6 Balancing act: supporting finance leaders to deliver on short- and long-term priorities
1. Thinking across multiple change horizons
Overview It is helpful to reflect on current arrangements and opportunities for improvement by thinking across three horizons: • optimising the current system • designing, testing and scaling new service delivery models • fundamental service redesign and normalising new operating models. These horizons are not about the timescale for change as much as the nature of the change being considered – in reality the different horizons are considered concurrently, with some initiatives delivered concurrently and some delivered one after the other, dependent on the type of change. The starting points differ across the country, with many feeling trapped in the short-term, with no headroom to think about important long-term elements. The key to these horizons is not to think of them as entirely sequential and to use them to inform an organisational/ system-wide view of improvement. Practical actions are set out at the end of the section. A supporting transformation roadmap and case studies are included in the appendices.
These horizons are not about the timescale for change as much as the nature of the change being considered. Equally, they should not be seen in isolation – they are most effective when considered together – one transformation agenda where outcomes are achieved within each horizon, providing delivery confidence and financial impact each year.
Finance leader reflections and experiences When faced with immediate short-term demands combined with the longer-term shifts required to deliver on medium-term financial sustainability, finance leaders reflected on how and where they currently operate across these multiple horizons, or how they wish they could do this better. The critical success factors for enabling multi-horizon thinking were also discussed, as well as the role of a finance leader in setting up some of the required enablers. The three horizon model set out in figure 2 was used as a discussion prompt during the roundtables and is a helpful framework for finance leaders to use with colleagues as they think about their own current areas of focus and opportunities. This will differ across each organisation and system.
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