The NHS finance function is set for its biggest shake-up under sweeping changes that could see the number of accountants it employs cut over the next five years.
An NHS executive working group is examining changes to the finance function across the service. The group, which has been told to report by the end of the year, is looking at whether the NHS needs all of its 16,000 finance staff.
It has also been asked whether the number of trained accountants – there are presently 2,600 – should be cut down.
In an exclusive interview with Accountancy Age, to be published next week, NHS finance director Colin Reeves outlines his concerns about ‘huge differences’ in hospitals’ financial performances. He wants all finance departments to match the performance of the top 25% of trusts and health authorities.
Reeves also wants finance functions to reflect the organisational changes to the NHS over the next three or four years, such as the scrapping of fundholding and the increasing likelihood of trust mergers.
It is expected to result in rationalisation, with the scrapping of many of the sections in which accountants work. One idea is to use more ‘agency’ teams to provide shared services such as payroll for family health services.
Instead of each health authority providing the service, an agency could provide the service on behalf of half a dozen authorities. The number of internal audit groups in the NHS has already been halved.
The review group – the finance staff strategy group, chaired by John Brassington, finance director at the NHS Executive’s Trent regional office – has been backed with initial funding of #0.5m.
Reeves said he had an ‘open mind’ about the review and would not comment on future workforce levels. But he said: ‘I think you will see quite a change in financial management in the NHS in future.’ He hopes to outline the preliminary findings in September at a gathering of senior NHS finance staff, where he is expected to tell delegates that financial training needs to be extended to every level.
One senior NHS source said the upshot of the review – already seen as a bid by the executive to exert more control over trusts and health authorities – would be ‘less rather than more’ finance staff.
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