The award winning team at Sherwood Forest Hospitals are using inventive approaches to dealing with the many tough tasks involved in financing modern health care provision. By Neil Hodge, freelance journalist.
What does it take to be a triple award winning finance team in the public sector? We asked Sherwood Forest Hospitals NHS Foundation Trust in the UK, which has recently added CIMA’s public sector Finance Team of the Year award to its trophy cabinet.
The award was based on the team's innovative approach to financial management and the judges said that the trust had ‘implemented a new approach for financial management involving a change in culture that impacted the entire organisation. They demonstrated strong teamwork to support change among both finance and non-finance staff.’
So what was this new approach? Elaine Konieczny, deputy director of finance and procurement at the trust, said that the award is a reflection of the department's closer involvement in finance and management, and the way it has lent itself as a resource for other departments to consult with.
Understandable, succinct and relevant financial information
The team won because it has transformed the way it analyses and presents financial information to make it succinct, relevant and easier for clinical staff to understand.
This can often be a sensitive area so good communication skills are clearly needed.
‘We see part of our role as providing management with information that they can use to develop their own departments and clinical needs,’ said Konieczny. ‘There is no point just confronting clinical staff and other heads of departments with figures saying how much they are spending and how much they need to save or cut in the next financial year. That is not how the National Health Service works. Instead, it is important to present a range of easily understandable information and work with them to develop a strategy that makes the best use of resources so that the trust can make money while meeting patient needs,’ she added.
As mentioned, this is not the first award that the finance team has won. In 2007 it won the John Havelock award from the Healthcare Financial Management Association for its education and training work in helping non-financial managers get to grips with finance, accounting and budgeting. Also in 2009 it won an award from the Institute of Payroll Professionals. The department aims to continue picking up accolades.
NHS and service line reporting
Sherwood Forest Hospitals began operating as a foundation trust on 1 February 2007. Split into two sites – King’s Mill Hospital in Mansfield and Newark Hospital – the trust has around 700 beds and has 410,000 outpatients, with 78,000 inpatient/day case spells per year. For this financial year, the trust has a planned turnover of £232m and in 2008/9 achieved a surplus of £8.4m. However, for the financial year 2009/2010 the finance team predicts a small deficit of £2.7m, largely due to a building impairment in the accounts of £6.1m.
The finance team is a keen supporter of the NHS’s latest push to improve management information. Called ‘Service line reporting’, the initiative aims for finance departments to move away from focussing heavily on budgetary controls and cost cutting to examining the strategic decisions behind the business, whether they make financial sense, and providing an opinion on whether the trust is reaching its potential as a result.
Patrick McDermott, project accountant in the trust’s finance and procurement directorate says Sherwood Forest has embraced the new style of reporting. ‘We think that looking deeper at the strategies that underlie the business, rather than just looking at the financials, can only benefit the trust. Having a better idea of what departments are trying to do – instead of just looking at what they spend and how they spend it – helps us make better informed judgements about the business strategy and how the trust can move forward,’ he said.
Tremendous challenges
Both McDermott and Konieczny say that the trust – as well as the NHS in general – faces tremendous challenges in 2010, particularly as public health spending and service provision will be a key political issue during the UK election campaign. ‘We have a new hospital building that will be fully operational in January 2011 that was funded through a £350m private finance initiative (PFI) scheme. We have to ensure that the trust has the money to meet the annual repayments of around £32m from a budget that could be reduced or frozen,’ said Konieczny.
‘On top of that, we are expecting to have more demands placed upon us by management to help identify where resources may be better allocated so that we can continue to deliver quality services to patients. We also expect to be involved with clinical staff to examine the levels of income from the services that they deliver, and work out ways in which they can be leveraged. This year will be a busy and tough year for all NHS trusts,’ she added.
Teams with such a robust and innovative approach as hers should be well placed to get through it successfully!