Rebecca Richards, Director of NHS Wales Finance Academy
What does your new role as director of the NHS Wales Finance Academy involve?
The NHS Wales Finance Academy is a collaborative board of all NHS Wales finance directors, led by the Welsh Government director of finance, Health and Social Services Group, Alan Brace.
The Academy’s vision is ‘finance adding value’ and it has a wide range of priorities focused around four key areas: developing people, innovation and adding value, working in partnership and excellence.
Developing finance staff by providing opportunities for continuous improvement and driving excellence in our systems and processes is vital. This all helps to ensure we are getting the best out of transactional processes in partnership with others such as procurement and workforce.
The Academy is also continually on the lookout for innovative work and learning that adds value and ensures best practice is spread across Wales. As director of the NHS Wales Finance Academy, it is my role to help the Academy board set the strategic direction and ensure the delivery of its plans.
I’m six weeks into my new role and as a former finance director in NHS Wales and chair of NHS Wales Finance Directors when the Academy was established in its current format two years ago, I thought I knew most things about it.
However, I’ve been excited and inspired to learn about the full breadth of its activities and feel honoured to be leading some very interesting developments.
What three things might the rest of the UK learn from Wales in dealing with the health and social care integration agenda?
My personal reflection on this really comes from working within Powys Teaching Health Board as finance director up until a year ago, where significant steps had been made together with Powys County Council in bringing health and social care closer.
What I noticed was that building trust and understanding between two very diverse organisations is probably as, if not more, important than the structural aspects of trying to put two organisations together. There are significant differences in culture, governance structures and Welsh Government performance requirements which in themselves could be an obstacle for even the most determined of organisations seeking to work together.
In Powys, in addition to the typical joint structures you might expect for directors and members, we also spent some time on team building and getting to know each other away from the usual business meeting. This helped us to better understand each other’s perspectives and improved our working relationships. I felt this was extremely useful and certainly helped when any tricky issues needed to be dealt with.
As well as this, letting staff at operational level guide the integration has been particularly powerful. The health board had attempted integration previously which was largely driven from the top down, but involving staff in setting out what would work better ensured their participation and engagement. Ultimately this meant the organisation could move faster than had previously been anticipated. The feedback from both staff and patients was also very positive in the areas where integration took place.
In Powys, our first truly integrated function was IT. Putting an IT infrastructure in place to help staff eliminate duplicate activities and share information was so important. This has been further built on more recently with Wales implementing a new Welsh Community Care Informatics System (WCCIS) which will be used jointly by both health and social care staff to capture patient/client records in one place. Powys was at the forefront of this and will be first in Wales to fully implement a joint information system with other boards and councils to follow.
How does the NHS in Wales differ from the rest of the UK?
Generally in Wales, I think our greatest asset is that we are end-to-end integrated, from primary care through to acute secondary care. We are uniquely placed to consider the totality of NHS care with seven health boards that cover all of Wales both in planning and operational delivery. This brings with it opportunities to consider the population of Wales over the whole life cycle and across entire pathways, not just in terms of joining up metrics but also in the way we potentially organise ourselves as integrated bodies. I don’t think we’ve yet grabbed all the opportunities available to us but I’d like to think the Academy could be at the forefront of driving and further influencing movement towards full integration as we develop as finance professionals in NHS Wales.
As health and social care start to work more closely together, what do you think finance professionals can do to help drive this agenda?
For me it starts with understanding each other’s role, remit and requirements. At Powys, the council finance director and I invited each other to our finance staff development days to help raise awareness of the different requirements of working within a council and in a health board. In addition, the process of developing a comprehensive Section 33 agreement a number of years ago helped significantly in engaging finance staff in thinking how to satisfy each other’s requirements while getting to know each other on a more developed basis. Only if we truly understand each other’s business through the finance lens will be able to spot the opportunities for improved value through better collaboration.
On a more national basis, Wales has been developing further the competence of public sector accountants through its training programmes for students. As evidence of this, a collaboration of publicly funded bodies including the NHS Wales Finance Academy, Wales Audit Office, Welsh Government, devolved bodies and the HE/FE/university sector won the 2017 Public Finance Innovation Award for Finance Training & Development Initiative in April. As a collaboration we believe we can build on this to ensure our finance staff have a greater understanding of the public sector offer in Wales and help spot opportunities for improvement for citizens and public expenditure.
What do you wish you had learned/known when starting out on your career?
I’ve had quite a linear approach to my career to date, taking the typical route from national finance trainee through to senior finance roles and attaining finance director status in two organisations. This was quite the norm at the time and doing anything different to this tended to raise eyebrows.
I think today, a more diverse career including stints outside of NHS finance might have not only been interesting but also given me a broader perspective from which to fulfil my roles. This is partly why I’ve taken on the very different role of director of the academy, albeit admittedly this is still within the NHS finance remit. I think had I realised how helpful attaining a broader portfolio might have been, I would have done something earlier in my career. This is why I’m so passionate about using my role within the Academy to help staff gain opportunities broader than purely NHS finance.
What would success look like for the NHS Wales Finance Academy?
We’ve already achieved great things within the Academy and my intention is to build on that going forward. We’ve around 700 staff working in a finance type role within NHS Wales and it is my ambition that every member of staff feels the benefit of the Academy and has a tangible relationship with it. This could be either in receiving development opportunities or contributing to its improvement programmes.
For me, success in the Academy would realise many benefits such as a stable of homegrown talent and having a competitive field for succession planning across all finance posts. It would be good to have a reputation for being crucial and valued by clinical and other non-finance staff, and being recognised as leaders in developing public sector accountants. This would enable more movement across sectors and the development of alternative career paths.
Other measures of success would be achieving Wales-wide adoption of internationally recognised best practice, leading the way in the pursuit of opportunities for creating value and having a mutual programme of development and learning with other professions including accreditation for clinical posts which have an influence on spending.
No pressure then!