Daily grind leaves directors unable to go with the flow

Finance directors are too worried about coping with daily pressures to prepare adequately for the new financial flows regime, the NHS Confederation has warned.

A telephone survey of finance directors in acute trusts, primary care trusts, and strategic health authorities by the confederation found there were serious concerns at the complexity of the new financial flows proposals and at the timescale for implementation.

Guidance from the Department of Health on how the new system will work is expected within weeks.

The survey report found that 'with a couple of exceptions the finance profession has not yet fully engaged, partly because of the pressure of current concerns'.

Many finance directors also expressed concerns that they did not have the resources available to carry out current initiatives. They were also fearful about the impact the demise of the directorates of health and social care would have on their workload.

Nigel Edwards, NHS Confederation policy director, said: 'There is a real need for the system to become mainstream policy on boards and in trusts as a whole.'

'There is the feeling among finance directors that engagement has not spread to other parts of the trust, specifically the boards, as they have so much else to do'.

The report highlighted concerns that the DoH is not properly linking together different initiatives - in particular, financial flows, foundations trusts and patient choice.

Many finance directors also said they were facing increasing problems over investment decisions, which were delayed because of uncertainty over the level of tariffs.

'At worst, there is anxiety some proposed investments will be stalled as it proves impossible to fit revenue costs within the likely standard tariff parameters, ' the report said.

Pressure cooker: finance directors' fears on new regime

Many finance directors believe the Department of Health has underestimated:

the true scale and nature of the technical issues to be addressed;

how complex relations between hundreds of trusts will be under new procedures;

the need to invest in better financial and costings systems;

the cost of investment in administration staff;

the management of the transition and cost variation; l the difficulty in dealing with patients who need high-cost treatment.