Last Word


Facing the financial challenge head on

Source: NHE Mar/Apr 16

Paul Briddock, director of policy at the Healthcare Financial Management Association (HFMA), on why financial and clinical staff need to work together much more collectively in the future to plan services.

As we near the end of the 2015-16 financial year, it’s clear that NHS finance is in an unnerving situation with a deficit far exceeding what was originally forecast. As such, the need for talented finance staff to help organisations to deliver high-quality services with restricted financial resources has never been higher. In the midst of these significant pressures, those working in the NHS finance function are dedicated and ready to meet the challenges head on. 

Every two years, HFMA takes a detailed look at the size and scope of the NHS finance workforce – which makes up about 1% of all NHS employees – through a staff census and staff attitudes survey. Despite the difficult climate, our most recent report, shows the NHS finance workforce remains stoic, reporting a relatively high and unchanged average level of job satisfaction, at 6.7 out of 10 (compared with 6.8 in 2013), and focused on the challenges ahead. 

We’re going to rely heavily on finance directors and their teams to see the NHS through the current financial challenges, so the key now is to keep the most skilled people in the service and keep them motivated. We must be mindful of the immense pressure these people are under and make sure that the new initiatives, caps and rules being introduced in a bid to make savings and improve productivity aren’t being used as a stick to beat them with. Rather, we need the entire health and social care system to work together collaboratively. 


When focused on getting a job done, people can often be guilty of working in silos and not reflecting the bigger picture. The same can sometimes be true for clinical and non-clinical roles in the NHS. The HFMA research shows that only 46% of finance staff feel valued by clinicians in their organisation, so it is clear that there is some disconnect between finance and non-finance staff. Many working in the finance function felt clinicians did not view financial management as part of their role and sometimes fail to see the positive contribution finance staff have on the system they work in. 

To help bridge the gap, we need to ensure clinicians understand better how NHS financial management works, as well as train finance staff on how clinical services are delivered and what new developments are on the horizon. Clinical and non-clinical roles are intrinsically linked as every clinical decision is ultimately a financial decision and every financial decision has a clinical impact. If we are to get best value from the limited financial resources, finance and clinical staff need to work together to plan services and evaluate different options. 


Recognition is another area our report looked into. As with other types of NHS staff in management roles, finance professionals can be portrayed negatively at times as an unnecessary expense, rather than being recognised as the people trying to diligently manage the service’s scarce resources to get the maximum value in terms of high-quality patient care and outcomes for every pound spent. This plays out when finance professionals were asked about how valued they feel – the vast majority (78%) feel their line managers value them and almost half say the same of their organisation’s board (48%), but far fewer feel valued by the government (just 10%), the public and patients (both 5%). 

With the new financial year on the horizon, there is a big job to do to balance the books, to continue delivering high-quality patient care, transforming services effectively and planning for a sustainable future. To do all this, our skilled clinical and non-clinical teams need to work together to build a stronger and fit-for-future NHS.

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