Jane's career to date has been spent working in NHS finance, starting with studying CIPFA as part of the East Anglian Regional NHS Finance Training scheme and most recently being Director of Finance for ten years at Papworth Hospital NHS Foundation Trust.
Working as part of a world-leading, specialist organisation provided many opportunities, particularly being able to gain a deep understanding of the cost profile due to the smaller range of services provided. In many ways, though, my role at Papworth was as a traditional Director of Finance, with responsibility for finance, business support and coding, procurement and performance management.
The directorate team of around 30 people covered all the main finance functions, other than payroll. Given the relatively small size of the trust, this often meant very small teams, typically single individuals, providing key functions such as sales ledger. Keeping the show on the road during times of staff shortages required a lot of juggling from the experienced senior team.
Firstly, picking up the baton at a very newly established Foundation Trust: Papworth a second wave FT, authorised part way through 2004/05.
Secondly, for the whole of my tenure, the trust was seeking approval to relocate Papworth from its current location in a village just west of Cambridge to the Cambridge Biomedical Campus, next to Cambridge University Hospitals Foundation Trust and close to major research and industry leaders. As a Foundation Trust this required approval from Monitor, Department of Health and HM Treasury, in addition to working with local commissioners, staff and patients.
The most memorable time for me came when earlier this year, after countless years in the planning, Papworth finally signed the deal for the relocation of the hospital. As the procurement was under the PFI initiative, the final element involved ‘financial close’ - the climax of which was a nerve-wracking teleconference with participation from all parties to the deal, such as the European Investment Bank.
Thankfully, I had been given a very clear script to follow in order to give the final go-ahead, as I could feel that my voice was shaking even more than it did during my wedding. Afterwards, whilst the lawyers brought out the fizz, the hard working team from Papworth and its advisors were much happier celebrating with soft drinks and chocolate. It is great to know that the New Papworth Hospital is now under construction and is due to open in early 2018.
When I joined Papworth, I was struck by the clarity and simplicity of working in the foundation trust regime: gone were the numerous, weekly requests for information from the health authority which had been replaced by a lengthy but consistent quarterly monitoring return. Yet over the last ten years of working in that regime, it seemed to me that year-on-year the additional reporting requirements, shortening deadlines and increasing regulatory burden built up to the point where finance teams were once more overwhelmed by the requirements of the day-to-day grind.
In small organisations, major tasks often fall to a very small team who end up producing the annual accounts, the organisation’s financial planning, the in-year monitoring and the rest. If I had a magic wand (after doing the obvious things such as increasing overall health resources) I would ask for some common sense thinking and co-ordination from the regulators. They could, for example, try to spread the key financial tasks more evenly through the year and give more thought to keeping the format and requirements as consistent as possible to help with automation and comparisons. The time and energy freed up could then be used to do some real thinking about implementing changes and doing things differently, rather than just keeping all the plates spinning.
Throughout my career I’ve been closely involved with training at a number of levels: through supporting the NHS graduate training schemes, local finance staff development in the Eastern Region, Future Focused Finance and HFMA. The day-to-day demands on finance staff tend to mean that little time and energy is left for staff development, therefore these umbrella organisations help to make best use of the limited time available.
It is very easy for conscientious finance professionals to hunker down when the pressure is on, therefore providing effective, local opportunities to network and share ideas is essential. In my new role at CIPFA, I’m keen to see how the existing health training networks can work with the CIPFA regions (who have traditionally provided excellent support in other areas of the public sector) to strengthen and further expand the training and networking opportunities for NHS finance staff.