Published: 20/03/2003, Volume II3, No. 5847 Page 24 25
Introductory Guide to NHS Finance in the UK Publisher: Healthcare Financial Management Association.
ISBN: 0-95422181-3-2. 196 pages.£21.50
Financial management is hard to get right and costs a lot to get wrong.
Managers grappling with it therefore need all the help they can get.
Enter the Healthcare Financial Management Association's Introductory Guide to NHS Finance in the UK. This is not a hardcore finance textbook, but a summary for puzzled general managers or health service neophytes.
This sixth edition of the HFMA guide runs up to May 2002, though HFMA has inserted late breaking news where possible.
The first eight chapters cover the basic funding framework of the NHS and its different types of organisation. The rest covers the range of distinct financial functions, with sections on costing (particularly around healthcare resource groups) and commissioning to the fore.
Perhaps the most keenly read chapter will be on performance management and control, an area that has cost - and will continue to cost - senior managers their jobs. This covers the regulatory framework, the four principal financial targets (financial balance, external financing limit, cost of capital absorption and capital resource limit) and reporting regimes.
Primary care trusts have been created since the previous edition. There is a chapter devoted to them - a (perfectly good and concise) summary of their powers rather than an attempt to tackle the complexities of commissioning and financial flows. Unfortunately, the GP contract gets only two sentences - basically 'It is coming, It is important'. The Local Improvement Finance Trust scheme is only briefly mentioned - and not covered at all in the chapter on public private partnerships (itself a good summary of private finance initiatives in practice).
Another new chapter covers strategic health authorities with good information on capital investment and workforce development confederations. As the guide points out, although simple in structure the wide-ranging financial powers of these bodies have, at least in theory, important implications for all types of trusts.
A chapter on partnerships with local authorities is short, but summarises well the mechanisms for different types of grant funding and pooled budgets.
The guide finishes with chapters on Scotland, Wales and Northern Ireland, plus selected statistics and a glossary of terms (an index would have been useful).
Though some subjects are covered a little too briefly (and inevitably a little overtaken by events such as foundation hospitals), this edition of the introductory guide will still be a required reference work, both for managers and non-executives.