Balancing act: supporting finance leaders to deliver on short- and long-term priorities 9
In reality, delivering against these horizons is not linear and will be informed by a number of existing processes and plans (such as month-end, control totals, executive boards, strategies, performance measures and so on). This is inherently complex and there is a role for finance leaders to hold strong on the multi-year objective framing, leading the way (through the complexities) to balance the conflicting pressures and keep their change journey on track.
The use of digital solutions applies across each of the three horizons. This is explored further in the HFMA’s briefing on the role of digital technologies in financial recovery 11 as well as the example set out in using predictive analytics to improve mental health services 12 . Appendix B sets out the key areas of focus within each of the three horizons. It can be used as a discussion tool to develop your own individual transformation roadmap.
Practical next steps Know your own organisation/system and where to focus:
• Where are the services where the ‘do-nothing’ situation is untenable? These are ‘no-regrets’ areas to focus on. • Complete an honest appraisal of which horizon you are in to determine where to focus (such as if you are just in ‘horizon 0’ and stripping non-recurrent savings – find a service area where you can plot improvement initiatives across the horizons). • Work with clinical, operations, and finance teams to set time horizons; define value; explore options; and manage short-term demands, medium-term sustainability and long-term planning. • Prioritise pragmatism over perfectionism in tracking system contributions and impacts, include anticipated impacts and assumptions in transformation plans, and identify success factors for multi-horizon thinking. • Collaborate with clinicians to understand unit costs and the value of activities influencing resource use. • Find delivery opportunities within each horizon and promote transparency between partners considering health and social care interdependencies. • Develop system leadership focused on collaboration, accountability, improvement, and help finance business partners (FBPs) balance reporting with transformational support. • Focus on cultural change as well as technical change. • Engage teams on patient and operational value rather than money and allocate time for larger transformations in horizons 2 or 3. • Balance a mix of horizons across the improvement agenda.
11 HFMA, The role of digital technologies in financial recovery , October 2024 12 HFMA, Update - using predictive analytics to improve mental health services , January 2025
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