NHS London – Board Development Day

The Board’s Role in Financial Control

A fascinating day in the company of NHS London Board members – executives and non-executives – at a large conference in London within spitting distance of The Tower of London. The keynote speaker Professor Keith Grint, the Professor of Public Leadership & Management at Warwick University was full of endless anecdotes and illuminating examples for every one of his well aimed points.

Here’s the synopsis of my session:

The Board’s role in ensuring adequate financial controls are in place has never been more important. This lively and informal session will identify key issues board members must address to give assurance that financial stability will be maintained, risks will be identified and that policies and procedures promote good governance. The session will be illustrated throughout by practical examples of good and bad practice and the profound effect that the board can have on financial stability, financial risk and a culture of financial success.

As part of the workshop I asked delegates to list the first three words or phrases which came to mind when I said the words “NHS Finance”. The results are illuminating:

Control

Agency

Budget Audit

Cost savings

Complexity

Detail

Boring

Detached from the business

Not commercial

Nice people

Challenging

Large

Incomprehensible

Complicated

Jargon

Volume

Cash

Broke

Balance Sheet

Opportunity

Savings

Disfunctional

Finite

Restructuring

Bottom Line

Voodoo Magic

Panic

Determination

Reality

Risk

Wastage

Public money

Payments

Negotiation

Modelling

Weird

Reactive

No

 
I particularly enjoyed the use of the phrase “Voodoo Magic” as one of the first three words or phrases which come to mind.

As promised to delegates, here are some relevant documents to illustrate the points in my session:

Code of conduct: code of accountability in the NHS – 2nd rev ed – DH Publication
A Guide to Finance for Hospital Doctors – Audit Commission Report
Learning the Lessons from Financial Failure in the NHS – Audit Commission Report July 2006
NHS Foundation Trust Accounting Officer Memorandum – Monitor 17 April 2008

Here are 10 Questions to Ask Your Finance Director in order to ensure you hold them to account:

1. What are the main reasons for any deviation from financial plan?
2. What are the main risks to the organisation meeting its financial targets?
3. What action needs to be taken to address any deviations and potential risks?
4. What level of contingency reserve does the Finance Director have to deal with any emergencies?
5. What is the Trust’s liquidity position and how does this relate to the reported I&E position?
6. Why has the debtors/creditors figure changed?
7. What action has been taken to reduce debtors and improve cash flow?
8. What are the main risks to long term financial stability?
9. How do the Trust’s costs and performance compare to other similar trusts?
10. What steps are being taken by management to improve performance/efficiency?

If you’re not sure what the question means, never mind the answer which you would get, please feel free to contact me about board development finance training.

Here are the Presentation slides from the day.

Many thanks to all those who took part.

davidbaileyfcca

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