Trust standardises finance initiatives across all professional groups, empowering staff through training and improving quality of financial management

Synopsis

Over the past 18 months the Finance Team has focused on Working towards excellence.

To do this we have embraced an initiative called Future-Focused Finance (FFF), which is about improving NHS finance for everyone; recognising the need for strong financial skills and understanding across all professional groups to deliver good patient care and value for tax payers.

We have successfully used this initiative to improve the quality of our finance team and financial management through a range of networks, frameworks and toolkits, as well as events, workshops and other learning and development opportunities with very positive outcomes.

Ambition

The impact of having an engaged and visible Finance team has been felt throughout the Trust. Staff now know who we are, we are getting better information as Finance are being thought of first and our finance staff can relate to the services and patients. Sharing of best practice outside of the organisation led to wider engagement.

We became the first Trust in the East Midlands to be Level 2 accredited for Working Towards Excellence (July 2019) after gaining Level 1 in January 2019. The FFF framework marries perfectly with the Trusts vision and CARE values. Our objective is to ensure everyone in Finance is empowered to challenge behaviours, speak-up around improvements that can be made and to ensure that finance is visible throughout the organisation and beyond.

The initiatives to help us deliver the objectives are outlined below:

Staff Engagement Group - 6 staff members from all areas of Finance come together to drive forward improvements. Leading the change to an ‘empowered’ culture.

Twitter - Engaging with other departments and individuals in and out of the Trust - 203 followers

Voice Box - anonymous feedback mechanism for ideas and improvements

Guest Speakers - to connect Finance with the wider Trust and patients. We have had ‘A day in the life of a DGM’, ‘Civility Saves Lives’ and NerveCentre

Service Visits - to understand how different services operate which helps our understanding of the service and how we can help add value to them and the patients

Volunteering - all staff have the opportunity to work with the volunteers in the Trust connects Finance staff to the wider Trust and patients

Training & Development - Increased our offering to ensure finance staff have access to quality training, ensured studiers have a mentor and all staff have access to a mentor and shadowing opportunities. Strengthened our support within the department with a T&D lead. Active member of the SDN (Skills Development Network) steering group to influence the training offering.

Annual Conference - A half day conference open to all Trust staff and neighbouring Trusts Finance functions. Adopted a workshop approach to cover topics that are relevant in a fun and interactive way - 50 attendees.

The next goal is to aim for Level 3 accreditation of Working towards Excellence’ within the next 12 months. This level takes into consideration the culture, inclusivity and diversity of the workforce and to do this we are working with the framework Great Place to Work.

Outcome

Recent recognition and feedback that we have received:

• Chair of the East Midlands Making a Difference group (EMMAD): I just wanted to say how impressed I was last week when some of your team came to the EM MAD group to talk about the progress you are making with staff development and FFF. It is extremely impressive to note the progress made since then, with staff engagement, FFF and the accreditation process; obviously achieving Level 1 earlier this year and (subject to FLC approval later this month) it’s looking like you may be awarded with Level 2. You’ll be the first in the East Midlands! In my role as Regional Value Maker you’re certainly in my view a flagship for the East Midlands, to the extent that I have asked the team to help deliver a FFF workshop at the East Midlands conference in November.
• Feedback from a FFF regional value maker: I attended one of your staff engagement events and thought it was great and there was a lot my organisation could learn from. EMMAD session went really well and you will be receiving an invite to present a similar session to the SDN leads. The Sherwood Forest finance team are a great example for other organisations in our region to replicate. If we could have more organisations like your team it would make promoting FFF so much easier.
• Extracts from the FFF Level 2 Accreditation peer review report: “The evidence submitted was of a very high quality and highlighted a number of areas of good practice and reassured the assessment team that Sherwood Forest is a “great place to work” and fits the model of what a highly performing finance function should look like.”

“Clear development culture from the apprentice’s right through the team with many given opportunities to act up into roles or shadow colleagues to get a greater understanding of the different aspects of finance. The trust also identifies talent within the team and positively encourages staff to apply for vacancies as and when they arise in the team.”

“I genuinely believe that the Finance Department at Sherwood Forest Hospitals fully embraces all elements of Finance Skills Development and engagement with the Future Focused Finance related programmes and are happy to share their good work.”

“Excellent Level 2 application with very sound evidence to support their progression and commitment to be a great place to work.”

Spread

We have recognised that to excel as a finance team we need to be visible and engaged with colleagues throughout the trust. Some of the things we have done to increase our visibility within the past few years include:

• Set up @FinanceSFH Twitter account to encourage engagement from areas around the trust and wider. We use the account to showcase work we have been doing and communicating dates for payroll deadlines as an example.
• We have held our 2nd Annual Finance Conference. Last year the Showcase was a way of gaining visibility in the Trust and relating the work we do to the patient. This year following feedback we went for a workshop theme. There were three workshops: 5 year strategy, how the money flows in the NHS and How SFH finance is leading the way.
• To show our commitment to the Trust we hosted a Superhero Day to raise money for the Gamma Scanner. The day involved us dressing up, the cakes had a superhero theme and our very own Batman went up to see the children on Ward 25. We raised £500.
• We present monthly at the New Managers Induction to give a brief outline of Finance and the Trusts financial commitments.
• We also hold quarterly Finance for Non-Financial Managers half day workshops to give other staff around the Trust an opportunity to learn more about the Trusts finances, how the money flows and budget control.
• The training lead also provides bespoke finance training for areas of the Trust who want to know more and ask the questions in a smaller group. In being able to tailor presentations helps Finance be more visible and to keep finance in the back of everyone’s mind when making decisions. It’s important for everyone to realise that we have a finite amount of money to spend and we want it spent in a safe and efficient way.
• We have been lucky enough to share our journey with colleagues at the EMMAD and the SDN Steering group meetings. We have presented in front of SFH Exec team, been to Northamptonshire General Hospital to present our journey and what worked for us, We have also run 2 workshops at the joint HFMA/SDN Conference.
• We have struck up a joint best practice sharing relationship with Chesterfield Royal Hospital so we aim to meet quarterly and have representatives from around the finance department.

Value

All the above work and commitment from the finance department and the staff engagement group has added value in many ways:

• Finance team: Empowered to make their own decisions to improve their working life. This is done through improving systems, processes and challenging unhelpful behaviour. It has helped us all unite and aim for the common goal of being the trailblazer finance team in the East Midlands. We also have a much greater understanding of services around the Trust due to us being able to go out on visits and shadowing different services. This has benefitted everyone, the services like being able to showcase the work they do and the patients they treat. It also allows them to ask finance questions that maybe they didn’t feel comfortable to in other forums.
• Wider trust and Community: The confidence in the outputs from finance has greatly improved over the past few years. Standardised reporting, dedicated finance managers and regular training opportunities have helped with that. This has benefitted the Trust because Finance is now high up on people’s agenda when making decisions. With the help of Finance we have reduced our Agency spend by £15.3m in 2 years. This is due to multi-disciplinary teams working together this has a positive effect on patient care, staff satisfaction and efficiency. The education of all staff in the benefits of getting finance involved with decision making has been a positive one, it has been noted on many occasions that staff have never felt more supported by finance or seen as much of us! The finance team are being recognised as forward thinking and value adding to the wider community with all the engagement work we have done and looking at ways to improve shared working. We have never worked so closely with our CCG.
• Patients: There are only benefits for patients with the way we are now all working together. It is the vision for SFH for ‘Healthier Communities’ this is being achieved through better understanding of services, education in finance and the finance department sharing their best practice with neighbouring trusts. All this leads to better patient care and use of resources.

All the above show that the more engaged finance have become with the Trust the better the patient care, efficiency and value created by working better together. This will be further improved through the work to Level 3 ‘working towards excellence’.

Involvement

It all started in November 2017 when from our staff survey results showed that finance needed support to help the department become a better place to work. The ‘Staff Engagement Group’ came together. This is made up of volunteers from all areas of finance and any grade, the one common goal to ‘make things better’.

The first thing we did a Voice box out to encourage suggestions for improvement or guest speaker ideas anonymously. We had an overwhelming amount of issues to discuss and communicate solutions via the monthly team brief to start with. We also looked at polices to improve work life. As this scheme has matured there are fewer gripes and much more positive messages to read out.

We talked to the Volunteers Hub co-ordinator to set up volunteering time for staff members. We also talked to various services where staff had shown an interest in visiting and set up the visits.

We talked to other trusts that had been through the Level 2 accreditation and gained insight as to what worked for them and what didn’t. In doing so, we have established a good network of peers around the NHS to share best practice and not just our local trusts.

It is almost impossible to put a value on the benefit of the way we are now all working together, however, the positive comments from others, the change in culture, the better communication, better education will have had an impact that some could argue is more difficult to achieve than savings. However, we have met our control total for the past 3 years in a row which shows the focus of finance within the Trust and our teams drive to improve our Use of Resources.

Finance were also asked to present to the HSJ Trust of the Year judges as our Chief Exec and his board have recognised the work we have done with culture within the department and the engagement outside of the department.

Our Director of Finance has also been successful in leading the finance side of our ICS. I think this shows our commitment to the wider community and his appointment reflects how much finance at the Trust has improved.

We could not have been able to become the East Midlands trailblazing finance team if it wasn’t for the hardworkand determination of all members of staff.