Birmingham Heartlands and Solihull trust
This trust has a revenue budget approaching£200m and a capital programme averaging£8m a year. It treats 600,000 patients annually.
The finance directorate, with 114 staff and four departments of its own, provides support for the trust's five business units, which in turn lead 5,500 staff.
The directorate held a business planning workshop earlier this year and decided it needed to review who its customers were, what they wanted and how to deliver.
It has now held a primary-secondary care interface day, created GP liaison officer posts to tackle issues such as waiting lists and outreach services, created service improvement groups, invested in training and development and promoted internal audit protocols. It has also introduced lunchtime workshops on topical finance issues and developed a budget-holders' manual. The directorate is now planning an annual consultation exercise with executive and non-executive directors and senior managers to discuss issues for consultation and obtain feedback.
The directorate has seen the approval of a£9m capital investment business plan for a new medical services facility, a project it led. It has sold VAT services to other trusts and developed a reputation for excellence in VAT advice. It has seen more than 50 per cent of its staff undertake continuing professional development work - with its finance director completing a masters degree.
It has also managed to pay 90 per cent of invoices within the stipulated guidelines and reduced the number of over 90-day debts from more than£1m in 1998-99 to just£300,000 in 1999-2000.
Unsurprisingly, the directorate undertakes internal and external benchmarking activity.
It reviews deadlines and sends out questionnaires to obtain departmental views on the service. It is a member of a number of networking groups and monitors its own VAT recovery against other trusts for which it provides a service.
The judges said:
This department demonstrated consistent improvements over a wide range of services and over a sustained period. They are good, they know they are good and they want to stay that way. Their approach to improvements is a range of innovations - from speed-reading courses for hard-pressed clerks to the development of a clinical governance system for the entire trust.
North Staffordshire Hospital trust
Another department that realised it needed to improve - but which had a lot further to go. The finance department was reorganised in 1998 and since then has 'exceeded all reasonable management expectations'.
Driving change were issues, including the new NHS financial regime, the reorganisation of the entire trust, non-achievement of external audit recommendations, ineffective financial systems, unreliable financial records, low morale and high sickness rates.
To overcome these problems, a senior management team was created to manage 68 staff.
Budgetary control was devolved to seven operational divisions, each the size of a small trust, and supported by a dedicated financial management staff and a divisional accountant.
Cross-departmental initiatives with the human resources department introduced establishment control and sickness and absence reporting.
A business-planning framework and a competency based training strategy were introduced to develop individual and team capacity. This year, the process has been extended to include delivery of a performance assessment framework.
There is now an annual business-planning cycle to ensure each department addresses customer requirements. Timeouts are held to get their views.
External customers are surveyed through market research. The finance training group considers these findings and reports back.
The new PAF is designed to ensure development activities match these requirements.
In concrete terms, the department has delivered its first, robust business plan with measurable objectives to deliver the benefits outlined in the change process and trust business plan. Progress against success criteria has been reviewed and reported to the finance committee. Training plans have been established following staff appraisal and a training matrix drawn up to deliver them.
In addition, the timeliness and integrity of board reports has improved. The trust has achieved break-even for the first time in four years and is in the process of recovering a deficit; all the action has been agreed by the regional office and external audit.
The judges said:
[The trust] has shown determination and creativity in addressing a series of poor indicators of performance. The judges would welcome a re-application next year, demonstrating a further year of evidence of success.