12 Balancing act: supporting finance leaders to deliver on short- and long-term priorities
The practical measurement of value was raised as a frequent obstacle. This covered a breadth of topics, from the macro challenge of not considering wider value such as healthy people’s contribution to the economy, through to the more granular challenge of tracing directly from a change implemented in one part of the system to which finance pot or budget line will be impacted elsewhere. Operating with a degree of pragmatism over perfectionism is often challenging when reporting cycles take precedence, but a move in this direction is likely to be required to support shifts into the community.
Participants also raised experiences of transformation schemes with benefits that are below a realisable scale. For example, releasing 1,000 bed days a year, but with no ability to aggregate similar impacts to enable the closure of an escalation ward. It was suggested that there should be increased discipline in the clarity on the route to value in initial programme planning documentation, supplemented by FBPs being able to support and challenge on the underlying value.
Practical next steps Define ‘value’ to align incentives and balance short- versus long-term trade-offs: • Broaden the calculation of service value to include new delivery models and failure demand impacts. • Create a framework for multi-disciplinary teams to decide on service improvements. • Set a clear but meaningful timeframe to expect to deliver on the value you have defined – being brave about multi-year solutions where the expected value impact is greater where a multi-year approach is taken. • Work with clinical, operations and finance teams to align across these decision points. • Prioritise pragmatism over perfectionism in tracking economic contributions and budget impacts. • Include anticipated impacts in transformation plans to support community shifts. Adopt a system mindset and lead collaboration: • Work with clinicians to understand unit costs and activity values affecting resources. • Foster transparency between partners, considering health and social care interdependencies. • Embrace system leadership, focusing on collaboration, performance and improvement accountability. • Consider the role of finance teams and be conscious in the skills you value.
• Develop new skills and recruit diverse thinkers to support transformational activities. • Enable finance business partners to balance reporting and transformational support.
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