations and commitments in life, and seek to understand their priorities, needs, abilities and limits. We take what others have to say seriously. We are honest and open about our point of view and what we can and cannot do.
  • commitment to quality of care: We earn the trust placed in us by insisting on quality and striving to get the basics of quality of care – safety, effectiveness and patient experience – right every time. We encourage and welcome feedback from patients, families, carers, staff and the public. We use this to improve the care we provide and build on our successes.
  • compassion: We ensure that compassion is central to the care we provide and respond with humanity and kindness to each person’s pain, distress, anxiety or need. We search for the things we can do, however small, to give comfort and relieve suffering. We find time for patients, their families and carers, as well as those we work alongside. We do not wait to be asked, because we care.
  • improving lives: We strive to improve health and wellbeing and people’s experiences of the NHS. We cherish excellence and professionalism wherever we find it – in the everyday things that make people’s lives better as much as in clinical practice, service improvements and innovation. We recognise that all have a part to play in making ourselves, patients and our communities healthier.
  • everyone counts: We maximise our resources for the benefit of the whole community, and make sure nobody is excluded, discriminated against or left behind. We accept that some people need more help, that difficult decisions have to be taken – and that when we waste resources we waste opportunities for others.

All these principles and values are reinforced by the duty of candour that requires all NHS staff and organisations to be honest, open and truthful in all their dealings with patients and the public. Introduced following the Francis Inquiry into the failings at Mid Staffordshire NHS Foundation Trust, the duty of candour is one of the Care Quality Commission’s (CQC) fundamental standards of quality and safety; it must be met by every provider on an on-going basis.

One NHS Finance has developed the NHS’ values into six underpinning values for the finance profession.One NHS Finance, NHS finance function: development strategy 2021-2026, September 2021 These values should be embedded within an organisation’s overall culture and tone and CFOs should uphold them in all that they do. The values are:

  • fair: we will be consistent and fair in the way our people are treated by creating a more inclusive environment and treating each other well
  • patient-focused: we will connect with the people and services we provide to improve quality and enable better decision-making
  • collaboration: we will collaborate across organisations, systems and nationally to share knowledge, ideas, experiences and solutions
  • innovation: we will harness the experience and ideas from our finance community to identify improvements in working practices and help to develop new ideas
  • inclusion: we will continuously strive to be better by nurturing and supporting all staff at each stage of their career. Our finance function will be a place where everyone feels comfortable bringing their authentic selves to work
  • accountability: we measure ourselves against the highest standards of integrity and fiscal responsibility and are responsible for our words, actions, and results.

Above all, finance staff, led by the CFO, should have a fierce pride in working to the highest possible standards. As the CFO depends on his or her team to deliver a professional service, it is also essential that there are sufficient finance staff with the necessary qualifications and experience. Good evidence of this is accreditation by One NHS Finance (ONF). Through the accreditation process, finance departments demonstrate their commitment to the development of finance skills across their workforce.

CFOs must also be aware of (and adhere to) a number of other codes and standards including those relating to disciplinary procedures set by their own professional accountancy bodies.

This includes the International code of ethics for professional accountants,IESBA, International code of ethics for professional accountants, September 2023 published by the International Ethics Standards Board for Accountants (IESBA). The Code’s introduction states that it:

 ‘sets out fundamental principles of ethics for professional accountants, reflecting the profession’s recognition of its public interest responsibility. These principles establish the standard of behaviour expected of a professional accountant.’

The Code establishes the five fundamental principles of integrity, objectivity, professional competence and due care, confidentiality and professional behaviour. 

The HFMA has its own ethical codeHFMA, Ethical code, 2022 for members that consists of fundamental principles which members are expected to apply and observe in the public interest, in order to build and promote confidence and the highest standards in the work of healthcare finance management. 

The HFMA has also published a briefing, Ethical standards: roles and responsibilities of the NHS accountant.HFMA, Ethical standards: roles and responsibilities of the NHS accountant, May 2024  

Also of importance are Nolan’s seven principles of public lifeCommittee on standards in public life, The seven principles of public life, May 1995 – selflessness; integrity; objectivity; accountability; openness; honesty; leadership. In addition, the CFO must be aware of and fully understand the fit and proper persons test. All NHS provider organisations have a duty not to appoint a person to an executive level post (including associate directors) or to a non-executive position unless they are judged to be a ‘fit and proper person’.

The assessment of a fit and proper person can be supported by the use of the NHS leadership competency framework for board membersNHS England, NHS leadership competency framework for board members, February 2024 which draws together the various guiding principles for operating at a senior level in the NHS.

Figure 1: Policy and guidance to support NHS leadership

Leadership competency framework

The six leadership domains set out in the leadership framework are:

  • driving high-quality and sustainable outcomes: The skills, knowledge and behaviours needed to deliver and bring about high quality and safe care and lasting change and improvement – from ensuring all staff are trained and well led, to fostering improvement and innovation which leads to better health and care outcomes.
  • setting strategy and delivering long-term transformation: The skills that need to be employed in strategy development and planning, and ensuring a system wide view, along with using intelligence from quality, performance, finance and workforce measures to feed into strategy development.
  • promoting equality and inclusion, and reducing health and workforce inequalities: The importance of continually reviewing plans and strategies to ensure their delivery leads to improved services and outcomes for all communities, narrows health and workforce inequalities, and promotes inclusion.
  • providing robust governance and assurance: The system of leadership accountability and the behaviours, values and standards that underpin our work as leaders. This domain also covers the principles of evaluation, the significance of evidence and assurance in decision making and ensuring patient safety, and the vital importance of collaboration on the board to drive delivery and improvement. 
  • creating a compassionate, just and positive culture: The skills and behaviours needed to develop great team and organisation cultures. This includes ensuring all staff and service users are listened to and heard, being respectful and challenging inappropriate behaviours.
  • building a trusted relationship with partners and communities: The need to collaborate, consult and co-produce with colleagues in neighbouring teams, providers and systems, people using services, our communities, and our workforce. Strengthening relationships and developing collaborative behaviours are key to the integrated care environment.

Essential CFO attributes – qualifications, experience and practical skills

Essential CFO attributes - qualifications, experience and practical skills

CFOs in the NHS must be qualified accountants who are members of either the Chartered Institute of Management Accountants (CIMA) or a member of one of the five accountancy institute members of the Consultative Committee of Accountancy Bodies:

  • Chartered Institute of Public Finance and Accountancy (CIPFA)
  • Institute of Chartered Accountants in England and Wales (ICAEW)
  • Institute of Chartered Accountants of Scotland (ICAS)
  • Institute of Chartered Accountants of Ireland (ICAI)
  • Association of Chartered Certified Accountants (ACCA).

To evidence a broader understanding of finance and managerial issues, a level 6 or 7 qualification, for example, a master’s degree in a relevant area is also desirable.

CFOs should also have experience across a wide range of the finance function’s responsibilities - for example, financial and management accounting; capital and investment appraisal; commissioning; financial performance management; budgeting/budgetary control; financial planning; costing/ financial analysis; financial systems; audit; payroll, and significant post-qualification experience holding senior positions in the public and/or private sector. 

As well as being suitably qualified and having relevant experience, CFOs need practical capabilities and technical knowledge. The National Finance Academy network identified the following practical skills and competencies as being particularly importantNational Finance Academy, NHS finance competencies, 2022:

  • communicating, influencing and negotiating 
  • team working and collaborating 
  • working across the system 
  • leading change and personal development 
  • being accountable 
  • solving problems and making decisions 
  • planning and organising 
  • challenging and innovating 
  • governance and managing risk 
  • using IT.

In addition, our members recognise the importance of relevant experience in terms of counter fraud, security management and procurement.

CFOs must also maintain and develop their knowledge and skills and stay abreast of emerging technologies and techniques. This is achieved both through participation in continuing professional development (CPD) and by other means - for example, by being an active member of the HFMA and/or their accountancy body. The precise requirements for CPD vary between accountancy bodies but all CFOs must participate in the relevant scheme and ensure that all their qualified staff and accounting technicians do the same. 

CFOs also have a responsibility for the future of the profession and a key role in helping to develop staff across their local areas.

Essential CFO attributes – personal characteristics

Essential CFO attributes - personal characteristics

In the introduction to this statement, we highlighted a number of character traits that today’s CFO needs to possess – resilience, adaptability and far sightedness. We also pointed out that he or she must be innovative, outward looking, an effective leader, team player and role model.

The NHS Leadership Academy has published Our leadership wayNHS Leadership Academy, Our leadership way, accessed June 2024 setting out six core principles for every leader at every level. It is designed to develop a respectful and inclusive leadership culture that will support staff and relationships across the health and care system.

  • we are compassionate
    •    we are inclusive, promote equality and diversity and challenge discrimination
    •    we are kind and treat people with compassion, courtesy and respect
  • we are curious
    •    we aim for the highest standards and seek to continually improve harnessing our ingenuity.
    •    we can be trusted to do what we promise
  • we are collaborative
    •    we collaborate, forming effective partnerships to achieve our common goals
    •    we celebrate success and support our people to be the best they can be.

System leadership is increasingly important and a CFO will need to understand the priorities of other statutory organisations as well as their own. Having done so, the CFO will need to recognise the priorities for the system as a whole and support or lead system-wide solutions. 

Understanding the system in organisational terms is important, but equally important is an understanding of how healthcare works in the wider economic, social and environmental systems. For example, if local decisions can improve air quality, the local NHS body will benefit from reduced admissions relating to chest and breathing difficulties. The CFO will make decisions that have the potential for either positive or negative impacts both on the local organisation and the wider economic, social and environmental systems.

The specific nature of a particular CFO’s role and the organisation’s style and approach will determine the relative importance of these qualities but all are needed to some degree. 

In practice, CFOs need to be able to respond to different situations using a variety of skills, behaviours and knowledge from across their competency ‘toolkit’. They also need to modify their behaviour and approach to suit new ways of working and to ensure continuing delivery of financial duties and other targets. 

Essential CFO attributes - key roles

Essential CFO attributes - key roles

In the HFMA’s view, a CFO’s core activities can be grouped under six broad headings: 

  • corporate leadership, management and decision-making
  • stewardship and accountability 
  • financial management
  • commercial skills
  • professional leadership and management
  • working with partners.

These headings are broadly consistent with the ‘core CFO responsibilities’ set out in CIPFA’s 2023 pan public sector statement – The role of the chief financial officer in public service organisations.CIPFA, The role of the chief financial officer in public service organisations, September 2023
In this section, we will look at each core role and:

  • explain why it is important
  • identify in broad terms what it involves.

Examples of key activities for each role are shown in appendix 2.

Role 1: corporate leadership, management and decision-making

Why this role is important

In all NHS organisations, the CFO must be a member of the board. The Treasury’s guide, Managing public moneyHM Treasury, Managing public money, May 2023 (which sets out good practice for all public services) explicitly states that the CFO should ‘have board status equivalent to other board members’ and that he/ she should be ‘a member of the senior leadership team...’. 

Although, in the NHS, ultimate statutory responsibility and accountability for financial duties rests with the accountable/ accounting officer,A formal role conferred upon the organisation’s ‘chief officer’ i.e. the chief executive. the CFO is integral to discharging those responsibilities and is often the next most senior manager on the board.

The board, management team, clinicians and others need to understand the financial implications of their strategic and service delivery plans and be aware of financial performance. It is the CFO who is responsible for meeting these needs and for providing support for strategic decision-making, financial leadership and guidance.

What this role involves

To be effective in this role, CFOs must earn the respect of their colleagues on the board/ management team by playing a full and constructive part in proceedings; balancing corporate and more ‘traditional’ finance responsibilities and ensuring that decisions are taken based on sound and thorough analyses. It is therefore important for the CFO to form a view and do their own thinking on all manner of issues in order to share their ideas, knowledge and opinion as needed.

Typically, this role involves:

  • contributing to the organisation’s overall management and leadership by playing a full, active and constructive part on the board and the executive/ management team and being a valued and well-respected member of each
  • playing a leading role in devising and implementing the organisation’s operational planning processes to ensure that strategic objectives are cascaded down to all levels and that plans are realistic and achievable
  • contributing to the development and maintenance of the organisation’s overall governance framework (including the development of effective controls, a robust and integrated approach to risk management and a meaningful assurance framework)
  • ensuring that the impact on the quality of healthcare services and patient safety is understood when reaching decisions in general and considering the associated financial implications in particular  
  • contributing to the development and maintenance of good relationships with all partners, internal and external stakeholders. This may include leading system change and requires an exceptional level of political astuteness alongside a wide perspective and a willingness and capacity to forge effective and durable relationships 
  • providing expertise and advice to the board and executive/ management team on finance related issues to support and facilitate effective strategic thinking and decision-making. This will include getting to the root cause of performance issues; providing advice relating to change management; business and commercial activities; financial strategy, planning and performance and investment appraisal
  • ensuring that the organisation’s finances are managed wisely and well and effectively deployed. CFOs are ‘moral guardians’ as they have the greatest influence in this regard.

This role is particularly challenging but no less vital for those CFOs who fulfil the role for more than one organisation and must manage competing priorities.

Role 2: stewardship and accountability 

Why this role is important

With regular change the norm in the NHS, there can be a tendency to focus on the demands of the latest policy announcement and lose sight of the need to safeguard resources, provide quality healthcare to meet demand and demonstrate probity. CFOs play a key role in ensuring that this does not happen. Although it is the accountable/accounting officer who is formally responsible for the ‘proper stewardship of public money and assets’ it is the CFO who has day-to-day responsibility in this area and who has a key role to play in demonstrating accountability to patients, the local public, the Public Accounts Committee and other stakeholders. Similarly, although statutory responsibility for internal control rests with the board and accountable/ accounting officer, the CFO is closely involved in providing assurance to stakeholders that effective controls are in place and working as they should. 

In short, CFOs must not lose sight of the fact that stewardship and accountability is a fundamental part of their role.

What this role involves

Typically, this role involves:

  • stewardship of public money – knowing the business thoroughly and demonstrating probity in the use of resources; ensuring that they are safeguarded at all times (through effective systems of control), that they are used wisely and well and in line with prevailing legislation, rules and regulations; ensuring that there is an effective approach to financial risk assessment and mitigation
  • being prepared to raise concerns/ report suspected fraudulent behaviour/ disclose irregularities in accordance with the Public Interest Disclosure Act 1998,The UK Government, Public Interest Disclosure Act 1998, 1998 states that a qualifying disclosure, and any allegation contained in it, must be substantially true. the Bribery Act 2010The Bribery Act 2010 makes it an offence to accept gifts or hospitality as an inducement or reward for doing something in a public role. It applies to both organisations and individuals and means that NHS bodies must ensure that they have in place adequate systems to prevent bribery. and other relevant guidance 
  • demonstrating accountability for the use of resources/ public money through meaningful financial reports that are fit for audience and purpose; an effective internal audit service that is valued and resourced properly; financial accounting that is rigorous and carried out in line with statutory and regulatory requirements; constructive working relationships with external auditors, regulators, inspection agencies and other stakeholders.

It is important to note that CFOs are responsible for the adequacy of the control environment irrespective of how financial services are provided. For example, CFOs in organisations that use shared services need to ensure that adequate safeguards exist in contracts to ensure that public funds are being used effectively and appropriately. Similarly, CFOs must ensure that sound financial systems and controls are in place to monitor ‘non-direct’ spending - for example, through contracts and personal health budgets, and ensure that resources are accounted for and spent properly. 

Role 3: financial management

Why this role is important

In The role of the chief financial officer in public service organisations,CIPFA, The role of the chief financial officer in public service organisations, September 202 CIPFA defined financial management as ‘the system by which financial resources are planned, directed, and controlled to enable and influence the efficient and effective delivery of public service goals’. It has also been described as the ‘engine room’ of the finance function and the area that has the greatest potential for adding value to the performance of NHS bodies. Effective financial management is therefore of critical importance and, although everyone in an organisation has a role to play in this area, it is the CFO who takes the lead – he/ she must ensure that the organisation’s approach suits its circumstances/ environment and is capable of supporting (and furthering) its strategic aims. A sound, consistent and transparent approach to financial management inspires confidence amongst staff and stakeholders and its relevance and importance should therefore be emphasised and championed by the CFO. 

What this role involves

Typically, this role involves:

  • championing financial management – ensuring that the importance of good financial management and what it means in practice is recognised and understood throughout the organisation
  • using financial management skills to deliver financial insight to partners, service users and colleagues
  • ensuring that an organisation’s approach to financial management suits its circumstances, structures and aims
  • ensuring that the financial management regime is comprehensive and supports innovation, improvement and delivery of high quality healthcare
  • ensuring that budget holders have the skills and information they need to carry out their roles
  • formulating, implementing and monitoring the organisation’s financial strategies/ plans 
  • ensuring compliance with national and local guidelines, duties and targets.

Role 4: commercial skills

Why this role is important

Given the environment within which CFOs work, with the need to ensure patient centred health and social care and deliver value for money while avoiding anti-competitive actions and facilitating the integration of services, commercial awareness and business skills are key attributes. The CFO must balance commercial skills with doing what’s right for the patient and wider healthcare system.

What this role involves

Typically, this role involves:

  • making the case for change - understanding current priorities and drivers for economic and service transformation including the creation of best value by segmenting and differentiating services to ensure delivery of the desired outcomes for patients and the wider health economy
  • maximising funding sources 
  • business-like thinking 
  • developing partnerships with other organisations (internal and external to the NHS) including negotiating contracts
  • responding to tenders and developing proposals for new business, often over the medium to long term  
  • implementing sustainable techniques for improving efficiency, effectiveness and the utilisation of resources
  • demonstrating the value of policy and operational changes, focusing on outcomes
  • maintaining up to date knowledge of procurement rules and guidance to ensure that the organisation is compliant in its actions
  • ensuring that money spent through contracts is managed to the standards expected for public funds.

Role 5: professional leadership and management

Why this role is important

Although it is important that all senior managers (executive and non-executive) are financially literate, the CFO plays a key role in establishing the overall financial tone and culture. It is therefore important that the CFO has the right qualifications, experience and skills; that he/ she commands respect across the organisation; and is a role model for finance staff, inspiring their loyalty and commitment. 

Professional personal conduct and setting, achieving and expecting the highest possible professional standards are also essential. This applies both within the organisation and across organisational boundaries, for example, where there are shared financial services or collaborative working. As CFOs depend on others to deliver a professional service, it is also important to create an atmosphere in which staff can thrive and professional values can prosper; individual members of staff need to feel valued and be given the opportunity to develop. They also need to feel able to raise any issues or concerns without fear of criticism or reprisal.

What this role involves

Typically, this role involves:

  • ensuring that there are high professional standards throughout the finance function and that it operates effectively
  • leading and managing the finance function well 
  • ensuring that finance staff are well trained and have opportunities to develop and grow and that the organisation has sufficient, appropriately skilled staff who are committed and enthusiastic. CFOs have a responsibility for the future of the profession and have a role in helping to develop staff across their local areas
  • ensuring that the functioning of the finance department is reviewed regularly with a view to maintaining high standards and looking for opportunities to improve and ‘connect’ with other disciplines and professionals
  • demonstrating (to a wide audience) well-considered thought leadership and being exceptional ambassadors for the professionalism of the function as a whole.

Role 6: working with partners 

Why this role is important

The Health and Care Act 2022UK Government, Health and Care Act 2022, 2022 enshrined integrated care boards (ICBs) and system control totals into law, alongside the existing statutory responsibilities of individual organisations. While the fundamental roles of the CFO remain, this additional requirement to look beyond organisational boundaries and work towards the collective financial position, in parallel with organisational requirements, creates an additional vital role for the CFO.

What this role involves

Typically this role involves:

  • managing the balance between organisational and system priorities, which may not always align
  • ensuring organisational financial sustainability while simultaneously supporting the system financial position
  • developing and enabling openness and transparency between system partners
  • fostering a culture of collaboration
  • working with partners to develop system approaches to local challenges which benefit patients, but which may result in a change of activity for the CFO’s own organisation
  • tackling the ambiguity and uncertainty that surrounds significant change and supporting the finance function to remain engaged and effective
  • building and maintaining effective relationships across all system partners.

Appendix 1 – Summary diagram of the key roles and example activities of the CFO

Role of the CFO

Appendix A - role of the CFO

Appendix 2 – Key CFO roles: examples 

This appendix gives examples of activities that fall under each of the CFO’s five key roles – it is not intended to be an exhaustive listing. Please note that activities are identified under what we consider to be the ‘dominant’ role, however, in some instances there is a degree of overlap and duplication. It is also important to bear in mind that although in practice many day-to-day tasks and activities will be delegated to other members of the finance team, the CFO remains ultimately responsible.

Role 1: corporate leadership and management example activities

Contributing to the organisation’s overall management and leadership

  • Playing a key role in developing the organisation’s constitution, vision, objectives and strategic direction while keeping in mind the overriding objective to provide high quality healthcare.
  • Helping to translate the constitution, vision, objectives and strategic direction into a meaningful and workable strategy/ corporate plan. 
  • Ensuring that financial implications (short, medium and long term) are taken into account as the organisation’s strategy/ corporate plan is developed.
  • Playing a key role in ensuring that the organisation’s constitution, vision, objectives and strategy are communicated effectively throughout the organisation.
  • Helping to ensure that statutory requirements (financial and non-financial) are met.
  • Helping to ensure that the board acts lawfully and that its decisions are impartial and fair. 
  • Helping to ensure that all board and management team members are clear about their roles and responsibilities.
  • Helping to manage the organisation’s performance – as a board member, the CFO shares corporate responsibility for managing the performance of the organisation and has lead responsibility in relation to financial performance. The CFO should play a key role in developing the organisation’s overall performance management framework and ensure that it covers both financial and non-financial information and meets with external requirements.
  • Helping the board to develop and work effectively – a CFO should use his/ her management skills to contribute to the development of the board and executive/ management team by advising in an impartial manner, ensuring that alternatives are considered and that adequate but not excessive evidence is collated to support decisions.
  • Challenging (when necessary) the board’s direction and/ or decisions and providing impartial advice even when it is not well received. Circumstances may arise where the CFO must take issue with board colleagues. Where the issue is significant and material the CFO should ensure that his/ her objection and the reasons behind the objection are noted. In these circumstances, the CFO should consider whether it is appropriate to disclose issues to a ‘higher authority’ - for example, to NHS England. Such a situation is likely to be the result of (or result in) a significant break down in the relationship between the CFO and the board, and should be seen as a last resort.
  • Anticipating legislative, political and economic changes and contributing to assessments of their implications (both financial and non-financial) for the organisation. 
  • Helping to lead, develop and implement change programmes.
  • Identifying new/ innovative ways of working/ delivering services.
  • Leading other functions (as required) that are outside their immediate expertise and experience - for example, IT; estates and facilities; performance; strategy; transformation and business development.
  • Acting professionally and ethically at all times and adhering to relevant codes of conduct such as the Code of Ethics for Professional Accountants, the ethics code for HFMA members, the Nolan principles and the NHS Constitution.

Playing a leading role in operational planning 

  • Ensuring that the organisation’s strategy is translated into workable, realistic and achievable operational plans. This will involve working with clinical, service and other managers to develop efficient, effective and innovative ways of delivering healthcare and advising them impartially on the financial impact of their plans and proposals (see role 3). 
  • Helping to ensure that operational plans are delivered – this involves having in place effective monitoring procedures that are understood and followed.
  • Ensuring that operational managers report regularly on progress during the year and that variances from budget and run rate are identified and action taken (see role 3).
  • Working with operational managers to deliver value for money/ cost improvement plans and identify opportunities for efficiency/ productivity savings. 
  • Ensuring that operational managers take into account the financial implications (short, medium, long term) of all major business decisions/ investments in a methodical manner so that decisions are supported by sound analysis and follow agreed processes and procedures.
  • Ensuring that there is a balance between the many competing demands for available resources while bearing in mind statutory financial duties.



Contributing to the development and maintenance of the organisation’s governance framework

  • Contributing to the organisation’s overall governance framework and ensuring that it underpins all that it does. 
  • Developing and maintaining effective financial governance arrangements.
  • Taking a lead role in helping the board to understand how much risk it must take to achieve its objectives.
  • Taking a lead role in ensuring that an effective assurance framework is in place based on a sound understanding of the principal risks faced by the organisation and the potential impact they could have, and that this assurance framework evolves over time. 
  • Ensuring that the organisation has in place an effective control environment and systems of internal control - for example, clear reporting lines; standing orders; standing financial instructions/ prime financial policies; a scheme of delegation and that these are communicated widely, understood and adhered to. 
  • Ensuring that there are clear guidelines relating to declarations of interest/ potential conflicts of interest and that these are understood and adhered to. 
  • Ensuring that the audit committee is operating as it should and that it is independent and effective.
  • Working with the audit committee to maintain an internal audit service that is resourced properly and performs well.
  • Ensuring compliance with national counter fraud requirements. 
  • Developing, maintaining and evolving a process for the assessment, tracking and management of business risks throughout the organisation – the CFO will normally lead on risk management including specifying the measures taken to counter risk, and monitoring the outcomes. 
  • Ensuring that there is in place a robust, organisation-wide digital strategy and (where it is part of the CFO’s role) developing and maintaining it.
  • Ensuring that there is in place a sound asset management strategy and (where it is part of the CFO’s role) developing and maintaining it.
  • Ensuring that there is in place a robust procurement strategy and (where it is part of the CFO’s role) developing and maintaining it.
  • Ensuring that there is in place a sound commissioning strategy and influencing, developing and maintaining it as appropriate.  
  • Intervening if the organisation looks like it’s heading for financial failure/ difficulty.





Ensuring that the impact on quality and safety is understood when reaching decisions

  • Ensuring that the board’s financial decision-making includes a close consideration of the impact on patient outcomes, healthcare quality and patient safety.
  • Ensuring that the reasons for the decisions taken are explicit, that supporting information is recorded and the expected impact on patient outcomes, healthcare quality and patient safety is clearly documented.
  • Ensuring that when financial decisions are being made all available information relating to activity levels, quality and cost is considered thoroughly so that the board has assurance that all angles have been covered.
  • Ensuring that a thorough quality impact assessment is carried out for all significant proposed savings schemes to ensure that patient outcomes, healthcare quality and patient safety are not compromised.
  • Ensuring that the board’s approach to reviewing the impact of its financial decisions looks at patient outcomes, healthcare quality, patient safety and finance (for example, using an ‘integrated performance dashboard’).

Developing good relationships with partners, internal and external stakeholders

  • Helping ensure that all stakeholders are aware of the organisation’s overall vision, objectives and strategy.
  • Representing the organisation in a professional manner in dealings with stakeholders including the public and partner organisations. CFOs must be able to represent the organisation on both financial and other issues - for example, at health and wellbeing boards or local authority overview and scrutiny committees.
  • Working collaboratively with other organisations in the local health economy to ensure that the best possible use is made of public money. This may involve providing leadership, vision and direction across the system.
  • Ensuring that plans agreed with partner organisations are reflected in the organisation’s overall strategy and budget.
  • Balancing the competing demands of internal and external stakeholders.
  • Identifying and addressing the risks and opportunities associated with partnership working.
  • Helping to develop and disseminate the organisation’s corporate communication strategy – the CFO has a particular responsibility to ensure that staff and stakeholders are fully informed in relation to financial strategies and plans as well as sharing corporate responsibility for communicating wider organisational issues.
  • Establishing good professional working relationships with external auditors, regulators and inspectors.

Providing financial expertise and advice 

  • Providing financial leadership at both strategic and operational levels.
  • Ensuring that the board and executive/ management team understand the financial environment within which they operate.
  • Ensuring that the organisation has a sound and comprehensive financial framework that will deliver its strategic objectives.
  • Ensuring statutory financial requirements are met.
  • Ensuring appropriate systems and processes are in place to identify the root cause of financial performance issues.
  • Ensuring that there is appropriate evidence to support requests for additional funding and that all other avenues have been explored to address the issues concerned.
  • Providing expertise and direction on financial strategy, planning, budgeting and performance. In particular, the CFO must ensure that the board sets realistic plans - for example, financial and commissioning plans, policies and procedures that will not compromise the achievement of the organisation’s financial duties. 
  • Providing sound and comprehensive information to support strategic decision-making – for example, by linking clinical outcomes to return on investment.
  • Developing the long/ medium term financial strategy in line with the organisation’s overall strategy/ corporate plan.
  • Developing the organisation’s annual financial plan/ budget, making sure it is in line with the medium/ long term financial strategy and corporate plan. Making sure that the process for its development is understood.
  • Ensuring that effective budget monitoring procedures are in place across the organisation and that progress during the year is reported regularly and clearly to the board and executive/ management team (see role 3).
  • Providing advice and support in relation to contracting and procurement – particularly when bidding for a new contract. 

Ensuring that the organisation’s finances are managed wisely and well

  • Ensuring that the board and executive/ management team receive accurate and timely financial information each month (see role 3).
  • Ensuring that resources are used efficiently and effectively within a framework of sound financial governance.
  • Ensuring that public money is used well; that systems are established to ensure that savings plans are achieved and best value delivered across the organisation and partners without compromising service quality. 
  • Ensuring that any financial agreements with stakeholders are managed effectively.
  • Maintaining financial stability/ viability while identifying opportunities for controlled change – as part of the planning process, CFOs should present realistic options for organisational/ service improvement and encourage the organisation to seize opportunities provided risks are managed and the achievement of financial duties is not compromised.  
  • Taking the lead in making decisions about relative priorities and advising/ informing the board and executive/ management team accordingly. This involves reviewing the financial implications of different options/ approaches in a systematic way; identifying the resources needed and seeking out innovative ways of working to meet objectives/ targets while achieving best value. 
  • Ensuring that finance responsibilities are not compromised by other roles/ areas of responsibility.

Role 2: stewardship and accountability example activities

Stewardship of public money

  • Ensuring that the organisation as a whole understands the importance of probity, regularity and value for money and that accountability for the use of public money is demonstrated at all times.
  • Ensuring that there is in place an effective system of internal control covering all that the organisation does (in conjunction with the board and executive directors – see role 1).
  • Developing and maintaining an effective and comprehensive system of internal financial control (including physical safeguards for assets; standing orders; standing financial instructions/ prime financial policies; operational and data security; authorisation and approval processes and segregation of duties). 
  • Ensuring that internal audit is resourced properly and working effectively (in conjunction with the audit committee – see role 1).
  • Ensuring that arrangements are in place to monitor compliance with controls and that action is taken when they are breached.
  • Ensuring that any income generating activities do not run at a loss and are not subsidised by NHS activities.
  • Ensuring that procurement takes place in line with best practice guidance and that payments to suppliers are accurate and timely and in line with administrative requirements.
  • Ensuring that the organisation’s asset register is up to date and comprehensive. 
  • Ensuring that adequate systems exist to monitor, control and forecast cash flow.
  • Ensuring that the organisation’s arrangements in relation to borrowing, investment and treasury management are sound. 
  • Ensuring that all financial plans, budgets and systems are subject to rigorous risk assessment procedures with risks formally recorded, quantified and graded along with details of actions taken to minimise their probability and impact.
  • Ensuring that provision has been made for the failure of systems – for example, to pay staff if the payroll service fails, and business interruptions. 
  • Ensuring that any charitable funds are managed and administered in line with their objectives and the appropriate regulator.

Disclosing irregularities/ fraud

  • Reporting to a ’higher authority’ any significant concerns (see role 1).
  • Disclosing any irregularities in accordance with the Public Interest Disclosure Act 1998 and related guidance.
  • Ensuring that the requirements of the Bribery Act 2010 are understood and that the organisation has in place sufficient arrangements to ensure compliance.
  • Ensuring that the organisation has in place sufficient counter fraud support.  
  • Developing and maintaining a fraud reporting policy in line with relevant guidelines and best practice. 
  • Facilitating access for investigations to take place in relation to potential thefts, fraud and false accounting. 
  • Adherence to NHS Counter Fraud Authority counter fraud standards.NHSCFA, Government functional standard 013, webpage accessed June 2024
  • Board level responsibility and accountability for organisational counter fraud efforts.

Demonstrating accountability 

  • Demonstrating accountability for resources by ensuring that the organisation’s financial information system captures and processes information accurately and that this information is presented in a meaningful format to the board, managers, regulators and other stakeholders. 
  • Ensuring that underlying financial accounting systems are rigorously maintained so that they remain reliable and sound. 
  • Ensuring that the information used when compiling reports is objective, in line with underlying accounting records and consistent over time. Any assumptions used should be explained clearly and unambiguously. 
  • Reporting to the board on all key financial performance indicators so that it is fully aware of the financial position and the reasons for any variances from the financial plan, thus enabling the board to manage performance and ensure that key financial targets are met.
  • Ensuring that reports to managers are concise, timely, accurate and reliable and that they help them to understand the financial position and the workforce/ activity factors that contribute to any variations from plans. 
  • Ensuring that monitoring reports - for example, to NHS England are consistent with information provided to the organisation's own board, produced on time and in the format required. 
  • Ensuring that financial and non-financial information is integrated so that a meaningful overall picture of the organisation’s performance is provided.
  • Ensuring that the annual accounts are produced in the format and to the timetables specified by NHS England/ Department of Health and Social Care; that the accounts are audited, appropriately approved and presented to the annual general meeting/ Parliament in line with prescribed timetables.
  • Managing the relationship with external auditors and regulators, ensuring that they receive the evidence, authority and assistance they need to undertake their roles. 
  • Establishing a good working relationship with the chair of the audit committee.

Role 3: financial management example activities

Championing financial management

  • Ensuring that the organisation as a whole understands the importance of good financial management and is financially literate.
  • Taking the lead in raising awareness/ promoting the importance of good financial management/ financial literacy throughout the organisation.
  • Ensuring that there is adequate and appropriate financial management training at all levels throughout the organisation.  
  • Delivering the information/ advice others need to make decisions relating to financial management. Ensuring that this information is reliable, timely, unambiguous and clear.
  • Ensuring that managers with financial/ budgetary responsibilities receive the information, advice and support they need.

Using financial management skills to deliver financial insights to partners, service users and colleagues

  • Ensuring (when relevant) that the integration of the provision of services is an explicit consideration in financial planning.
  • Developing a culture that automatically involves finance staff in all material decisions (as defined by the organisation).
  • Ensuring that relevant colleagues are supported in negotiating, agreeing and monitoring of contracts.
  • Looking out for opportunities to introduce innovative changes to ways of working that improve patient outcomes, quality of care and value for money.

Having in place a financial management regime that suits the organisation’s circumstances, structures and aims

  • Ensuring that there is a sound and comprehensive approach to financial management that is understood at all levels.
  • Ensuring that financial management arrangements sit comfortably with service responsibilities and structures.
  • Ensuring that service/ activity plans and their financial implications are aligned and resources used as well as they can be – this requires a thorough understanding of the relationships between value and outcomes.
  • Ensuring that robust arrangements are in place for financial planning, budgeting, monitoring and reporting.

Ensuring that the financial management regime is comprehensive and supports innovation, improvement and quality

  • Ensuring that managers throughout the organisation are financially literate and have the skills and competencies they need to discharge their financial management responsibilities.
  • Constantly looking to improve financial performance so that the best possible quality and range of services to patients is delivered. 
  • Making sure that the board, clinicians and managers understand the importance of securing best value for both on-going and new activities/ ways of working. 
  • Identifying opportunities for increasing service quality while delivering cost reduction/ efficiency savings and leading on the delivery of agreed cost improvement plans (see role 1). This will involve working with clinicians, managers and partner organisations to explore alternative service delivery models/ care pathways that will increase service quality while improving cost effectiveness.
  • Making use of a range of information sources/ techniques to facilitate the re-engineering of service delivery – for example, identifying and sharing best practice, making use of reference costs, care pathway costs, benchmarking and risk assessments.
  • Modelling alternative scenarios to ensure that investment plans are optimised, risks identified, tracked and managed, best value delivered and the organisation’s resources used wisely and well.
  • Identifying and pursuing opportunities for partnership working while ensuring that they are underpinned by sound financial governance arrangements.
  • Ensuring that financial issues are considered alongside service pressures – for example, when external stakeholders are involved in the process of identifying priorities for service development, financial opportunities and constraints need to be highlighted.
  • Driving continuous improvement in financial management skills and techniques - for example in relation to: 
    •    costing and value – to ensure that decisions are soundly based, the costs of activities are analysed; the key drivers identified and their behaviour modelled in different circumstances. This information should also be shared across the organisation
    •    procurement – to identify opportunities for increasing quality and delivering savings.

Ensuring that budget holders have the skills and information they need to carry out their roles

  • Ensuring that operational managers have the relevant skills and are competent to manage budgets.
  • Ensuring that budgets are understood and supported by budget holders.
  • Ensuring that adequate expertise, advice and training is available to budget holders so that they can understand the financial information they receive and effectively manage the resources under their control.

Formulating, implementing and monitoring financial strategies/plans

  • Formulating financial strategies/ plans based on a realistic assessment of future resources and using them in the best possible way. 
  • Ensuring that strategies/ plans consider a number of scenarios that reflect a variety of possible outcomes and levels of risk or uncertainty, including realistic ‘downside’ scenarios.
  • Ensuring that financial strategies/ plans include:
    •    a realistic allowance for inflation/ pay rises and other cost pressures 
    •    realistic (but challenging) targets for cost improvements, productivity and efficiency gains.
  • Developing robust systems for setting capital and revenue budgets in conjunction with budget holders. 
  • Ensuring that budgets are in line with the overall long/ medium term financial strategy and reflect operational plans (see role 1).
  • Establishing a systematic approach to monitoring, reporting and forecasting performance against budget/ plan that covers financial and non-financial information, including measures of quality.
  • Providing regular reports of the organisation’s financial progress (including year-end forecasts) that are timely, relevant, accurate and meaningful to:
    •    budget holders/ service line managers
    •    the board and executive/management team
    •    external bodies – for example, NHS England.
  • Ensuring that there is a process for dealing with variances from budget in a timely way, including taking corrective action when necessary.  
  • Ensuring that there is a process for reviewing (and improving) the organisation’s approach to developing and operating its financial strategies/ plans, budgets and capital programme. 

Ensuring compliance with financial guidelines, duties and targets

  • Ensuring that the organisation achieves its statutory financial duties and that this requirement underpins all financial strategies, plans and processes.
  • Ensuring that finance related national guidelines and targets are met. For example: 
    •    better payment practice code
    •    accounting requirements
    •    approved costing guidance
    •    the national tariff document.

Role 4: commercial skills example activities

Making the case for change

  • Ensuring that the ‘right’ financial information is available to decision makers at all levels so that choices between alternative options/ scenarios can be made in an informed way.
  • Ensuring the organisation has and uses a robust business planning process including the preparation, review, validation and evaluation of business cases involving investment/ option appraisal. All investment proposals should be analysed thoroughly to ensure that they are credible, realistic and consistent with the organisation’s corporate and operational plans and financial strategy.
  • Ensuring that new and innovative ways of providing services are considered.

Maximising funding sources 

  • Identifying opportunities and risks associated with new funding sources.
  • Demonstrating consideration of the broad perspective in relation to opportunities for growth or divestment for the long term benefit and sustainability of the organisation. 

Business-like thinking

  • Ensuring an outward focus based on sound understanding of the organisation and its core business.
  • Thinking about how things could be done differently – for example, by considering what service users want and need and may be willing to pay; what, if any, is the opportunity cost?
  • Ensuring that the financial performance and progress of the organisation is well described in words as well as numbers.
  • Considering how the organisation can best use data, technology and technological developments to support the achievement of its objectives such as the sharing of electronic patient records across health and social care.

Developing partnerships with other organisations

  • Ensuring that collaboration with other organisations delivers a cost effective and efficient service while enhancing value for money.
  • Focussing on outcome/ quality based contracting particularly where new models of care and organisational forms are developing.
  • Ensuring that clinical services are engaged in internal and external discussions and decision-making and that any contractual commitments given can be delivered. 
  • Ensuring that outsourced provider(s) deliver effective services in line with agreed contracts. 

Responding to tenders and developing proposals for new business in the UK and further afield

  • Drafting formal proposal documents in response to invitations to tenders issued by other organisations.
  • Identifying new services which the organisation could provide and sell.
  • Developing service solutions that meet customer specifications. 
  • Costing and pricing services in a way that is commercially competitive.
  • Evaluating potential mergers and acquisitions.

Implementing sustainable techniques for improving efficiency, effectiveness and the utilisation of resources 

  • Providing financial input and advice in relation to service reconfigurations and major business cases.
  • Challenging and verifying financial assumptions made by other organisations to ensure that robust plans are drawn up that maximise value for money.
  • Implementing, developing and utilising patient level costing and service line reporting to inform decision-making throughout the organisation.

Demonstrating the value of policy and operational changes, focusing on outcomes

  • Challenging and supporting decision makers, especially in relation to affordability and value for money.
  • Ensuring that policy and operational proposals with financial implications are signed off by the finance function.

Ensuring that money spent through contracts is managed to the standards expected for public funds

  • Ensuring that where they are in use service level agreements/ contracts:
    •    are robust and comprehensive
    •    identify any accountability and risk sharing arrangements
    •    specify key performance indicators, monitoring processes and financial controls
    •    where appropriate, meet the requirements of the integrated support and assurance process (ISAP) for novel and complex contracts.

Role 5: professional leadership and management example activities

Ensuring high professional standards

  • Displaying personal conduct that is beyond reproach.
  • Being an effective leader who inspires confidence and respect – someone that finance staff look up to, trust and admire. 
  • Setting high standards of professional conduct – being the ‘head of profession’.
  • Adhering to the principles and values set out in the NHS Constitution and ensuring that finance staff do the same.
  • Adhering to and exhibiting the core values expected of CFOs (see section 1 of this statement). 
  • Ensuring that finance staff are aware of the values and standards expected of them. 
  • Adhering to relevant professional codes of conduct - for example, the Code of Ethics for Professional Accountants and accountancy body rules and regulations (including continuing professional development requirements).
  • Providing a high-quality service and encouraging all finance staff to do the same.
  • Ensuring that the finance function is regarded as an essential and invaluable component of the organisation’s management, adding value and facilitating improvement. 
  • Ensuring that the organisation as a whole is financially literate, including ensuring that financial leadership is covered in the board development programme and that non-executive directors, governors, lay members, clinicians and managers are supported as they acquire financial management skills.
  • Providing professional guidance and support to the board, management/ executive team and the finance team. 





Leading and managing the finance function

  • Ensuring that the finance function has sufficient staff to be able to fulfil its objectives effectively. 
  • Ensuring that suitably qualified and experienced staff are recruited, trained and retained.
  • Developing ‘succession plans’ for the finance function.
  • Adopting the highest possible standards of management, to provide a finance function that is highly motivated, well-trained, and dedicated to quality, honesty and integrity.
  • Looking out for new and better ways of working.
  • Informing and involving staff when change is needed so that it is seen as an opportunity, not a threat.  
  • Recognising the needs of individuals undergoing change and supporting them. 
  • Communicating effectively with finance staff and encouraging feedback and participation.
  • Ensuring that finance staff are aware of whistle blowing guidance and empowered to use it if necessary.
  • Remaining approachable and sensitive to the needs/ interests of finance staff.
  • Being available to discuss issues of professional conscience or conflict, in an environment that offers absolute discretion.
  • Being alert to emerging problems/ difficult circumstances and dealing with them swiftly and fairly.

Staff development and training 

  • Encouraging all staff to maximise their potential, through training, job experience and participation in NHS wide training and development schemes. The One NHS Finance (ONF) four strengths for NHS financeOne NHS Finance, Four strengths for NHS finance, accessed June 2024 can be used.
  • Ensuring that all staff are ‘developed’ using a personal development planning process in line with the requirements of the NHS Knowledge and Skills Framework (KSF) and the accountancy institutes’ CPD schemes. 
  • Providing adequate resources and training facilities so that agreed development needs can be fulfilled. This will involve ensuring that:
    •    trainers (internal and external) are available to help with training and development needs
    •    a wide range of opportunities is available for all staff levels.  
  • Ensuring that there is an appraisal process for staff and that they are provided with monitoring and feedback as an integral part of the personal development planning process.
  • Ensuring that individuals are offered the opportunity to study for professional qualifications (CIMA/ CCAB/ AAT) where that might be beneficial to the individual and organisation.
  • Ensuring that qualified staff meet their accountancy body’s CPD requirements and that resource is available to help them do so. 
  • Ensuring that there are sufficient, appropriately skilled finance staff within the organisation. CFOs have a professional responsibility to ensure the development of finance staff, and the finance function more broadly, within their organisation
  • Encouraging staff to ‘aim high’ so that future leaders can emerge.
  • Ensuring that there is an active link to the local FSD network.



Reviewing and improving the finance function/ department

  • Reviewing continuously the quality of information produced and service provided by the finance department.  
  • Encouraging all finance staff to have a ‘customer focus’.
  • Encouraging staff to network with colleagues in the NHS and partner organisations – for example, through involvement with ONF.
  • Being open to suggestions from staff for secondments where these provide an opportunity to improve the quality and motivation of staff available to the NHS.
  • Ensuring that regular feedback is sought from service users of the finance department and other stakeholders.
  • Encouraging finance staff to feedback views on the service provided and to put forward suggestions for improvement.
  • Fostering an environment focused on achieving continuous improvement, taking advantage of emerging technologies and new ways of working.
  • Enabling and encouraging finance staff to connect with other disciplines and professionals – for example, clinicians, procurement specialists and suppliers.
  • Considering accrediting the finance department with any relevant schemes - for example, accountancy body CPD/ training accreditation schemes.

Role 6: working with partners example activities

Developing a culture of collaboration and transparency

  • Ensuring that governance arrangements are clear to avoid confusion around responsibilities and accountabilities
  • Acting in an open and honest manner
  • Agreeing how to manage conflict and disagreements between partners
  • Identifying and addressing barriers to working together
  • Utilising existing networks and relationships to enable and progress system working

Supporting system financial sustainability

  • Considering the financial impact on the system of organisational decisions
  • Agreeing a risk and gain share approach to system decisions
  • Enabling and supporting system conversations on pathway redesign and service change
  • Identifying opportunities to work together to use resources more effectively, for example shared corporate functions

Enabling staff to work collaboratively

  • Identifying opportunities for finance staff to gain knowledge and experience with system partners
  • Supporting staff to work in a collaborative way by modelling the behaviours required
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