‘As a child, I always had a fascination with how complex systems worked,’ Eimear McCauley FCCA recalls. ‘At airports or hospitals, I was completely intrigued by the fact everyone knew where they needed to be at the right time and wondered how it all happened.’
Today, as executive director of finance, contracts and capital development with Western Health and Social Care Trust, McCauley has found her calling. When you lead the finance function for one of Northern Ireland’s biggest health administration areas, managing and cutting through complexity are all part of the day job. Covering almost a third of the province geographically, the Western Trust serves 300,000 people with 12,000 staff and operates on an annual expenditure of £1bn.
‘Health and social care are everybody’s business’
CV
2021
Appointed executive director of finance, contracts and capital development, Western Trust
2008
Joins Western Trust as senior financial management accountant
2002
First public sector role with Foyle Trust, as financial accountant
Community focus
Taking up her current role in 2021, McCauley has shown a career-long commitment to health and social care and is guided by a firm belief that best practice in finance can be of real consequence in this area. ‘In terms of motivation, I’m a community person. I believe health and social care are everybody’s business. Everybody needs these services at some point. What I’ve taken satisfaction from in my finance roles is maximising the resources at our disposal, looking at how we can spend money better and how we can make better decisions.’
Behind the decision-making, however, she stresses that some fundamentals can never be out of view. ‘One of the ways we in finance add value to a complex system like health and social care is by bringing a strong sense of corporate governance to it. A strong application of governance within an organisation that everybody pays attention to means less for everyone to worry about as we deliver on our obligations.’
One system
A reorganisation of the NHS in Northern Ireland in the noughties saw the creation of the Western Trust as one of five health and social care trusts in the province. One of the strengths of the current system is, McCauleys says, its integrated approach. In contrast to England, where social care is delivered by local authorities, ‘this fully integrated approach means that people who need hospital care, mental health care and care in the community can all be provided for within the one system.’
‘The NHS is very challenged, and there’s a risk to services as a result’
Less appealing are the ever-tightening budgetary constraints Northern Ireland operates under. The House of Commons was told last year that NHS waiting times in the province were the longest in the UK, with public services described as ‘in crisis’ because of a chronic lack of funding.
McCauley says: ‘We are in a time where the NHS is very challenged, and there’s a risk to services as a result of that. The budget settlement for 2025/26, if it proceeds, could have significant further impact.’
‘Finance does not operate through a single lens’
Leadership
If finding efficiency can sometimes feel like setting the stage for the next cost-cutting challenge, it is also an environment where leadership and values matter. For McCauley, a collective, collaborative approach is key. ‘I am somebody who believes in strong relationships with the people I work with. I couldn’t do this job without my team – they make me look good every single day.’ Her firm grounding in her local community also colours her overall approach.
‘One thing that I stress to my team is minimising the idea that finance is operating through a single lens or is “responsible for this only”. We’re a support function and here to serve the Western Trust in whatever way it needs us. We will always look at finding ways to do things at a lower cost as opposed to impacting directly on service levels.’
Leadership brings other responsibilities too. ‘One of the most significant shifts for me in taking on the role of director was recognising the buck stops with me,’ she says. ‘A director of finance carries a lot of responsibility in any organisation, but there is a whole other level of accountability in the public sector.’ Across health and social care generally, she says ‘people have never been expected to carry more risk than today.’
‘ACCA helps people who may otherwise have gotten lost in the workplace’
Providing a path
If McCauley’s commitment to public service is deeply felt, less obvious in her younger years were the opportunities she would have to lead within it. ‘Leaving school, I had no intention of going to university. I wanted to get out into the world of work.’
A position in an accountancy firm led to her taking the accounting technician course – her first introduction to ACCA. Fast forward to last year and she recalls ‘being at a conference in London, where I spotted ACCA staff at a stand and made a beeline for them. It was the first time I’d spoken to anyone in ACCA since qualifying and I wanted to express my gratitude to this wonderful organisation. It enabled me, and people like me, who might otherwise have gotten lost in the workplace, to fulfil our potential. I had to work very hard, juggle difficult circumstances, but ACCA provided a path.’
That juggling took work-life balance to new heights. McCauley recalls being ‘all set for my final exams in June 1999 and, the night before, realising it wasn’t going happen. My daughter was delivered the day I was set to do the exam.’ Six months later, baby in tow, she completed her final paper.
Beyond the office
Outside of work, it will be no surprise that family remains central. ‘My three children are all grown up – the youngest is 19 now. We are a very tight-knit family, and spending time together is hugely important to us.’
McCauley also finds time for the gym – even if it requires starting the day at 6am. ‘I try to keep things simple for the most part, but I would be lying if I said I have this work-life balance thing down pat,’ she smiles. It’s a work ethic that has guided a successful career, but its richest dividends are surely to the community McCauley cherishes.
More information
Read the AB article ‘NHS needs urgent health check’ on the challenges facing the NHS
