The Structure of the NHS and How Money Flows

This article sets out to explain the structure of the NHS, how this is changing and how the money flowsthrough the system.

Financial Awareness Training

The finance department at Lancashire Care has always delivered financial training to support budget holders, clinicians and managers. The COVID–19 pandemic threatened to curtail these important interactions. Understandably financial training wasn’t a priority as the pandemic manifested but as the months progressed and a sense of routine developed, clinicians reached out to the finance department to request some financial awareness training. It demonstrated that whilst the NHS has had to cope and manage with the ‘greatest threat to mental health since the second world war’ (Guardian, Dec 2020), clinical and finance colleagues decided that the show must go on! This article describes the training that was delivered and how finance departments can still interact and engage with non-finance colleagues during these challenging times.

How Can the NHS Account for “Care Correct First Time”

NHS Healthcare providers are under constant pressure to make costs savings. There seems to be no way to account for the costs of errors, harms and inefficiencies in patient care. If we could account for these costs then we could create medium to long term plans to reduce the costs lost in the consequences of errors, harm and delayed or low quality care of patients. If we get Care Correct First Time these wasted costs will fall and could well achieve the 5% savings within 5 years. I propose a conceptual framework to allow accounting for these costs wasted on the consequences of error, harm or delays caused by Opportunity Costs in the inefficient way frontline staff have to work to Do Patient Care.

You’ve improved the process, but do you know how much you’ve saved the NHS?

The NHS is a rich tapestry of professionals from all walks of life, dedicating their working lives to serving the UK population’s health needs. Everyday there are individuals seeking to make a positive difference, for their patients, for their teams and for their students. Throw in Brexit or even a pandemic, and the cogs just keep turning

Virtual Outpatients

The new normal in the outpatient management of children. How hospitals managed appointments throughout Covid-19, from people not attending due to fear through to taking appointments online to ensure the safety of patients and staff.

“Cheshire Chat”

An innovative way of delivering patient engagement and consultation.

Transfers of Care Around Medicine

This article covers both patient safety issues and optimising medicine use, this national initiative is known as Transfers of Care around Medicine (TCAM). When a patient moves from one care setting to another, this is known as a transfer of care. When transfers of care occur there is an increased risk of adverse effects due, in part, to medication errors arising. This article asserts that a relatively small investment can generate significant cost avoidances; thereby delivering significant financial, economic and social benefits to the health community as well as enhancing patient safety.

Payments Systems in the NHS

Finance within the NHS is poorly understood by clinicians and the limited engagement of clinical leaders in finance decisions is recognised as a common pitfall in recent inquiries such as the Francis report1 and recent King’s Fund report into financial failure2. The complexity and rapidly changing landscape of financing systems in place across the NHS on a background of complex and transient organisational structure makes it challenging for the patient focused clinician to achieve a working knowledge of finance. This article will discuss various payment mechanism and explore their advantages and disadvantages and then discuss how they have been used on their own or in combination to fund healthcare organisations. In order to provide context for clinicians, we will discuss how the payment contracts influence day to day health service practice.

Redeployment Case Studies

Since the start of the Covid-19 Pandemic, NECS have initiated a redeployment process across our workforce where employees have temporarily been asked to work in either different surroundings to their usual work place, in a different line of service or for another NHS organisation within our local health economy. We have been keen to hear from our colleagues who have been redeployed and have captured some of the experiences from multiple teams across our unit.

Clinical Engagement with Finance: Now more than ever!

The COVID-19 pandemic has affected all aspects of healthcare. The NHS has had to manoeuvre faster than ever before, which is remarkable for a huge organisation known to advance slowly and steadily. The adaptations have had both positive and negative impacts. There were also funding changes, in the form of temporary contractual arrangements. As the NHS plans for the future, an opportunity has arisen to fundamentally change the NHS funding structure. This article will describe the effect of COVID-19 on healthcare finance, the challenges in developing a new payment structure, and the role that clinicians can play in helping shape funding arrangements in the future.