Non-clinical workers may not directly save lives, but they provide essential support to clinicians who do

While most people are aware the NHS is a huge organisation, how many of the 1 million patients it deals with every 36 hours think beyond the nurses and doctors who treat them to try to comprehend the scale of the hundreds of different roles needed to run the service?

A patient will cross paths with a receptionist, maybe a porter, but beyond that their interaction with anyone in what are termed ‘non-clinical support services’ will be limited.

Yet it is this hidden army of people – experts in everything from finance to administration and facilities to management – which comes together day after day to keep patients flowing through the service.

Non-clinical workforce

This non-clinical workforce – something I have been part of for more than a decade as a finance director – may not directly save lives, but the clinicians who do would not be able to without its support.

‘There are 16,000 finance professionals currently working in provider and non-provider NHS organisations’

Because our health service is free at the point of care the vast majority of people do not ever need to think about the financial implications of each and every single clinical decision that is made in the NHS.

But this is what the 16,000 finance professionals currently working in provider and non-provider NHS organisations concern themselves with day in, day out.

With the health service in the most dire financial straits it has ever experienced, their role is becoming increasingly prominent and increasingly scrutinised.

Every two years, the Healthcare Financial Management Association takes a detailed look at the size and scope of the NHS finance workforce – which makes up about 1 per cent of all NHS employees – through a staff census and attitude survey.

The most recent iteration, released this month, shows the number of finance staff has remained relatively stable over the past two years, following significant changes in numbers as part of the reorganisation of the NHS in 2013.

Short-term savings

In a climate where it may be tempting for some NHS employers to cut or outsource what are often seen as ‘non-essential’ roles to make short-term costs savings it is reassuring to hear our numbers are holding steady and the value of the finance function is being recognised.

In fact, our research shows a shift in the mix of activities finance teams are undertaking which points to the increasingly important role that finance is being asked to play to reduce current deficits and deliver sustainable services.

‘It may be tempting for some NHS employers to cut or outsource what are often seen as ‘non-essential’ roles’

A slight increase in finance staff undertaking financial management activities, for example, suggests a move towards more strategic roles and a workforce that is supporting the service in the pursuit of greater value and transformation.

The finance workforce is also increasingly highly qualified, with the majority already holding or studying for some kind of finance qualification.

Unnecessary expense

Recognition is something our new report looked at too. Finance professionals can be portrayed negatively at times as an unnecessary expense, rather than being recognised as the people trying to diligently manage the service’s scarce resources.

This was borne out when finance professionals were asked about how valued they felt – the vast majority (78 per cent) felt their line managers valued them, and almost half said the same of their organisation’s board (48 per cent) and the clinicians in their organisation (46 per cent).

But fewer felt valued by the government (10 per cent), public or patients (both 5 per cent).

‘Finance professionals can be portrayed negatively at times as an unnecessary expense’

Despite the difficult climate the NHS finance workforce remains stoic, reporting a relatively high and unchanged average level of job satisfaction, at 6.7 out of 10 (compared with 6.8 in 2013), and ready to meet the current challenges.

What motivates them? For 71 per cent the public sector values of the NHS keep them going, while for others the focus on improving patient care (60 per cent) and the satisfaction they gain from their role (54 per cent) drives them.

Almost two-thirds (64 per cent) of NHS finance staff told us they would like to spend the rest of their career in the service.

Working collaboratively

When asked what would most improve the value added by their finance team to the NHS, 60 per cent were keen to see ‘better communication between finance and non-finance staff’ and a similar number (59 per cent) cited “improving the financial literacy of non-finance staff”.

We are going to rely heavily on finance directors to see the NHS through the current challenges.

‘Skilled clinical and non-clinical teams need to work together to build a stronger NHS’

We must be mindful of the immense pressure these people are under and make sure that the new initiatives, caps and rules are not being used as a stick to beat them with.

We need the entire health and social care system to work collaboratively.

With a new financial year on the horizon, there is a big job to do to balance the books, deliver high quality patient care, transform services effectively and plan a sustainable future.

To do all this, our skilled clinical and non-clinical teams need to work together to build a stronger and fit for the future NHS.

Paul Briddock is director of policy at the Healthcare Financial Management Association.