Reflections from the HFMA Convergence 2.0 conference

Encompassing the annual provider and commissioning faculty conferences 

#HFMA overview

National policy is aligning more organisations from health and care. Systematic issues around governance, payment and contracting are being discussed at length, without a “one size fits all” solution. Cultural issues around different organisations working together is introducing a wave of fast-paced and widespread change to peoples everyday working lives, which newly appointed system leaders need to manage effectively.

Managing the convergence and mixture of roles between health & care, commissioner and provider, and in the new “system world” has become a day to day issue for a number of financial leads for organisations, regulators and wider systems. Previously the Director of Finance of an organisation lived in a rules-based, physical bound environment, working for the good of the organisation within the contractual and regulatory framework they were based.

The changing role of finance director

As discussed by and with a number of these individuals from across the country, the role of “Director of Finance” has changed significantly. Some of these changes are clear, well understood, and make the day job easier, whereas a number of these changes lead to more complication, risk, and working in areas previously not within the remit. The idea of a shared Director of Finance is now a reality, both cross commissioners, commissioner to providers, providers and overall systems. These roles are new and being tested in different ways, but work in a different set of guidelines where finances, plans, and actions are based more on trust and working together, than traditional contracts, payment by results, and contract variations.

To aid with these roles, and for individuals to work together, trust and transparency are crucial.  Many systems are going through the process of developing team dynamics during the planning and contracting rounds and a number of systems have used a third party to facilitate this transition as the changes to the way individuals and teams work is clear. They have also been having to work in a different way with both NHSE and I regulators to ensure that there is an overall system view, supported by the move to system control totals, and the memorandum of understandings that support them.

Transformational change for the future

The other area of change that Directors of Finance are seeing is the pressure to plan, and then deliver transformational change across systems, and moving finances into the community and primary care, to benefit the system.

This can have a negative impact on a pure acute provider for cost but designed to have a positive impact on activity and pressures in the future. The traditional finance “organisational business case” process does not work in this aspect – as they will often have an impact for an organisation but an overall positive benefit.

The financial teams are moving towards this system approach and testing the steps along the way including what you do to support and help in times of pressure of risk. Taking teams, boards, and themselves on this journey widens the essential skill sets for financial leads and tests wider organisational buy into system thinking and delivery.

HFMA Convergence conference 2.0 took place on 5th–6th July 2018, bringing providers and commissioners finance professionals together to facilitate networking and shared learning.

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