How do you provide NHS accountants across the UK with valuable and cost-effective CPD at a time when budgets are stretched? For Tim Kelland FCCA, assistant director with the Welsh NHS Executive, the answer was an exchange programme that would enable accountants from the four nations to share best practice with each other.
‘My vision is that we will, in the long term, develop lots of new networks of qualified accountants working across the home nations,’ says Kelland. ‘This will assist them with upskilling, learning best practice, and just generally being the best version of themselves.’
Working with Keith Wood, a senior finance manager based in England, Kelland developed the initiative, known as the NHS Four Nations Finance Exchange programme. As part of the exchange, accountants from one nation are paired up with accountants from another. They then work alongside each other for two weeks, with each accountant spending one week as a host and a second week as a visitor.
‘I wanted to ask the different nations what they’re doing in a cost improvement capacity’
The first phase of the programme – a pilot project – kicked off earlier this year. Places were offered to all qualified accountants in the NHS throughout the UK. The pilot attracted a healthy level of interest, with most applicants coming from middle and senior management. In total, 22 accountants were selected to participate.
In February, Wales hosted the launch week for the pilot, bringing together the participants from across the four nations. All participants attended a one-day conference hosted by the NHS Wales Finance Academy. The visiting finance professionals spent the rest of their time shadowing their partners and attending meetings that were relevant to their work.
Learning opportunity
Frances Freeman ACCA, a finance manager for the East Suffolk and North Essex NHS Foundation Trust, applied for the pilot to find out how other parts of the NHS tackle the challenges that she also faces.
‘We’re struggling to find any cost improvement savings,’ says Freeman, who supports women’s and children’s services. ‘So, I wanted to ask the different nations what they’re doing in a cost improvement capacity. Maternity care is all about safety, so it’s hard to make any meaningful savings. But I wanted to find out whether they have the same budgetary constraints and how they do things differently.’
What she discovered, she says, is that ‘everyone seems to have the same problems’.
‘I brought a lot back that I’d like to be looking at within the service’
She says she took away learnings from discussions with clinicians and finance professionals, and gained an understanding of how NHS Wales approaches commissioning. She also heard how NHS Wales is adjusting to rising caesarean section rates – an issue for her own trust. ‘I brought a lot back that I’d like to be looking at within the service,’ Freeman explains.
New perspectives
John Darragh FCCA, divisional accountant for the Northern Ireland-based Northern Health and Social Care Trust, was also attracted to the pilot by the prospect of new perspectives. ‘One of the mantras I had in my head was, is there a way we could do things differently in finance?’ he says. ‘Is there a way we can present data differently? Is there a way we can engage with managers differently?’
In his role, Darragh acts as finance business partner to the trust’s community care and mental health divisions. During the pilot week in Wales, he met his counterparts at the Aneurin Bevan University Health Board to discuss their challenges and learn how they present their financial information. He also enjoyed meeting the board’s director of finance, who gave a strategic overview of the Welsh health sector.
‘I view my exchange partner as a “critical friend” who I can bounce ideas off’
Darragh’s Welsh exchange partner visited Northern Ireland at the end of March for a return visit. During this time, Darragh shared his own approach to financial reporting and arranged for his partner to meet with finance professionals and clinical leaders within his trust. Participating in the exchange was helpful from both a learning point of view and because it has enabled him to develop his network, Darragh says. He now views his exchange partner as a ‘critical friend’ whom he can bounce ideas off.
Relationship building
Networking has been a valuable benefit of the exchange, concurs Keely Flower ACCA, finance programme lead for value-based healthcare at the NHS Wales Executive. Within NHS Wales, value-based healthcare focuses on improving patient outcomes within available resources. So, Flower felt she was well matched with her exchange partner, a financial improvement senior manager with NHS Scotland.
‘I’m now able to advise the Scottish government on incorporating value-based healthcare into finance’
‘The main benefit for me was the relationship side of it,’ Flower says. ‘To be able to link up with someone who does a similar role to me, in a similar team that has the same challenges, but slightly different approaches that we can learn from.’
After hosting her partner in Wales, Flower made a return visit to Scotland in April. During that week, she attended a conference in Glasgow and shadowed a director of finance, as well as attending an executive team meeting, among other activities. She found that finance professionals within NHS Scotland were particularly interested in how NHS Wales approaches value-based healthcare.
‘Going forward, I’m now able to advise the Scottish government on incorporating value-based healthcare into finance,’ she explains. In terms of takeaways from the pilot, Flower has some ideas to help her team collaborate better and will be encouraging her colleagues to be more open to new connections.
Kelland hopes that the Four Nations Finance Exchange could be a model for other such programmes within the NHS, including for clinicians and HR professionals. Certainly, the success of the pilot suggests that the model works.
‘It’s a great experience seeing what other organisations do,’ Darragh says. ‘There’s always learning that we can take away from other people and other organisations.’
