Audit Commission

Improved communication and working relationships between clinical and finance staff are vital if the NHS is to be more efficient and improve services for patients, according to a report published today by the Audit Commission.

A Prescription for Partnership: Engaging Clinicians in Financial Management addresses the fact that failure to engage doctors and other clinical staff in managing their budgets has been found to be at the heart of financial problems in the NHS and can result in poorer services for patients.

The report reveals some strongly held negative stereotypes between the two professional groups which contribute to the problem. But it also shows how clinical and financial staff can come together to improve the quality and efficiency of services.

A number of practical measures were identified to promote better joint working to ensure that those dealing directly with patients are more involved in how the money is spent. These include training clinical staff in financial management; providing more timely and accurate financial information; and finance staff increasing their visibility and front line knowledge. These measures are summarised in a checklist for chief executives, medical directors and finance directors.

Steve Bundred, Chief Executive of the Audit Commission, said:
'This is about giving power and responsibility to those in the very front line. Most NHS money is spent by doctors and other clinical staff. It is they, rather than finance managers, who are best placed to identify how funds can best be used to improve the quality and efficiency of services. Where there is an ongoing lack of trust, respect and mutual understanding between clinical and finance staff, decision making can be poor and progress very slow. But where they do come together, it can transform services.'

Case study

One of the case studies featured in the report is Kings College Hospital NHS Foundation Trust. In 2004/05 the Trust reported a deficit of £2.7 million. It launched a programme to improve the patient experience and reduce unit costs. A lack of understanding about cost drivers and the relative profitability of each service area became evident when clinicians were asked to develop strategies setting out what aspects of the services currently being delivered they expected to expand and which would reduce. An improvement of their systems to provide more meaningful financial information to clinicians has contributed to Kings now reporting a strong financial position with a £4.4 million surplus in 2006/07. For further information contact the corporate communications team, Kings College Hospital, on 020 3299 3257.

Notes to editors

1. The Audit Commission audits NHS trusts, primary care trusts and strategic health authorities to review the quality of their financial systems and works with foundation trusts.
2. The Commission is an independent body responsible for ensuring that public money is spent economically, efficiently and effectively, to achieve high-quality local services for the public. Our remit covers around 11,000 bodies in England, which between them spend more than £180 billion of public money each year. Our work covers local government, health, housing, community safety and fire and rescue services.
3. Further details about the role of the Audit Commission can be obtained from www.audit-commission.gov.uk.