CIPFA spoke to Paul Simpson, the Director of Finance and Deputy Chief Executive at Stafford & Surrounds CCG and Cannock Chase CCG. Paul fulfils a combined role at these CCGs in what is his first NHS position after a career in local government.
Stafford and Surrounds CCG and Cannock Chase CCG took over responsibility from the former South Staffordshire Primary Care Trust in April 2013. Combined, these two CCGs are led by GPs from 41 practices, serving a population of more than 270,000 people and have a budget of £300 million.
As the Finance Director with the CCG’s, my role is to provide the strategic financial leadership to the organisations and advise the accountable officer and the Board on the organisations’ financial operation and performance. Any senior finance post in the public sector also of course has a very important role to safeguard public money and in the NHS, which has to be in the context of ensuring patient care is of the highest quality within the resources available.
This is my first health service job, having spent much of my career in local government as well as central government and one of the big four audit firms. There are many similarities in terms of the role but also a number of key differences. The most notable is probably the overarching governance model. In local authorities, an officer’s role is to support and advise local politicians, who are the primary decision makers. In the NHS you have similar local accountability to the Governing Body (albeit it is not a political organisation), but also to NHS England at a local and national level.
As a senior finance professional, I see that a critical element of my role is to bring on the next generation of finance professionals and the future finance leaders. It’s important to encourage new talent into public services, with fresh ideas and ideally those with strong values and belief in the public service ethos.
That’s why I’ve always been such a big supporter of CIPFA training and the CIPFA qualification as it focuses on a cohort of people who want to become senior finance professionals but they have a strong motivation to make a difference to people’s lives . Despite all of the cuts in public spending in recent years, the public sector still accounts for a significant proportion of the UK economy and there are still countless opportunities to carve a successful career in public sector finance. With the Institute’s growing influence on the International stage as well, CIPFA is becoming an even more attractive option for people wishing to pursue a finance career.
In my last job at Nottinghamshire County Council I set up a joint public sector financial management training scheme. This was a partnership between district councils, the county council, police, the fire service, Grant Thornton and the NHS. We initially appointed 9 trainees from over 250 applicants. The success of the scheme has been borne out by the fact that not only have a significant number of them already been appointed to substantive posts, but a number of the students have won prizes for their performance in CIPFA’s exams. I’m very proud of that fact, and the icing on the cake was receiving the Tom Sowerby Award (outstanding service to CIPFA students) at the Institute’s conference last year.
I think most people working in public services would agree that one of the key factors that would help us do our jobs more effectively is having a greater level of certainty about resource levels. The NHS was one of the key battlegrounds in the general election and the political parties all pledged that they would ensure it got the resources it needs. Being able to plan for the medium to longer term would help public services think more strategically and to take the necessary steps to manage over the medium term.
Politics plays a huge role in both the NHS and local government.
While in the NHS you don’t have the direct political contact that you have in local government - as the political decisions are largely taken at a national level- it’s nevertheless a ‘political’ job. The impact of both national and local decisions has a direct impact on the work that I do, particularly of course in terms of decisions about the allocation of resources. Political decisions, such as whether or not to increase council tax or how much additional money should go into the NHS, are critical to the work of Finance Directors in public services. That “public scrutiny and accountability” dimension is I think one of the key differences that sets a senior finance role in the public sector apart from a similar role in the commercial world, and what for me makes the jobs so interesting and rewarding.
The saying goes that prevention is better than cure; the challenge is around short term vs long term benefit and the ability of public services to be able to plan effectively and take decisions that will have a long term benefit. That can be difficult, particularly given my previous point about the impact of political decisions. The ability to have certainty and plan for the longer term would help, but as public servants we also have to be cognisant of the imperative for politicians to be re-elected, and the practical realities that brings.
The challenge facing the NHS is that we know we have an increasingly elderly population, which is great from the perspective of people living longer but also unfortunately means that people are likely to suffer from conditions such as dementia, and because of their increased frailty, are more likely to suffer from falls and therefore can frequently end up in hospital. We are also seeing increases in long term conditions such as diabetes and an increasing number of people suffering from obesity. All of these issues give rise to increased pressure on the NHS.
Addressing these challenges will take long term solutions, but we have seen over the course of the winter the immediate pressures facing Accident and Emergency Departments. With limited resources, striking the right balance between prevention and cure is tough but that in itself is why working in the sector is so rewarding as I can help find a solution to these huge challenges.