NHS Wales – the publicly funded healthcare system for Wales – has been the responsibility of the Welsh Parliament since devolution in 1999. It has established the NHS Wales Finance Academy, which is the voluntary collaboration of every NHS Wales finance director of the statutory health bodies and 15 hosted health organisations and their staff, a cohort of around 800 finance professionals, supported by a small programme team led by its Director, Rebecca Richards.
The aim is to develop a finance function that is “best suited to Wales but comparable with the best anywhere”. It was formed several years ago by the finance directors to address a number of worrying indicators, including lack of candidates from within NHS Wales aspiring to director of finance positions, along with an ageing staff profile with no succession plan in place.
The Academy’s programme now spans a range of improvement programmes that aspire to develop NHS Wales Finance along four core themes: developing its people, innovation and adding value, working in partnership, and driving excellence. Between the four interdependent programmes, all staff working in NHS Wales Finance are incorporated into the Academy, they lead and develop the improvement programmes with support from the programme team which enables them to contribute to the improvement of the finance function and support the development of leadership at all levels.
Richards had been an NHS Wales finance director for 15 years before coming into this post four years ago. She saw what a decade of austerity did to training and professional development. Feedback from staff through regular surveys and visits to organisations demonstrated the urgency with which staff training was needed to improve career development, help staff come up through the ranks within the Welsh system, and create a pool of talent to underpin the future of the finance function within NHS Wales.
We’re already seeing results
“We needed to take action, so the Finance Academy was set up partly to tackle succession planning and to ensure that we had growth in terms of our future leaders,” says Richards. “Through our Talent Pipeline programme, we’ve already seen successes in enabling individuals build the confidence and skills to apply for very senior leadership roles, including directors of finance positions. We also wanted to encourage people to be innovative in the way in which we improve our systems, processes and governance, and the way in which we use NHS funding, doing it in a safe place to try out new ideas and celebrating our successes where we find them.”
She continues: “A further important part of the process was learning from others, be they in the private or the public sector, to avoid being insular in our thinking and approach, constantly horizon scanning for best practice that we could adapt and adopt.”
Personal development taken into account
If finance professionals within NHS Wales were to be professionally developed, it was also important to take a long hard look at the way in which personal development reviews (PDRs) were carried out for all staff, not just those on development programmes and whether they were achieving what was intended by the process. “PDRs are mandatory, and we report on the number that take place within teams, but what I was interested in was the quality of those PDRs and whether they were helping. I found it was variable, but too many staff were not having a good experience of that PDR conversation and they didn't feel it was helping them either within their current role or, importantly. to achieve their future role,” she says.
“A couple of years ago, we started to reach out to find out how other organisations were tackling this, and we’ve continued a partnership of learning from each other. We identified some fantastic competency frameworks for the finance function, and we have implemented the best bits of those ourselves.”
Starting the right conversations
The idea is to support not only the member of staff to inform a quality conversation with their line manager, but also to aid the manager in framing the conversations that needs to take place through focussing on the competencies expected in their current and aspired role. This conversation should result in creating helpful personal development plans that focus on experiential learning that managers can help facilitate, as well as any formal learning required. Further, the competency framework, once populated by all staff, will provide the Finance Academy with the insight to identify current and future development needs across the finance functions in Wales for which it can plan a response.
In terms of the finance competency framework developed, the skills that are addressed run the full gamut from interpersonal skills, technical skills through to leadership. “It tries to capture all aspects of what we would expect from all members of staff in all parts of the finance family. This is very much work in progress and its early days, but we’re also looking for constant feedback to ensure its continuous evolution,” she says.
The competency framework is aimed at those in the “core finance family”, as Richards puts it. “These are people who are involved in annual accounts preparation, management accounts, finance business partners, and senior finance leaders, for example. We will be extending this work to those staff who are slightly adjacent to finance, for example payments staff, internal audit, counter fraud – where there is an appetite to do so.
NHS Wales is heavily focused on value-based healthcare for which it is fast becoming world renowned. “There's therefore an expectation that every member of finance staff understands what value-based healthcare is, and that they have the skills to be able to operate within a value-based approach that is patient outcome focussed. The framework should describe the competencies we expect, as well as examples of how those competencies can be acquired,” says Richards.
She also explains that as the Academy’s overall development programme identifies good practice, this will feature in the skills expected and learning offered through the framework. For example, given the impact of the pandemic and Brexit, part of the programme is exploring the role of NHS Wales in the Foundational Economy, and how it can make the best use of the NHS pound in furthering the Welsh economy, supporting local businesses and local employment. “From a health economics perspective, we know that the more people that are gainfully employed in good employment, the better their health outcomes. There's a circular benefit to us, but we also want to contribute to sustainable and green policies through our procurement approach and understand the opportunities and impact,” she says.
What started this whole process was the imperative to future proof the finance functions within NHS Wales organisations, though developing people and enabling them to build confidence and succeed in their career ambitions. The ambitious improvement programmes that have developed over time, combined with the competency framework tool to help individuals manage their personal development, provide a strong foundation for the Finance Academy to be on track with its ambition to be “Best suited to Wales but comparable to the best anywhere”.
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