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.

Tell us what you think – have your say below or email


There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

latest healthcare news

Highest ever numbers accept GP training posts

19/10/2018Highest ever numbers accept GP training posts

The number of people entering GP training is the highest in NHS history, according to new figures from Health Education England (HEE). A tot... more >
‘No realistic prospect of progress’ for integrated health and social care, PAC warns

19/10/2018‘No realistic prospect of progress’ for integrated health and social care, PAC warns

The government is still “a long way” from achieving an effective strategy for integrated health and social care and has been urged to... more >
One in six trusts could end PFI contracts due to poor performance as NHS heads for £1bn loss

19/10/2018One in six trusts could end PFI contracts due to poor performance as NHS heads for £1bn loss

A new report has revealed that 15% of all NHS trusts using private finance initiatives (PFI) could terminate contracts due to poor performance. ... more >
Council strips contract from NHS trusts and hands it to Virgin after High Court row

18/10/2018Council strips contract from NHS trusts and hands it to Virgin after High Court row

Lancashire County Council (LCC) has awarded a controversial £104m healthcare contract to Virgin Care for the second time after a hearing in... more >


Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >
Simon Stevens: A hunger for innovation

25/09/2017Simon Stevens: A hunger for innovation

Simon Stevens, chief executive of NHS England, knows that the health service is already a world leader when it comes to medical advances – ... more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >


Recoup and recover

10/10/2018Recoup and recover

The ease and round-the-clock nature of making cashless payments has transformed the way we pay for goods and services – and, from now on, t... more >
The clinical voice at the heart of procurement

10/10/2018The clinical voice at the heart of procurement

Jo Gander, director of the Clinical and Product Assurance (CaPA) team, talks about their role as part of the new NHS Supply Chain. NHS Suppl... more >
Deal or no deal?

10/10/2018Deal or no deal?

Dr Andrew Dearden, BMA treasurer and Brexit lead, takes a look at what different Brexit scenarios could means for both patients and healthcare pr... more >
A push for digital in mental health

10/10/2018A push for digital in mental health

Sean Duggan, chief executive of NHS Confederation’s Mental Health Network, argues that mental health services could hugely benefit from dig... more >

the scalpel's daily blog

On your bike!

17/10/2018On your bike!

Sathish Sethuraman, travel and transport plan co-ordinator at Northumbria Healthcare NHS FT, explains how efforts to promote cycling to work at the trust are resulting in more staff travelling on two wheels. At Northumbria Healthcare, we are committed to becoming a greener organisation and reducing the environmental impact of delivering p... more >
read more blog posts from 'the scalpel' >