2 NHS FINANCE CAREER STORIES

NHS finance career stories December 2015 2 NHS FINANCE CAREER STORIES

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CONTENTS: NHS FINANCE CAREER STORIES

Sian Alcock NHS national graduate management trainee 9

Paul Baumann Chief financial officer, NHS England 11

Ben Bennett Director of business planning and resources, 13 National Institute for Health and Care Excellence

Mark Brooks Chief finance officer, Southern Health NHS Foundation Trust 15

Caroline Clarke Finance director and deputy chief executive, Royal Free London NHS FT 17

Jamie Foxton Deputy director of finance, Hull and East Yorkshire NHS Trust 19

Andrew Geldard Chief executive, North Essex Partnership University NHS FT 21

Kavita Gnanaolivu Manager, Ernst & Young 23

Kate Hannam Director of operations, North Bristol NHS Trust 25

Andy Hardy Chief executive officer, University Hospitals Coventry and Warwickshire NHS Trust 27

Gemma McGeachie Senior manager – financial strategy, NHS England 29

Gill McKetterick Project manager, Mersey Care NHS Trust 31

Dinah McLannahan Senior business consultant, NHS Trust Development Authority 33

Loretta Outhwaite Chief finance officer, Isle of Wight Clinical Commissioning Group 35

Yarlini Roberts Chief finance officer, Kingston Clinical Commissioning Group 37

Adam Sewell-Jones Director of provider sustainability, Monitor 39

Justine Stalker-Booth Head of financial management specialised commissioning finance, 41 NHS England national team

Paul Stocks Deputy director group finance – financial control, Department ofHealth 43

Ray Thomas Assistant chief finance officer, Countess of Chester Hospital NHS FT 45

Alison Tonge Regional director of specialised services, NHS England (North) 47

Richard Wheeler Finance director, East Midlands Ambulance Service NHS Trust 49

Robert White Health director (value for money audit), National Audit Office 51

Kate Whiting Finance director, specialist medicine, Central Manchester NHS FT 53

Paul Williams Research manager, HFMA 55

Janet Wood Non-executive director, South Essex 57 Partnership University NHS FT 42 NHS FINANCE CAREER STORIES

Introduction

Future-Focused Finance commissioned the HFMA to produce this series of NHS finance career stories to support its Great Place to orkW workstream. Our joint aim is to highlight different career pathways and the attractions of working in NHS finance. The stories promote the benefits to people considering their career options at all points in the spectrum – for example, from students and schoolchildren thinking about what they might do in later life, to finance directors working in other industries. They will also be of interest to NHS finance professionals considering what their next step might be.

The series of 25 stories captures a diverse mixture of careers that showcase the range, opportunities and appeal of working in NHS finance. They highlight the ability to have a successful career at any level and the opportunities for wide-ranging personal and career development. They show that time spent in NHS finance can enhance a career that spans other sectors or even non-finance careers.

This summary is intended to be of interest to a wide range of audiences, from NHS staff, to school leavers and graduates, commercial sector employees and those in the wider public sector. It draws on the individual career stories and summarises the key themes common to them all.

When talking to people considering a career in the NHS, one of our interviewees gives the following advice: ‘There are lots of opportunities for you in the NHS – for example, you may want to work as a technical accountant, a management accountant, an internal auditor or a contract accountant. The NHS offers you this and you can expand your skills beyond the finance team if you choose to.’

Why become an accountant?

Our career stories show the many different reasons people have for wanting, or just ‘falling into’, an accountancy career. In this section we look at how the people we interviewed became professional accountants and senior managers in the organisations they work for.

For some it is the extension of their studies at school and university that lead them to pursue a professional qualification combining business, numbers and people. Caroline Clarke, finance director and deputy chief executive of the Royal Free London NHS Foundation Trust, studied economics at the London School of Economics. This was also where she first set her sights on accountancy as a possible career, as she saw it as providing both a technical and portable skill. However, it wasn’t the beauty of a well-balanced spreadsheet that attracted Caroline. Instead, identifying the links between what she was learning in final year psychology and her accountancy modules, she was intrigued by how you could use numbers to influence people’s behaviour.

Andrew Geldard, now chief executive of North Essex Partnership University NHS Foundation Trust, was 5

working as a statistician in a regional health authority In the next section we explore in more detail the routes before starting his NHS finance career. He explains: that have led people into a career in NHS finance. ‘The regional director of finance was unhappy that the data analysis capacity was not within his department. Consequently, he tapped me up to apply for a job in his Why choose a finance career department.’ Andrew initially turned it down, thinking in the NHS? finance didn’t really appeal, but he says a call from the finance director changed his mind. Andrew went on to Working in the NHS has been a rewarding and diverse sign up for CIPFA’s senior entrants course and says career choice for our interviewees, packed with that he ‘owes a huge debt of gratitude’ for being opportunities for career development and providing a encouraged to do so. strong sense of job satisfaction. Several of the people featured in our career stories have family members Adam Sewell-Jones, director of provider sustainability working in the NHS – not necessarily in finance – and at Monitor, also admits he had no plans to be an so working in the NHS was a familiar choice. Others accountant while he was at university studying maths expressed their desire to work in the public sector at and statistics. A family friend, working as a finance an early stage and have combined their NHS careers director in the NHS, pointed him in the direction of the with spells in local government and other public sector NHS national finance training scheme. ‘All of a sudden institutions. Others had a different perspective on the I realised that doing accountancy in something like the NHS however, joining later in their careers, but speak NHS, where the accountancy wasn’t the end goal, could passionately about the work they do. be exactly what I wanted,’ he says. Kate Hannam, director of operations at North Bristol For others, the appeal of accounting is the professional NHS Trust, joined the NHS finance training scheme qualification. NHS England chief finance officer (CFO) in 1994 after completing an accounting and finance Paul Baumann started his career through a commercial degree. She had always wanted to join the NHS, management traineeship at Unilever. He says: ‘It seems following in the footsteps of a large number of her to me, you have to have a profession. And I thought family. ‘I always had public sector values,’ she says. finance would give me the best opportunity to exert ‘I considered working for one of the big accountancy broad influence across the whole range of things that firms, but I felt the NHS would give me a greater Unilever did.’ Unilever’s view of the finance role – it had opportunity to make a difference, I didn’t know exactly a commercial function rather than a finance department what I wanted to do within the NHS. I was quite – helped him to see this broader potential from a finance interested in general management, but I felt the finance career. But on his move to the NHS more than 20 years training scheme would allow me to transfer between later, he says: ‘I think I’ve made the move to the public disciplines more easily if I wanted to.’ sector for good. It is difficult to conceive of any parts of the sector that are as interesting, challenging or fulfilling For Sian Alcock, NHS national graduate management as the NHS.’ trainee, while working as a student during university holidays in NHS administrative jobs, she realised she Gemma McGeachie also works for NHS England, quite liked working in a hospital. Her belief in the need as senior manager – financial strategy. She studied for finance to put patients at its heart springs from this economics at university and had a place on the early work experience. On passing her degree, she went government economic service graduate scheme, which back to the NHS, first in the outpatient department and she turned down to follow a career as an accountant. then as executive assistant to the directors of finance She explains: ‘I was on a summer internship at EY at and nursing at Taunton and Somerset NHS Foundation the same time I applied for the government economic Trust. During this time she applied to the national service. During the seven weeks I spent at EY, I got graduate management training scheme. involved in a wide variety of projects and enjoyed it more than I was expecting.’ 26 NHS FINANCE CAREER STORIES

For some, a career in the NHS was not something that People come to the NHS for a variety of reasons but in was planned. Jamie Foxton, deputy director of finance the next section we look at what makes them stay and at Hull and East Yorkshire NHS Trust, says he’d never what they love about their jobs. thought about working in the public sector. He was conscious of a view across parts of the commercial world, where he started his career, that public sector What drives NHS finance professionals? finance managers were little more than budget accountants. ‘My perception had been that the NHS was Our interviews highlight the huge range of opportunities a bit of a backwater and it was not viable for a career,’ he and experiences the NHS can offer and what it is people says. But he was keen to continue his career by staying find most rewarding about their work. Many spoke about in the local area and when a job came up in 2010 at the personal satisfaction achieved from meeting tough the local hospital, he thought he should take a look. His challenges. For others it is the opportunity to work with view had also started to change over the past year as clinicians and see the impact of their work on improving his wife’s pregnancy had brought the couple into more patient care. contact with NHS services. ‘The more time I spent at the hospital, the more fascinated I became,’ he recalls. Loretta Outhwaite is CFO at Isle of Wight Clinical Commissioning Group. She says, ‘the variety is Similarly, Ray Thomas was drawn to the NHS by positive something I very much enjoy, along with the complex, experiences – of finance staff and NHS care. Now ever changing and somewhat unpredictable environment assistant director of finance at the Countess of Chester of the NHS. The aspects I enjoy are also the ones Hospital NHS Foundation Trust, he initially joined the trust that provide the most challenge in the role. I love as chief financial accountant. ‘It is my local hospital and a challenge.’ When starting out her career Loretta where my children were born. I knew the care there was deliberately chose to get some experience of life on the excellent and I wanted to build on my good experience front line, in clinical services working as a directorate on secondment to the NHS.’ He had previously been accountant. ‘I worked a shift in each clinical department, working at KPMG, specialising in corporate transactions. so I could understand what they did – mopping floors in ‘The role was particularly attractive because of its the urology operating theatre, providing support to A&E technical nature’, says Ray. He describes the transition staff and reassurance to patients and relatives.’ to the NHS as straightforward, ‘the people working at the trust were brilliant and very supportive.’ Alison Tonge, regional director, specialised services commissioning for NHS England (North), has always For Richard Wheeler, East Midlands Ambulance Service been interested in the bigger picture and making NHS Trust director of finance, it was the range of changes through specific pieces of work, such as organisations and services that attracted him to the NHS the private finance initiative, capital development and and a desire to improve business practices and put the writing business plans. Alison says, ‘I was interested in NHS onto a sure footing financially. the numbers telling the story – and still am. For me, it’s about using financial information and knowledge to make Finally, Andy Hardy, chief executive officer, University improvements.’ Hospitals Coventry and Warwickshire NHS Trust explains what makes an NHS finance career really stand out Kate Whiting recently joined Central Manchester NHS from other sectors. ‘Being an accountant in the NHS is Foundation Trust as finance director, specialist medicine. different to being an accountant anywhere else. We’re ‘The role is finance, but based within the medical not dealing with widgets; it is all about people and division, so is a perfect balance for me,’ she says. Kate making a difference to their lives. Anyone who works has relished the challenge of working at a large hospital in the NHS, whether they’re a clinician or not, is in a and is making good use of her general management job that makes a difference,’ he says. Andy says that experience. As she explains: ‘I now know I am asking the while working in NHS finance is rewarding, it is not for right questions. I can see where the problems are likely the fainthearted. ‘These are tough jobs,’ he says. ‘The to arise and can suggest ways to overcome them. I’d pressure can be relentless and how you respond is recommend spending time in an operational role, it really the true test.’ does make you a better accountant.’

Ben Bennett, director of business planning and resources at NICE, also enjoys the breadth of his role. His responsibilities extend beyond the CFO duties to business planning, human resources, IT infrastructure, procurement, estates and facilities, governance and board support. While he may not have formal qualifications in these areas, the accountancy qualification provides transferable skills. He also takes part in managing and reviewing the body’s clinical, public health and social care outputs. He says the work NHS FINANCE 37 CAREER STORIES is ‘fascinating’ and even though his focus is primarily on The focus on developing skills, not just becoming better finance, process and governance, it is a far cry from his accountants, is key to our interviewees’ experiences of narrower accountancy training. the NHS. In the next section, they share what they have learned. For Mark Brooks, CFO at Southern Health NHS Foundation Trust, the best things about working for the NHS are ‘the dedication from the clear majority of people. How can your career develop Working in an organisation that makes a difference to in the NHS? people’s lives is genuinely attractive’. As well as finance, Mark is responsible for procurement, IT, estates and In this section we summarise the advice that people corporate assurance. He says: ‘When in the office, I work have received as their careers progressed and what with a fantastic finance team that undertakes much of they have learned. As Yarlini Roberts, Kingston Clinical the day-to-day work. There is no typical day for me and I Commissioning Group CFO, says, she’s found that being enjoy a wide range of aspects in my role.’ a good accountant is taken as read. The skills she now relies on most are negotiation and relationship building. Gill McKetterick, project manager at Mersey Care Yarlini explains: ‘When you become a CFO, it suddenly NHS Trust, speaks highly of the opportunity to develop. hits you that you are accountable for everything. She says: ‘There are good support networks in the NHS It’s a huge responsibility, but also a huge honour. I and opportunities for those that want to take them. would recommend working in NHS finance to anyone When I worked in manufacturing, it felt like the only considering a career in accountancy. Also it’s not just incentive to progress was for more money. In the NHS, about numbers, it’s about doing the best for patients.’ it feels different. It is about expanding your skills and adding more value.’ Paul Williams, the HFMA’s research manager, says the best piece of career advice he has received is to keep While NHS finance and Dinah McLannahan’s current developing yourself and be patient. ‘When the right job role as senior business consultant at the NHS Trust comes along, you have to be ready to take it,’ he says. Development Authority are always going to be a step ‘You could go and find it for yourself, but don’t stress removed from the front line, Dinah believes she is having yourself out by swimming against the current.’ For those a direct effect on patient care. She is in a better position considering a job in the NHS, he has a clear message: than most to be able to say this, having previously been ‘There are many opportunities, so many exciting a nurse. ‘When I was a nurse there were many life and developments. It’s a great place to develop yourself death situations, but also lots of occasions when I was and do a good job for those who will benefit. This could able to make someone’s life a little easier,’ she says. be someone you know’.

Kavita Gnanaolivu is a doctor who now works as a Robert White, health director (value for money audit) at manager at EY. She started her NHS finance career as the National Audit Office, joined the NHS as a senior a graduate trainee and was able to develop a range of finance manager, after previous experience in private management skills, in addition to finance, while retaining healthcare. He remembers a number of accountants the connection to patients she wanted. Kavita says: ‘I were making the switch from the private sector and that applied to the NHS graduate financial programme at a not all of them could adjust. Robert was advised to get as time when the general management programme was much experience as possible of all parts of the service. not being provided. I didn’t have any prior experience He has taken this to heart, working over the years in in finance or accountancy, but luckily for me the many different part of the NHS. graduate assessment looked for the right transferable skills and ability for applicants to develop the required competencies. I had a great time developing my management and finance skills and all the time I was very conscious not to lose the link to patient care.’ 8 NHS FINANCE CAREER STORIES

Paul Stocks, Department of Health deputy director group health authority. ‘It struck me that he never took credit finance – financial control, joined the NHS as a deputy for something that someone else did. If it was a paper finance director of his local NHS trust more than 20 years to the board, for example, he always let them present it ago. He has continued to work at that level in several themselves,’ says Janet. roles, gradually moving to bigger and more diverse organisations. This often required him to learn new The best advice Justine Stalker-Booth, head of financial skills, which he did by spending time with non-finance management specialised commissioning finance in NHS colleagues. Paul says: ‘Spending time out of your England’s National Team, has been given for her NHS comfort zones really does help with your development’. career is to focus on what the next steps are for you, He also spent five days working in an accident and rather than about grade or money. emergency department. ‘It was a reminder about what we are here for,’ he says. ‘I’d recommend finance staff And Justine has her own advice for those considering do something similar – it really does give you a different a career within the NHS. ‘Sometimes it can be hard to perspective’. break into the NHS, but I think it is more about skills than the history,’ she says. ‘When I’m interviewing, I look for Janet Wood, currently non-executive director, South transferable skills. There are often internal candidates Essex Partnership University NHS Foundation Trust, who are very strong, so to break in you need to says there are two main influences on her career. The accentuate how your skills and experiences are relevant. first was a teacher during her first year in accountancy, I’d definitely recommend a career in NHS finance. It’s who was able to bring the subject to life. She is still in incredibly rewarding and you get to work with so many touch with her. The second was a chief executive of the great people.’

Conclusion

Our finance career stories showcase 25 individuals with experience of working in finance teams in more than 500 NHS organisations. But as well as providing an intriguing insight into personal journeys of career development and hard work, our stories uncover values and attitudes found across the NHS.

The first is the public sector ethos shared by so many. A career in NHS finance is about more than just accounting. Our interviewees were either attracted specifically to the NHS or determined to do something in public service. The timing was earlier for some than others, but was always borne out of their experiences and interactions with the NHS, which continue to drive and motivate them.

Second, accountants really can see how their roles add value to patients’ experiences. The NHS accountant is shedding the label of ‘bureaucrat’ as finance staff increasingly work in partnership with clinicians to develop high- quality services for patients that provide the best possible value for money.

And finally, there is real job satisfaction to be had from a career in NHS finance. Our interviewees, in common with thousands of their colleagues, thoroughly enjoy their work, want to help patients and can see how their work contributes to that.

What is clear is that NHS finance offers huge variety. Not everyone has a defined career plan in their head at the outset but the range of roles available and the portable skill set of the NHS accountant mean that lots of different opportunities for a well-rounded and rewarding career are likely to arise. NHS FINANCE 9 CAREER STORIES

Name: Siân Alcock

Job: NHS national graduate management trainee Learning to focus on the patient

Siân Alcock was late for work on degrees and my mum worked in and then to the audit committee.’ her second day as a trainee on the a hospital. She handed me an Working with the finance director NHS national graduate management application form for the staff bank and led her to choose finance when she scheme, but she had a good excuse. told me I must get a job if I’m living at was applying to the graduate training She came across an elderly lady home. I did loads of [NHS] bank work scheme. She believes her varied who couldn’t find the renal unit. And while at home and during university background, including time spent in because Siân didn’t know her way holidays and I realised I quite liked customer service and close to the around the hospital either, she found working in a hospital.’ front line of NHS care, has helped her someone who could direct the lady On passing her degree she in the graduate scheme. to the appropriate department. It went back to the NHS, first in the was a simple gesture, but it helps to outpatient department and then as Key influences illustrate her focus on patient care executive assistant to the directors The staff she worked with at the and patient experience. sharp end of the NHS had a huge ‘You have to remember the influence on her thinking. patients. It would be easy to spend ‘When I left the outpatient your life not seeing anything of the department at Taunton, the staff there front line. The finance department is told me never to forget where I had often in a separate building and if you come from. I have worked on the bring your own lunch you could avoid front line, I have been a band 2, so I the main building and not see any should remember that. patients at all,’ she says. ‘It’s important to people to Her belief in the need for finance understand what they do. There are to put patients at its heart springs managers who don’t know everything from her early work experience, about what their staff do on a day- when she spent holidays and to-day basis. They don’t understand time out of education working in the problems they face. If I am ever NHS administrative jobs, including managing people, I will take the time outpatients. to find out.’ ‘I have worked in jobs where I have Her mum has been another spoken to patients every day and I influence, both by instilling a hard have always got that in the back of working ethic and pointing her in the my mind,’ say Siân. ‘I have worked in direction of the NHS. a lot of customer service roles and so of finance and nursing at Taunton Siân adds that Rebecca Harriott, I know the importance of being nice and Somerset NHS Foundation the chief officer of Northern, Eastern to people.’ Trust. During this time she applied to and Western Devon CCG, gave her She had been keen to work in the national graduate management some good advice when discussing healthcare since her school days. training scheme. her future career. Work experience with a doctor told The executive assistant post came ‘She asked me to think about what her clinical work was not for her, but up after a director advised her to I like doing,’ she says. ‘I like working she stuck with science, gaining a bolster her management credentials with people, for example, so she got DipHE (diploma of higher education) by taking a job closer to trust me to really think about what I wanted in chemistry with medicinal chemistry. management. to get out of a job rather than what However, she was not attracted to the ‘It was a sideways move, but it the job title is. isolation of working in a lab and took was a good opportunity to get ‘I now know I’d rather work in a a degree in nutrition. experience of what managers do place with a good team around me, By this time, she had started while applying for the graduate where I feel valued. I hate to be working in the NHS. ‘I ended up in the scheme,’ says Siân. ‘It was a good bored, so I like being busy and having NHS by accident,’ she says candidly. mix of finance and patient focus. I responsibility.’ ‘I was living at home between used to go to safeguarding meetings She has been on the graduate 102 NHS FINANCE CAREER STORIES

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scheme since September 2013 and ‘I have worked in every band from Employment history she rates being accepted onto the band 2 upwards and I believe that’s a Qualifications Currently NHS scheme as her greatest work-related great thing. Some of my skills come national graduate achievement to date. ‘My placements from the fact that I have worked management have been varied and, depending in other jobs and have a better trainee, studying for on how long they have been, I have understanding of the NHS.’ CIMA qualification worked in different departments. At While she admits that accountants 2007 Taunton and the Royal Devon and Exeter, I have can feel removed from everyday Somerset NHS been working on business cases and patient care, she believes this can be FT, administrative the contract with the CCG.’ counteracted. ‘You can feel like a cog assistant (staff in a bigger system, but what everyone bank) On the move does has an impact on patient care in Moving around so much can make life some way. It is important to see the 2012 Executive assistant challenging, Siân acknowledges, but bigger picture. 2013 NHS graduate it is helpful to experience the different She cites as a recent example her management aspects of an NHS accountant’s experience of a trust board meeting. trainee (finance), ‘It was helpful because it put my work including into context and brought everything placements at together,’ she says. “You can feel North Bristol She will spend an extended period NHST; Northern, in a management accounting role at like a cog in Eastern and the trust, after spending June and Western Devon a big system, July with the Department of Health in CCG; Royal London as part of a national scheme Devon and Exeter but what of short placements outside local NHS FT; and the NHS organisations, including at the Department of everyone does has Department and accountancy firms. Health (financial It is an exciting time to work at the policy and strategy) an impact on patient Department, as the new government care in some way. It finds its feet. ‘I will be in the financial policy and strategy team working on Outside interests is important to see the spending review and learning In the limited time Siân has outside about the wider health system. It’s a work and study, she enjoys going to the bigger picture” great opportunity,’ says Siân. gigs and is also renovating a house. Becoming a Future-Focused Finance value-maker has also proved Favourite film The Lion King work. ‘It helps you see areas you to be a big opportunity, giving her a Favourite book The Great Gatsby, want to work in and areas you don’t, chance to help present a workshop F Scott Fitzgerald though I haven’t yet found anywhere I at the national HFMA annual wouldn’t want to work. The end of the conference, for example. ‘I am also Favourite TV shows Game of graduate scheme is still a while away, on the HFMA qualifications board, Thrones, Homeland, Sherlock but I feel ready for a proper job with which has led to further opportunities.’ Top three songs The Wolves (Act more work and responsibility now.’ Her work with the HFMA and FFF I and II), Bon Iver; We Looked The scheme has also enabled her has widened her vision, she says, Like Giants, Death Cab for Cutie; to surprise herself. Working in income adding: ‘It’s easy to get stuck in your Mountains, Biffy Clyro and costing, she was faced with own little bubble. Being a value- databases that presented several maker has given me the chance to Favourite food Pad Thai challenges, including technical break out of that bubble and meet Favourite website Pinterest – ‘mostly programming. ‘But with the help of people from all over the country. for ideas for renovating our house’ a colleague, I learned to do SQL ‘I’ve received countless words programming, which I didn’t think I’d of wisdom and career advice from ever be able to do,’ she says. more experienced colleagues, Would she change anything about which has really emphasised to me her career? ‘I wish I had found what the importance of supporting and I wanted to do earlier. I started the developing those around us.’ graduate scheme when I was 29. But, She summarises her experiences at the same time, if I had not had all so far: ‘There are some really great these different experiences I don’t people in NHS finance that we are think I would have got where I am. lucky to have.’ NHS FINANCE 11 CAREER STORIES

Name: Paul Baumann

Job: chief financial officer, NHS England Commercial road to NHS home

There are few examples of finance finance career. The firm provided flows to support the new process- managers who have made the switch the perfect context. ‘Unilever is driven structure. from the private sector to the NHS completely international, and even Knowing the business was key, and at the most senior level. The sector- more interesting to me was the fact Paul says a lot of time was spent on specific knowledge and experience that it respects local cultures, the factory floor and with marketing needed on both sides of the divide drawing its strength from applying teams ‘helping them to construct are often seen as too big a barrier. its values in a local context,’ says their innovations to deliver the best NHS England chief financial officer Paul, ‘You can also see the roots of possible value for consumers and Paul Baumann is proof that you can a business that really cares about shareholders’. make the transition, and he believes its employees. That is instilled in the In the mid-1990s, Paul moved to the differences – at least between way it does business – and that’s Dublin for four rewarding years as some parts of the commercial sector important to me.’ finance director for Unilever Ireland and the NHS – can be exaggerated. His CIMA training took slightly before moving back to Hamburg After 23 years with global food and longer than expected (three and in 2000 as finance and IT director household goods business Unilever, a half years), as a series of rapid for Unilever’s largest European Mr Baumann joined the NHS in 2007 promotions cut into his study time. subsidiary, UDL. He sees this as and is convinced the switch – to his biggest operational challenge – the ‘most interesting, exciting and ‘helping to revive what had become compelling’ part of the public sector – something of a slumbering giant’. is likely to be permanent. Paul insists he has never followed Dream job a detailed career plan. But planned This paved the way for his next or otherwise, a degree in modern and role – a ‘dream job’ – as vice- medieval languages doesn’t seem president for financial excellence. It the most obvious launch pad for brought him and his growing family becoming one of the health service’s back to the UK while allowing him most senior finance directors. to experience first hand the wide A gifted linguist – he studied both variety of international businesses in German and French at Cambridge Unilever. The role involved leading – Paul says he saw possible career Unilever’s global ‘Finance of the paths in the diplomatic service or an future’ programme, which reinvented international business. Both options the finance function to deliver drew on an enthusiasm to see the benchmark efficiency and bring world, inspired perhaps by Swiss the best evidence-based decision- grandparents and far-flung family At the age of 28, Paul became making techniques to major choices connections. The global business divisional controller of a large facing the business. option simply came along first, in agribusiness company, preparing With six years in post, it was 1984, as a commercial management what had become a non-core a rare chance to see the project traineeship with Unilever. business for sale in 1991. After a through to conclusion, from devising But why accountancy? ‘It seems to year in head office, he moved to the strategy to creating a finance me, you have to have a profession. Hamburg as financial controller academy to implementing the new And I thought finance would give me of Unilever ice-cream company model across the whole business. the best opportunity to exert broad Langnese-Iglo. But in 2007, Paul decided it was influence across the whole range of The company was in the midst of time for a change. Recognising that things Unilever did,’ he says. a major modernisation programme another move would most likely take Unilever’s view of the finance role and Paul, who was responsible for him abroad again – at a time that – it had a commercial function rather performance management, set would have been disruptive to his than a finance department – helped about adapting the approach to children’s education – he started him see this broader potential of a finance and management information thinking beyond Unilever. A call from 12 NHS FINANCE CAREER STORIES

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recruitment consultants put the NHS director of finance, he focused on Employment history in his sights, with newly appointed rolling out a pan-London financial Qualifications CIMA NHS London chief executive Ruth strategy to accelerate transformation 1984 Unilever, various Carnall wanting to recruit a finance and build momentum behind roles in UK director for the new strategic health productivity improvement. operations and authority from outside the service. In May 2012, he became chief global head office Paul was intrigued, and talking to finance officer to the then shadow his potential new boss convinced him NHS Commissioning Board, which 1993 Langnese-Iglo, it was the right move. ‘The quality began life the following April as NHS financial controller of the leadership you work with is England. It was a natural extension 1996 Unilever Ireland, probably the biggest determinant of of his NHS London role, but with a finance director success in whatever you undertake,’ budget jump from £15bn to £95bn. he says. ‘The role sounded exciting While NHS England nominally 2000 UDL, finance and IT and Ruth was assembling a great has a commissioning perspective, in director group of people. It was a recent start- reality the view is much wider. 2001 Unilever, vice- up, which appealed, with big strategic ‘The objective is not to make the president financial issues to be tackled – Ara Darzi’s commissioning system successful, excellence but to use the commissioning system to make the NHS as a whole more 2007 NHS London, “You wouldn’t successful,’ Paul says. Working with director of finance other national finance leaders (from and investment do this in a Monitor and the Trust Development 2012 NHS England, Authority, for example) gives useful chief financial officer corporate perspectives and makes the task ‘richer, if at times complex’, he says. environment Three years in, and Paul says the Outside interests finance profession has achieved a A classically trained musician from – changes at every huge amount – not least the launch an early age, Paul is an organist and level, no dry run. But of the new commissioning system member of various chamber choirs. in April 2013. ‘You simply wouldn’t He says playing the organ – he has the NHS pulled it off” do this in a corporate environment one in a crowded ex-dining room, – switching literally overnight, with plus a grand piano and other musical changes at every level and no paraphernalia – is the perfect daily Healthcare for London review was opportunity for a dry run – but the antidote to any work-related stress. just getting under way, for example.’ NHS pulled it off,’ he says. He met his wife through music and Paul admits he had a ‘massive As the service faces the challenge says his three children are now ‘more learning curve’, but says he was of delivering sustainable services accomplished musicians than I will allowed a couple of months to using new models of care, he singles ever be’. He even lays claim to some soak up as much knowledge as out faster progress towards fairer thespian credentials, having featured he could before assuming his full allocations as a change that will have as a singer in the first episode of TV responsibilities. Other national a big and lasting impact. detective series Morse. leaders – notably Richard Douglas Paul’s commercial experience, Favourite book Chocolat, and David Flory – helped him to with its focus on applying new Joanne Harris integrate into the broader finance business models across complex function and understand some of the environments, is proving a Favourite TV show Morse (see system’s ‘quirkier financial dynamics’. good foundation for his work on above) Perhaps surprisingly, he did not find transformation in the NHS. And Favourite music Anything written a major culture gap between Unilever his background in modernising the before 1750 and the NHS. He suggests there are finance function at Unilever has made greater cultural differences between him a driving force for the NHS-wide Favourite food Brownies (made by Unilever and other consumer goods Future-Focused Finance initiative. his children) companies than between Unilever Paul is clearly in a job he enjoys and the NHS - the similarities being and says he has no plans to move on based on ‘deep seated roots in any time soon. communities’. ‘I think I’ve made the move to the Politics (with a capital P) and the public sector for good. It is difficult to accompanying media spotlight were conceive of any parts of the sector perhaps the biggest differences. that are as interesting, challenging or In his five years as NHS London’s fulfilling as the NHS,’ he says. NHS FINANCE 13 CAREER STORIES

Name: Ben Bennett

Job: director of business planning and resources, NICE Pacing can be the key to success Careers last a long time, so enjoy introduction to health service finance. with a health background,’ he says. what you do at each stage and don’t Despite this, he ended up leaving ‘What attracted me was the wider be in a rush to take the next step. before he qualified. Having recently experience of lots of different things. This is the advice from Ben Bennett, started a family, Ben was keen to So while I was recruited for my director of business planning and move into a substantive role. So he knowledge in health, I moved to do resources at the National Institute finished his CIPFA qualification at lots of things in local government, for Health and Care Excellence. He Wandsworth Health Authority, where housing and even outside finance.’ says he has followed no firm plan in he was promoted to unit finance He specialised for a time in his career and, like many people, has manager, with responsibility for devising and carrying out bespoke taken opportunities as the right ones advising the continuing care unit. reviews of housing management arose, rather than forcing the issue. The role had him rubbing issues in London boroughs, having a Ben admits he did not leave school shoulders with more senior finance particular impact on the improvement with a burning ambition to be an NHS professionals undertaking the of rent arrears management in one accountant. Nor was accountancy equivalent role for the bigger acute south London borough. In another foremost in his mind while studying example, reviews of a London NHS for his economics and computer trust’s energy and maintenance science degree at the University of arrangements led to major changes Keele. ‘The choice of finance went to the management arrangements for with the economics and computer its estates functions. science territory,’ he says. But even if it was the broader But if he simply followed a line of value-for-money work that most least resistance into accountancy, attracted him, the financial audit work he was perhaps more destined to was also rewarding – Ben believes pursue his profession in the NHS. there would be benefits for all finance Looking back, he admits that student staff to do some audit. For example, jobs – as a cleaner in a small it provided an opportunity to observe orthopaedic hospital and a kitchen and work with top managers in porter in a large psychiatric hospital audited bodies. ‘I saw a range of – had been ‘formative experiences’. different chief executives and finance And various members of his family directors with different styles and worked in the NHS, so it seemed units such as St George’s Hospital. approaches, and you pick up different a natural choice. He had never There were significant development things from all of them,’ he says. contemplated applying for chartered opportunities: responsibility outside The audit role also helped him accountant positions with major finance (for supplies); working with a develop skills in delivering difficult firms and, if nothing else, he says clinician as his unit general manager; messages in a constructive way and his NHS ‘background’ helped with and even personally laying the cable taught him the importance of keeping applications. to plug the office’s one computer into issues in perspective and ensuring Gaining a place on the South East the mainframe! you look at the big picture. Thames Regional Health Authority A year with the Blood Transfusion However, with changes to the graduate training scheme in 1983, Service at South West Thames scope of the Audit Commission’s he studied for his CIPFA exams while Regional Health Authority was work, the opportunities for carrying serving placements in the South followed by a change in Ben’s career out non-mainstream audit work East – from Guy’s and St Thomas’ in path – a job at the Audit Commission. narrowed and Ben decided it was London to the Royal Victoria Hospital While the role would involve some time to move back to the NHS. in Folkestone. He recalls these as financial audit, the chief attraction for So, after 13 years at the Audit great experiences, with several days Ben was supporting the watchdog’s Commission, where he rose to senior attached to a senior registrar in growing value-for-money study work. manager, Ben made a move to NICE. Ashford Hospital fresh in his memory. ‘The commission was expanding He had had some insight to the He says the scheme was a brilliant into health and wanting people organisation, having audited its first 142 NHS FINANCE CAREER STORIES

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set of accounts (1999/2000) while widening of its role. Last year, for Employment history still at the Audit Commission. Since example, it produced the first safe Qualifications CIPFA joining, his own role has changed and staffing guidelines – a direct result 1983 South East Thames expanded along with the organisation. of recommendations following the RHA, financial Starting as head of finance and Francis report on Mid Staffordshire management trainee information technology in 2004, when NHS Foundation Trust. With NICE NICE was a £20m body employing having set up the process and 1986 Wandsworth HA, 130 staff, he became director of created guidelines in two areas, NHS unit finance manager business planning and resources England is now taking over this role. 1989 South West Thames in an organisation that now spends The NICE expansion has come with RHA, unit accountant £70m and has five times the staff. significant pressures to reduce costs (blood transfusion Again, he says it is the breadth – a 10% cash reduction in the current service) of the role that appeals. His planning period. Ben has led on this, responsibilities extend beyond the taking a key role in relocating much of 1990 Audit Commission, chief finance officer duties (with NICE’s work to Manchester and also various roles to overseeing mergers and transfers senior manager of functions to NICE, such as the 2004 NICE, head of National Prescribing Centre and finance and IT A committed some of the National Patient Safety Agency functions. 2007 Director of cold water As executive lead for human business planning resources, Ben has had responsibility and resources swimmer, for a range of challenging Ben swims employment issues relating to Outside interests management of change, disciplinary A committed cold water swimmer two to three times and grievance matters. And with (without wet suits), Ben swims two responsibility for risk assurance to three times a week and competes a week, competing and governance, he has sought to occasionally. He is also a qualified instil high standards of business swimming teacher and cycles to occasionally conduct probity and transparency keep fit. He is a self-taught guitarist across the organisation – achieving and gigs occasionally in a local consistently high ratings from auditors band with friends. He is currently a relatively small 10-strong team) for the design and application of risk a trustee and honorary treasurer of to include business planning, management and internal control. charity Age UK Lambeth. human resources, IT infrastructure, He says he is happy at NICE with procurement, estates and facilities, a good work-life balance, but doesn’t Favourite book As I Walked governance and board support. While rule out a move back into frontline Out One Midsummer Morning, he may not have formal qualifications healthcare. But it would need to be Laurie Lee in these areas, the accountancy the right opportunity. People can be Favourite film Brazil, Terry Gilliam qualification provides transferable in too much of a hurry to make the skills and is recognised as doing so. next step, he says – a career is a Favourite food Japanese He also plays a part in the marathon not a sprint. Alternative career choice Architect management and review of NICE’s Ben is enthusiastic about finance clinical, public health and social care staff lending their professional skills outputs – its clinical guidelines and to voluntary roles, especially health technology appraisals. Ben says the and social care charities. He has held work is ‘fascinating’ and even though several honorary treasurer roles for his focus is primarily finance, process clubs and charities and is coming to and governance, it is a long way from the end of his last possible term as his narrower accountancy training. treasurer at health and care services He says this involves working provider Age UK Lambeth. (It is closely with senior clinicians and seeking a replacement – for details other experts and having the email [email protected]). knowledge and confidence to ‘It’s not just a worthwhile thing to do, challenge them. NICE is widely it’s also great development for finance recognised as having been a success professionals,’ he says. ‘And for both in the UK and internationally – finance directors, it is a way of keeping a success that has led to a further in touch with the sharp end.’ NHS FINANCE 15 CAREER STORIES

Name: Mark Brooks

Job: chief finance officer, Southern Health NHS Foundation Accountant with a Trust technical edge

Before joining the NHS in 2009, role, so in 1990 he moved to Smith the strategy was correct and the Mark Brooks spent almost 20 years & Nephew, a firm manufacturing benefits delivered.’ working in the medical device medical devices with a global market. Mark returned to mainstream industry in a range of UK and The division he worked for was 20 finance at Smith & Nephew and international finance roles. His first times larger than his previous one at worked in two more financial control NHS role was as director of finance Computype, and included spending roles at a time of great change for and corporate assurance at Humber six months working in Milan and the company. He describes his NHS Foundation Trust, a mental then Hamburg. ‘The culture of the experience as a key influence for health and learning disability services organisation was key to me,’ says later moving to the NHS. provider in Hull and East Yorkshire. Mark. ‘There was also a great focus It was here that Mark saw the role He has been in his current role at on developing people. Accountants of medical devices in helping people Southern Health NHS Foundation typically rotated between roles every to regain their lives. ‘The company Trust since 2013. couple of years, which provided was incredibly customer focused,’ he Mark always wanted to work in opportunities to develop and meet says. ‘I could see how my work was business and feels it was a natural your aspirations.’ having an impact despite not working progression to study accounting at the front line.’ His move to the and finance. ‘I saw it as a good NHS wouldn’t happen until later in his qualification that would allow me to career but the values and culture of be involved in business in some way the NHS was a key motivator. or other. I had a level of interest in finance, which developed while I was Stock Exchange ambition studying,’ he says. Mark worked at Smith & Nephew for His first role after university was 17 years. He left to fulfil his aspiration at Computype, an organisation to become a finance director for a that manufactured high-precison company traded on the New York barcodes. Mark describes the Stock Exchange, joining Symmetry organisation as small but forward- Medical Inc in 2007. The company thinking. He says the employees made medical devices, primarily were well regarded and supported artificial hips and knees. by the organisation to achieve as It was at Symmetry Medical that much as they could. Mark liked its Mark faced his greatest challenge organisational model. to date - leading the restructure ‘It reflected a text book company,’ It was at Smith & Nephew that of a subsidiary that was a heavy he says. ‘It was an American firm, so Mark gained his first experience of loss maker and faced accounting there was an overseas parent with a wide range of strategic initiatives challenges. ‘At Symmetry multiple subsidiaries and it operated across worldwide manufacturing Medical there was a clear drive in different markets.’ projects. for an improvement in financial Managing directors were sent One key project was creating a performance and a focus on value for from the US to the UK, one of whom new organisation as the company shareholders,’ he says. positively encouraged Mark and divested in manufacturing devices Mark successfully restructured the helped him to understand the options that it did not consider to be part of finance department and along with available to him if he became an its future. He describes it as ‘a great the chief operating officer significantly accountant. He qualified with CIMA at project where all my financial skills improved the company’s financial the age of 23. were put to good use, with finance performance. In planning his career, Mark has playing a crucial role supporting the While at the company, he made always been aware of the art of the focus on customers’. it a clear focus for accountants possible and what an accountant ‘We started with very little and to generate strong financial can achieve. After two years at quickly created a strategy,’ he says. management information and Computype, he wanted to progress ‘Over two years we developed the develop an environment of proper into a bigger and more challenging business and it was great to see financial control. ‘It is important to 16 NHS FINANCE CAREER STORIES

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develop and maintain relationships the best possible care for the monies Employment history and really understand where available,’ he says. ‘Management Qualifications CIMA customers are coming from,’ he says. accounting teams working with 1987 Computype, ‘Finance can support by using strong clinical staff can find ways to develop company analytical skills to understand what and deliver sustainable services. accountant is happening. Organisationally, we The effective working relationships then know where to focus and how to of the finance team can add value to 1990 Smith & Nephew, address the challenges to add value.’ any good organisation.’ various senior Joining Humber NHS Foundation He sees the HFMA as a finance roles Trust in 2009, Mark put this into key resource for NHS finance including operations practice and found it essential to professionals, of a type and quality financial controller listen to people, learn about the that is not readily available to the 2007 Symmetry Medical organisation and remain confident in private sector. Inc, chief finance his own skills and prior experience. ‘The NHS is lucky to have such rich officer Europe He says it is important not be afraid resources and expertise available to challenge in a positive way what is to finance teams,’ he says. ‘The 2009 Humber NHS FT, opportunities for meeting people and director of finance networking are beneficial whatever and corporate “There is a stage of career you are at.’ assurance Now chief finance officer at 2013 Southern Health Southern Health NHS Foundation role for us NHS FT, chief Trust, Mark is transferring his recent finance officer all to ask skills and experience from working in East Yorkshire. how finance, ‘There are a number of challenges Outside interests nationally for the NHS that are Mark is a Hull City football fan and a estates, IT and any being met in different ways and with keen sportsman. He enjoys cricket different levels of success. I am really and when he can find the time he corporate service enjoying working in the NHS and I is the opening batsman for his local can support the best am enthusiastic about coming to work club side. when I get out of bed in the morning.’ possible care” Favourite film The Hunger Games Work balance Favourite book Birdsong, Sebastian This is important to Mark because Faulks happening. By looking objectively with he works 200 miles away from his Top three records Mr Brightside, business managers and clinicians, home. ‘There are challenges striking The Killers; Will You, Hazel O’Connor; Mark was able to improve the way a good balance between home and London Calling, The Clash teams worked and the management work. It is as important at home information that was available. that you are engaged in quality Alternative career Archaeologist He joined Humber after the trust activities as it is when you are at had made an unsuccessful initial work,’ he says. foundation trust application. As well ‘When in the office I work with a as a desire to make a difference, fantastic finance team who undertake it was the challenge of applying much of the day-to-day work. There his skills in a different environment is no typical day for me and I enjoy that attracted Mark. Within a few a wide range of different activities. months, the trust was successful in its As well as the financial aspects of application. the trust’s activities, I am responsible ‘Humber sought in me strong for procurement IT, estates and financial leadership and I was corporate assurance’ he says. fortunate to learn a lot from very good And the best things about working people in the NHS,’ he says. for the NHS? ‘The dedication to the Mark says working in a finance NHS and patients from the vast team can mean that sometimes it majority of people. Working in an is difficult to see directly the link to organisation that makes a difference patient care. ‘There is a role for us to people’s lives is genuinely all to continuously ask how finance, attractive. Many people across many estates, information technology and organisations support excellent front any corporate service can support line services.’ NHS FINANCE 17 CAREER STORIES

Name: Caroline Clarke

Job: finance director and deputy chief executive, Royal Free London NHS Foundation Trust Public service, local focus

The biggest lesson Caroline Clarke national finance training scheme, ‘Like Colin, he was very direct. believes she has learnt in her NHS having been impressed by the He was happy to take risks – albeit finance career is that you don’t recruitment process and one of her educated and informed risks,’ she know everything. It is much better to assessors, Colin Gentile. says. ‘And he taught me it was acknowledge this to yourself and to In fact, she was soon working with okay to do that, to be different and others, says the finance director and Colin at Hampstead Health Authority, to speak the truth – to say it as deputy chief executive of the Royal where he was director of finance, as you see it. That is so important, Free London NHS Foundation Trust. her first placement on the scheme. especially in the highly politicised But if there is one thing Caroline Describing herself as a ‘shaper, environment of the NHS.’ did know, even as a teenager, it early adopter and innovator’, She was impressed with Keith’s was that she wanted to work in the Caroline says Colin had a big ability to influence policy makers, public services. influence both on her decision to join recognising that this was based not Having studied for her O levels at a the NHS and how she worked. just on what he said, but the fact that comprehensive school in Cardiff, he delivered in his day job. a scholarship gave her the chance to go to a well-renowned public Dealing with failure school for her A levels. And it was Shortly after starting at Kensington, here that she believes she developed Caroline found out that she had a ‘real sense of the privileged elite failed her CIPFA project on charitable and the under privileged’. From then funds and it hit her hard. on, she knew her future lay within the ‘It was the first thing I’d ever failed, public services. and I failed because I didn’t ask Four A levels later and she was enough people for help. So it taught at the London School of Economics me the power of consulting and studying economics, where she built asking at an early stage. You can on earlier bouts of political activism have a good idea, but it is really only by taking a year out to be treasurer good if lots of people share it.’ of the student union. A new project was lined up, based This was also where she first set on the large-scale transfer of nurses’ her sights on accountancy as a homes to a housing association. A possible career. year and 10,000 words later, she had However, it wasn’t the beauty of her CIPFA qualification. a well-balanced spreadsheet that ‘It was a good project, based attracted Caroline. Instead, on something I did in reality and it identifying the links between what taught me the importance of talking she was learning in final year to people,’ says Caroline. ‘You can’t psychology and her accountancy ‘He had a very direct approach – always think you know the answer – modules, she was intrigued by how he was very practical and a doer,’ in fact usually you don’t. you could use numbers to influence she says. While at Hampstead, in ‘That is a good gift to have, and people’s behaviour. the first leg of what was to be a it is perhaps easier to say now that Accountancy also appealed return journey, she was involved with I am more senior, but it is difficult – compared with, for example, the creation of the Royal Free as a when you are starting out. It is more general management – as she saw freestanding NHS trust. credible to expose your ignorance it as providing both a technical and Her first ‘proper job’ was and be honest with people, and that portable skill. This would serve as an at Kensington, Chelsea and is a good thing to learn.’ insurance policy if things didn’t work Westminster Health Authority as a A first deputy finance director role out with plan A. project accountant working under at Camden and Islington Health This plan turned out to involve finance director Keith Ford – another Authority was followed by a first real the NHS, and a place on the NHS major influence. taste of provider-land at the Royal 18 NHS FINANCE CAREER STORIES

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Brompton. Caroline then gained her patient record well ahead of the trend. Employment history first director job at the new City and The trust’s success was built on Qualifications CIPFA Hackney Primary Care Trust. it having a good team and good 1993 Kensington With a completely new organisation relationships and partnerships with Chelsea and needing to be set up, Caroline says other local health organisations. Westminster HA, she was able to play to her strengths ‘I started to become more aware of project accountant and to ‘get on with the job’. my external profile and my ability to ‘I learnt [from chief executive Laura represent an organisation and carry 1996 Camden and Sharp] that good management and a message and ensure it gets landed Islington HA, leadership aren’t about control and back internally,’ says Caroline – all of finance manager – power – they are about getting the which are key aspects of the finance deputy finance best from other people,’ she says. director role. director She also chalked up some more 2000-2001 Royal Brompton career firsts – signing the technically Learning from KPMG Hospital NHST, challenging first LIFT scheme in East After five successful years at assistant finance London and – reaching outside her the Homerton, Caroline joined director finance role – linking service and KPMG, initially as a director and estates strategies. subsequently associate partner, to 2003 Homerton University Caroline says that location has help build a health practice within the Hospital NHS FT, always been important for her career. consultancy. finance director She not only wanted to be in the She says she learnt a lot and 2007 KPMG, associate public services, but connected to her had two good years working with partner own local services – and so pursuing some very bright people. But she recognises now that the move ‘didn’t 2009 NHS North Central fit entirely with who I am’. London She adds that it had always been Commissioning “Good her intention to return to the NHS, Agency which she duly did – armed with the management 2011 Royal Free London knowledge of how to be a better client NHS FT, finance and – in 2009. director and deputy Then, in 2011, she made her return chief executive leadership journey to the Royal Free, this time as finance director and later adding Outside interests aren’t about control the deputy chief executive role to her Since becoming a mum two years responsibilities. ago, Caroline says her diary is and power – they Now in her fifth year, Caroline says managed better to avoid so many she is proud of the work she has done long evenings at work. She cites are about getting at the organisation that originally music and theatre as her big outside trained her. ‘We’ve put a real focus on interests, though she doesn’t like the best from other safety, quality improvement and value musicals (with exceptions, see people” for the patient,’ she says. songs below) and she attends gigs This is an interest she has also where possible. pursued by heading the value workstream for the national Future- Favourite book Perfume, Patrick her career in and around her home Focused Finance initiative. She also Süskind; The Checklist Manifesto territory of north and east London has picked up the HFMA Finance Director (non-fiction), Atul Gawande been a deliberate strategy. of the Year Award in 2012. Favourite song Gimme Shelter, In 2003, she continued this However, Caroline insists that her Rolling Stones; Give a Little Love, connection when she moved to the achievements are all the results Bugsy Malone Homerton hospital – a trust with of great teams, not individual ambitions of becoming a first-wave performance. Alternative career choice foundation trust – where she stepped She returns again to the advice of Bass guitarist into her first provider director role. one of her mentors, Keith Ford: you She remembers a trust ‘punching don’t and can’t know everything, so massively above its weight’ in gaining get some help. its FT status, implementing the Any careers advice for other finance fledgling payment by results system practitioners? A little humility goes a and introducing a new electronic long way. NHS FINANCE 19 CAREER STORIES

Name: Jamie Foxton

Job: deputy director of finance, Hull and East Yorkshire NHS From farmyard Trust to finance

Having left school at 16 to work chip company, people weren’t too family-run environment of Portakabin. on his family’s farm in Yorkshire, a fazed by the age thing,’ he says. ‘I was in my mid-20s and career in accountancy was not really ‘I really enjoyed it, but I knew enticed by the career opportunities on Jamie Foxton’s radar. But 15 I didn’t want to pursue a career and potential for going round the years on and now deputy director of in audit. I was more interested in world. And for six months or so I finance at Hull and East Yorkshire industry – I wanted to be influencing really enjoyed it. But after a couple NHS Trust, Jamie is sure he made what was going to happen, not of years, the culture of a really the right move. looking back at what had happened.’ big profit focus didn’t fit with my He admits to stumbling into His first step towards this came personality and I started looking for accountancy. Ill health as a teenager with a move to Portakabin in York. something different.’ brought his school days to a Although he started in internal audit, Jamie says he’d never thought premature end after finishing his he soon moved into his preferred about working in the public sector. He GCSEs. But a year of farm work management accounting role in was conscious of a view across parts at his parents’ farm was enough the modular building company’s of the commercial world that public to convince him he wanted a more European division. sector finance managers were little academic challenge. more than budget accountants. ‘My ‘A job came up in accountancy in perception had been that the NHS a small local practice. I didn’t get it, was a bit of a backwater and it was but I had managed to get my name not viable for a career.’ onto recruitment agencies’ lists as a potential candidate for AAT-level jobs Local focus in accountancy. And that led to a call However, he was keen to continue for an interview with PwC in its Hull his career in the local area. When office,’ he says. a job came up in 2010 at the local He says he ‘hounded’ the firm after hospital – Hull and East Yorkshire the interview, desperate for a new Hospitals NHS Trust – he thought he career path. His persistence paid off: should take a look. His view had also he was offered a job and within 18 started to change over the previous months he had his AAT qualifications year as his wife’s pregnancy had and had started on a fast-track path brought the couple into more contact to being a chartered accountant. His with NHS services. ‘The more time AAT training cut down his required I spent at the hospital, the more training period to two years. fascinated I became,’ he recalls. Thrown in with slightly older Despite being a big organisation, An interview with then finance graduates, Jamie acknowledges he with a group turnover now exceeding director John Barber further felt he had something to prove given £220m, Jamie says it is still quite convinced him it was the right move. his different academic path. But with definitely a family company with a ‘He was quite inspiring and he sold an enthusiasm for learning, he found great ethos and one that values its the job well,’ says Jamie. ‘We talked himself a fully qualified accountant by employees. ‘It was a great place to about the trust’s foundation trust the age of 22, picking up a regional work. I spent two years there and aspirations and the greater autonomy prize in the ICAEW professional level really enjoyed it,’ he says. and commercial approach that exams on the way. However, he admits to ‘being would bring. But there also seemed Having become an assistant dazzled again by a big blue-chip to be such a great team-working manager at PwC, he soon moved plc’ and made a move in 2007 to environment, which was really into audit, where he found himself join multi-national consumer goods something I was looking for.’ travelling and overseeing audits company Reckitt Benckiser. The The role was senior business unit in major companies. ‘It was quite company, which produces health and accountant for one of three surgical daunting and high pressured at a hygiene products such as Dettol and units and the interview, which also young age, but being in a big blue- Nurofen, was a stark contrast to the involved the unit’s clinical director, 20 NHS FINANCE CAREER STORIES

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made it clear this would involve close provide more patient-focused care. Employment history work with clinicians. This would have involved bringing all Qualifications AAT, ICAEW ‘This was really appealing to me – elective activity onto a single site, but 2000 PwC, assistant the opportunity to support business the tough financial environment made manager cases that could have a direct impact it impossible to take the plan forward. on patient care. That gave me a real The trust is now looking for other 2005 Portakabin, buzz.’ When he was offered the job, ways to deliver the same outcomes. finance manager he didn’t hesitate. Jamie believes the experience was 2007 Reckitt Benckiser, ‘It was a steep learning curve, but hugely developmental and gave him supply controller you have to throw yourself into it and great exposure across the trust, as learn on the job,’ he remembers. well as the opportunity to build lasting 2010 Hull and East ‘But right from the off, I was going to relationships with clinicians. Yorkshire NHST, business meetings and presenting the senior business financial position and opportunities for Director shift unit accountant, savings and talking through finance A further role change has seen Jamie head of finance, and non-finance metrics.’ become the trust’s deputy director deputy director of of finance. ‘Moving to the NHS was finance the right thing for me,’ says Jamie. “The ‘I’ve loved the learning over the past Outside interests five years.’ He says the opportunity With two children aged two and four, opportunity to pursue his career in his own local Mr Foxton says there isn’t a lot of hospital has added to the experience. time for much else. He describes to support ‘I’m a local person and I feel proud his hobbies as ‘holidaying’ and business of my hospital and the fact that my the seemingly polar opposites of family use it.’ ‘fishing and fast cars’. However, he cases that could Jamie is pragmatic about his future. also enjoys keeping fit and playing He remains career-minded and football for a trust five-a-side team. realises he may need to leave to have a direct impact make the next step up. ‘I’m keen Favourite book Animal Farm, on patient care – that to broaden my experience and George Orwell recognise my next career move may Favourite place Maldives gave me a real buzz” need to be to a clinical commissioning group, a commissioning support unit Favourite song Can’t Stand Me or more on the strategic side,’ he Now, Libertines It helped that the clinicians were says. ‘Wanting to stay local clearly Best career advice A fulfilling career learning too. While many clinicians makes this more challenging.’ is a marathon, not a sprint might do ‘maths as a hobby’, as He has changed his own initial his clinical director put it, they ideas about the NHS and says Alternative career choice Probably weren’t experts in how NHS finance ‘accountancy in the NHS offers a journalist – I always enjoyed works and how the funding flowed as many if not more challenges creative writing or costs accumulated. But they than dealing with finance in the were interested. ‘Most clinicians commercial sector. appreciated honesty and a fresh Importantly, there’s an additional perspective. I really liked the ethos payback in contributing to the that we were doing this together.’ development of good and better A subsequent merger of the patient services.’ surgical units a year later saw Jamie says he would consider a Jamie promoted to head of finance move back into the private sector if of the new, bigger group. ‘This was the right role came up. In his view, a great role. It was a £120m unit – ‘the experiences gained in the NHS responsible for about a quarter of have made me a much more rounded the trust’s cost base – and we had finance professional’. our own ‘board’, including medical, ‘I now take a much more holistic nursing and operations directors plus view of business proposals rather myself. We all had different strengths than just the bottom line,’ he says. – but we worked really well together.’ ‘The development of my influencing In one notable initiative, the team skills and ability to take people with built up a £10.5m investment plan me has been essential in my to reconfigure surgical services to progression.’ NHS FINANCE 21 CAREER STORIES

Name: Andrew Geldard

Job: chief executive, North Essex Partnership University NHS Foundation Trust Gathering data and recognition

Life could have turned out very sent to the DHAs. Frustrated by for the creation of the purchaser/ different for Andrew Geldard. He the lack of accessible information, provider split in the service. In admits he tried to avoid working for Andrew made a name for himself demand because of his database as long as possible – and succeeded by producing a booklet that set and spreadsheet skills, he was until he was 25. out activity information for each of approached to help start the He graduated from the University the DHAs. thinking in the regional health of Wales with a degree in geography Luck played a part when he authority about commissioning and American studies and was keen was asked to learn a spreadsheet services and to lead on the modelling to continue his studies. A lack of package known as Multiplan. of commissioning plans. public funding in the UK sent Andrew Spreadsheets were in their infancy Andrew explains how he made his overseas and he spent a year in and Andrew was one of the few move into the finance department. Canada at the University of Manitoba ‘The regional director of finance, completing a masters degree in Stuart Welling, was unhappy that geography. He was keen to stay in capital was not part of finance and Canada but he didn’t meet the criteria that the data analysis capacity for obtaining a permanent visa. was not within his department. Andrew returned to the UK to Consequently, he tapped me up to succumb to the inevitable and look apply for a job in his department. for a job, but it was the mid-1980s and not any easy time to enter the Mixed feelings labour market. He explains: ‘There ‘When I was offered it, I turned was not much employment in the it down and explained that the north of England at that time, so I questions in the interview had made had to be open-minded about my me realise that a job in finance did options. After a year of job hunting, I not appeal. Stuart then rang me to spotted an advert for a statistician at explain the error of my ways. I’m so South East Thames Regional Health glad he did.’ Authority and applied for it.’ The job involved preparing While at that time Andrew did not for the introduction of the NHS have a particular interest in working internal market and included in the NHS, his masters thesis was people at the regional health developing allocation formulas for on accessibility to primary care in authority who could use them. commissioners in the region. the Canadian city of Winnipeg. ‘Being able to use a spreadsheet It was in this role that Andrew This stood him in good stead – he enabled me to carve out a niche studied CIPFA. At the time, there was got the job. for myself,’ he says. ‘In 1986, there a push for finance to be a core part Andrew recalls that the regional was a big push on reducing waiting of NHS management and unqualified statistics team provided support lists and I was able to do some finance directors were being for three district health authorities spreadsheet modelling, which helped encouraged to qualify. (DHAs). There were information to support what we were doing.’ Even though he was working in the systems at district level but most Jobs in the capital planning and finance department, Andrew had no of the analysis was carried out at public health departments of the intention of becoming an accountant. regional level. regional health authority quickly Things changed when he received Andrew recognises that there were followed and in both he continued another call from Stuart. two factors that had a significant to develop his data analysis skills, ‘He asked me why I hadn’t signed impact on the direction his career including how to use databases. up for CIPFA’s senior entrants course took – his personality and luck. At The 1988 white paper Working and explained that I would struggle that time, data programmes were for patients brought about a big to go much further in NHS finance run over night and printed off on change for Andrew as well as for the without being qualified,’ he says. ‘I continuous paper, which was then NHS. The paper set out proposals owe him a huge debt of gratitude.’ 22 NHS FINANCE CAREER STORIES

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In 1992, Andrew started what he director of finance and performance Employment history calls his ‘first proper finance job’. at Southend-on-Sea Primary Care Qualifications CIPFA It was at Brighton Healthcare NHS Trust in 2000. While he enjoyed 1986 South East Thames Trust as deputy finance manager, certain aspects of the role, particularly RHA, statistician where he was responsible for working with GPs, he missed working providing management accounts in a provider organisation. 1987 Capital planner support to the surgical department. Attracted by work in mental health, 1988 Policy analyst As Andrew recalls: ‘I’d not worked Andrew then became director of in a hospital before and there was a resources at North Essex Partnership 1989 Financial planning lot to learn. Luckily, the finance team NHS Trust in 2002. His first priority manager was very supportive.’ was returning the trust to a stable 1992 Brighton His data skills came to the fore financial footing and putting a Healthcare NHST, again and he found ways to improve robust financial plan in place. The deputy finance reporting at the trust by extracting improved performance at the trust led manager data from the ledger, which led to to it getting foundation trust status in better manipulation and analysis. 2007 and Andrew led on the financial 1996 Surrey and Sussex aspects of the application. Healthcare NHST, He recalls how his move to become deputy director of “I like to be very a chief executive came about. ‘I had finance and planning no ambitions to be a chief executive. 2000 Southend-on-Sea visible in my But when the then chief executive PCT, director of went on long-term sick leave, I was finance and organisation. asked to fill the role on an interim performance basis. I felt I couldn’t say no. I was I walk the committed to the organisation and 2002 North Essex had to step up.’ Partnership wards, meet Andrew focused on addressing the University NHS FT, teams and issues that needed sorting and a year director of resources later was permanently appointed into 2008 Chief executive service users, always the role. As chief executive, Andrew says Outside interests ask for feedback” he spends most of his time on customers. ‘There are two groups,’ Andrew makes time for his family by he says. ‘Our commissioners and being at work by 7am and leaving at Gaining in confidence and getting patients. I like to be very visible in 5pm. His hobbies include watching more serious about his career, he my organisation. I walk the wards, football (supporting Blackburn took up the post of deputy director meet the teams and service users. Rovers) and managing his son’s of finance at Crawley Horsham NHS I’m always asking for feedback so cricket team now his playing days Trust in 1996. ‘It was a much deeper we improve what we are doing. I’m are over. step into NHS finance’ he says. keen on patient surveys to give us Favourite book Trainspotting, Irvine In 1998, the trust merged with East something concrete to improve on.’ Welsh Surrey Hospitals NHS Trust to form Andrew is in no doubt that a Surrey and Sussex Healthcare NHS background in finance is a good Favourite film Italian Job Trust. Andrew was responsible for grounding for an NHS chief executive. Favourite TV show Top Gear the management accounting and ‘Being able to quickly understand planning side of finance. complex data and get behind the Top three songs London Calling, While CIPFA had an impact on numbers of the organisation really The Clash; Anarchy in the UK, Sex Andrew’s work life, it also had an helps. It can give you a sense of what Pistols; Boredom, Buzzcocks – ‘I’m unexpected impact on his love life. It is and is not important, but is only one still stuck in 1976 I’m afraid!’ was while Andrew was volunteering piece of the jigsaw,’ he says. Favourite website BBC Sport as a P3 CIPFA project examiner The best piece of advice Andrew that he met the woman who would has been given is to make the best become his wife, Veronica Watson, use of other people’s resources. also an NHS accountant. ‘Being a good finance manager in the It was his keenness to be closer NHS is not just about working with to Veronica that prompted Andrew’s what you have,’ he says. ‘It is about next move. He decided to take a generating new resources, by working risk and experience what it was like with others, doing things better and to be a commissioner, and became winning new business.’ NHS FINANCE 23 CAREER STORIES

Name: Dr Kavita Gnanaolivu

Job: manager, Ernst & Young Doctor with a ‘go for it’ spirit

Kavita Gnanaolivu qualified as a to the UK with my husband and I shop floor, what we were doing well doctor before training to become an applied to the NHS graduate financial and what didn’t work or was causing accountant. At school, she had a programme at a time when the staff and patients frustration,’ she keen interest in space and research general management programme says. and set her sights on working for was not being provided,’ she says. Kavita has sought mentors when NASA, but in the end she decided ‘I didn’t have any prior experience she felt she needed to and, years to take a more traditional route, in finance or accountancy, but luckily later, still seeks the opinions of studying medicine. for me the graduate assessment mentors from her NHS training ‘Healthcare was exciting and looked for the right transferable skills scheme. One deputy director of the alternative was probably an and ability for applicants to develop finance advised her to ‘go for it’ and engineering degree,’ says Kavita. ‘I the required competencies. this has become her mantra. ‘I have chose medicine because I realised ‘I had a great time developing my always been encouraged to say yes it would give me the opportunity to management and finance skills, but to people and to help them,’ she have a positive impact on people’s all the time I was very conscious not says. lives and healthcare is relevant all around the world. Also, I tend to Go the extra mile choose what I perceive to be the She encourages her colleagues to greatest challenge and medicine was work in this way, to spread ideas and a much longer course.’ challenge them not to become too Studying at Stanley Medical comfortable. She was encouraged to College in India, following her take on more when she was already schooling in Kuwait, Kavita qualified busy, not to take the easy route and as a doctor and worked as a to go the extra mile. house officer with a wide range of ‘I have witnessed occasions where specialties. ‘The public health service finance colleagues have said no in India is very stretched and cannot because of cost pressures and it cope with demand,’ she says. ‘We can be perceived in a negative way would see 100 outpatients in a and affect longer-term relationships,’ morning and there was no regular says Kavita. ‘I’ve usually found there follow-up. There were lots of good is a way of moving things forward, doctors, but we had limited resources particularly if it improves the care resulting in shortages of basic given to patients.’ equipment. We are lucky to have to lose the link to patient care.’ While the support of mentors such a great NHS.’ Having graduated from the has been important, Kavita She quickly realised that she scheme, Kavita joined Cardiff and has supplemented it with other wanted to play a bigger part in Vale Health Board in 2004 boasting development activities such as improving healthcare. Kavita saw a relatively unique combination of leading the research work for HFMA healthcare management as the way financial and medical qualifications – Wales. She is keen to understand to do this, taking her beyond the a combination that would stand her in how different healthcare systems one-on-one interactions she had good stead for her career ahead. have evolved and the benefits with patients and their families, and Kavita arranged with the medical and challenges faced by different enabling her to have an impact on a clinical director to attend some of countries and cultures. wider scale. the clinics taking place within the She has taken part in HFMA study It was a big decision to change board’s hospitals. It was similar to tours in America and Canada and disciplines, but if it didn’t work Kavita the normal observerships that take facilitated the setting up of the HFMA knew she could return to clinical place in medical training, but it was UK-Australian exchange programme. practice. The management skills she not hands-on nor did it maintain her ‘There are a range of development was developing would not be wasted. medical CPD. ‘I wanted to make sure opportunities and support available in ‘I had an opportunity to move I knew what was happening on the the NHS,’ she says. 24 NHS FINANCE CAREER STORIES

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Kavita has found that her work streams and have worked on Employment history background and approach has been redesigning clinical services so there Qualifications MBBS, CIPFA useful for service planning, design are sustainable services across a and making decisions. ‘Understanding whole health economy.’ 1999 Government the clinical service and working Kavita’s recent roles have included Stanley Hospital , house officer closely with general managers pays supporting one trust looking to India huge benefits, and ensures realistic acquire another and redesign their 2001 Cardiff and services are developed that don’t just future portfolio of services. She was Vale University work on paper’ she says. also part of the team co-ordinating Health Board, ‘My clinical background gives me the disaggregation of services at Mid finance manager, an advantage and greater ability to Staffordshire NHS Foundation Trust commissioning challenge. I know how doctors are (MSFT), where EY was the special and performance trained to think and work. I offer administrator. improvement viable solutions in translating clinical Kavita describes this as the accountant; NHS proposals into reality while getting as most challenging achievement in financial much value for money as we can and her career. ‘The safe transfer of management trainee enabling clinicians to work to their full services, appropriate governance , and maintaining patient safety 2013 Ernst & Young manager could not have been achieved “I know how unless all clinicians were on board. Disaggregating MSFT across two Outside interests receiving trusts and co-ordinating the doctors are In her time off Kavita likes to relax change across multiple stakeholders on adventure holidays. She recently trained to was very complex.’ went to Machu Picchu in Peru and Kavita led the medicine work trekked across the Andes and think and stream, with the aim of ensuring Amazon jungle. She also likes less sustainable services. ‘We had to physical activities, such as going work and I offer adhere to tight deadlines. Working on cruises to experience different in circumstances with significant viable solutions in cultures and meet different people. operational and staffing challenges translating clinical required a lot of sensitivity.’ Favourite film The Secret Life of The project was completed but Walter Mitty Kavita says challenges remain. proposals into reality” Favourite book Outliers, Malcolm ‘Although the work was successful Gladwell and the two organisations have potential, which is very satisfying.’ the best chance of success, the Favourite TV shows Sci-fi and While working within the NHS, underlying problems will take time to fantasy, currently watching Defiance Kavita enjoyed the variety, the work through,’ she says. Top three records ‘I listen to most opportunity to change roles and She believes the NHS can learn kinds of music – maybe Third Day the number of interesting projects from private sector approaches. by Katie Melua’ running at the same time. Keen to And a lot of good work in the NHS progress her career and continue to can be shared more widely so that Favourite food Hot cookie dough be involved in challenging projects, other organisations learn. ‘At EY, Favourite website Interesting posts Kavita explored opportunities within when a new project is delivered or via Facebook or LinkedIn, such as and outside healthcare. In 2013, she a new concept is successful it is Wired, Harvard Business Review took up a manager post with EY. quickly assessed and turned into a As she explains ‘Moving to EY I methodology or framework that can wanted to try something different. be rolled out in other teams and other My role in the NHS had lots of things types of work,’ she says. happening and I took advantage of Working in finance keeps options lots of opportunities, but broadly the open, says Kavita. ‘There are so core work was cyclical and followed many roles in the NHS that could fulfil the financial calendar. At EY I have your career. Your skills are valued,’ seen a shift in my working pattern, so she says. Her advice is to be open the focus is on what the client needs. to anything that comes your way. ‘After 12 months I started to get ‘Providing the best possible value into the rhythm and pace of work for the patient often involves getting and balance my work, development the best possible value for yourself,’ and personal life. I support clinical she says. NHS FINANCE 25 CAREER STORIES

Name: Kate Hannam

Job: director of operations, North Bristol NHS Trust Finance route key to management

Kate Hannam always wanted to was about working in partnership Trust. But she didn’t stay long in this make a difference and, as director with managers and clinicians. We post. She explains: ‘I enjoyed the of operations at North Bristol NHS developed integrated reporting to link role back in finance, where I covered Trust, she sees her accountancy workforce and activity information seven directorates and had good experience as having a positive with the traditional financial variety in my work. I didn’t stay too support. management information,’ says Kate. long because I was keen to get back She joined the NHS finance training ‘All this is common now, but it wasn’t to general management.’ scheme in 1994 after completing an back then.’ In 2002, Kate moved to Swindon accounting and finance degree. Kate Her next opportunity came from and Marlborough NHS Trust as had always wanted to join the NHS a close working relationship with general manager. In her new role, and to follow in the footsteps of family the director of the directorate she Kate played a greater part in project members who worked in the NHS. supported. ‘The director asked management and completed her ‘I always had public sector values. I me whether I would like work on a PRINCE2 project management considered working for one of the big secondment basis, and cover the qualification. accountancy firms, but I felt the NHS ‘I was involved in a number of would give me a greater opportunity large tender exercises and I really to make a difference,’ she says. benefited from the experience,’ she While being attracted to the NHS, says. ‘Finance provides a great Kate was keen to keep her options platform to develop and learn a open and was attracted to both number of other disciplines if you finance and general management. want to. I aimed to manage the ‘I didn’t know exactly what I wanted business guided by my experience to do within the NHS,’ she says. as a finance professional. ‘I was quite interested in general ‘While I had a clear focus on management, but I felt the finance patients, I was still able to use training scheme would allow me to financial measures to gauge what transfer between disciplines more was happening. Nothing tends easily if I wanted to.’ to happen without a financial Having completed the training consequence, and that can be scheme, Kate qualified as a CIPFA positive as well as negative.’ member. Her first substantive post Working in the women and was as a senior management associate director role,’ says Kate. children’s services directorate, Kate accountant and she was involved ‘I think she saw the understanding stayed nearly six years. A highlight in the merger of Frenchay and I had for the business and the was establishing an integrated Southmead hospitals to create North good relationship I had with the children’s service as part of the Bristol NHS Trust. ‘It was a great management team.’ children’s national service framework. experience to be involved in the However, on taking up her first ‘The work was incredibly interesting finances of the merger and how to role in operational management, and I enjoyed myself. It involved lots realise cash-releasing savings at that she found her skills needed to be of partnership working – for example, stage of my career,’ she says. ‘Much developed. ‘My finance background with social care as well as other of what I did then is relevant today.’ naturally suited more analytical acute providers – and it really made Kate worked as a finance business approaches to management. There a difference to what we were doing.’ partner in the newly merged was a lot for me to learn and I was North Bristol NHS Trust. The trust lucky that I had great support from Long-term view pioneered an approach where the my colleagues.’ Kate says a few people questioned management accounting team was After a successful secondment, whether staying at one place and in embedded in the clinical directorates Kate moved to back into finance and one role for so long was a good idea. with an equal voice at directorate a new role as assistant director of She feels one really good outcome of management boards. ‘My role finance at United Bristol Healthcare her time at Swindon and Marlborough 26 NHS FINANCE CAREER STORIES

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was having the opportunity to learn a integrated pathways of care. ‘My Employment history single organisation very well. personal objective was to take the Qualifications CIPFA ‘I really enjoyed my time at the trust opportunities to build operational and and always felt like I was learning,’ leadership skills, both personally and 1994 South Devon she says. ‘You have to be in a role within the clinical and operational Healthcare Trust, finance for a couple of years to be able to teams for which I was accountable.’ management trainee influence things. When you change Kate moved on in 2013 to become 1997 North Bristol NHST, roles, you have the opportunity to chief operating officer at Salisbury senior finance manager reinvent yourself; when you stay, NHS Foundation Trust. ‘I applied for and assistant director you sometimes have to live with the the role because I wanted to gain – women’s health and care consequences of the decisions you board-level experience. Salisbury is of the newborn make when you are new into the role.’ a high-performing smaller trust with It is clear Kate has focused on her a number of specialised services. It 2001 United Bristol Healthcare personal development throughout her was a unique opportunity for me and Trust, assistant FD career and has engaged help from a great experience.’ 2002 Swindon and mentors and coaches at different She has since moved back to North Marlborough NHST, Bristol NHS Trust. ‘I never moved general manager and away from Bristol,’ Kate says. ‘I have project director always lived within the area and “There commuted for work – it is nice to only 2009 Taunton and Somerset are lots of have a 20-minute journey into work.’ NHS FT, director of acute Now in a different role working service development, and opportunities with new services in a state-of-the- divisional director (ops), art hospital, Kate faces different then director of acute in the NHS, challenges every day. ‘When I service development returned to North Bristol NHS Trust, 2013 Salisbury NHS FT, chief lots of finance roles. the two main hospitals had relocated operating officer the majority of their services into a You can expand your brand new hospital,’ she says. ‘We 2014 North Bristol NHST, focused on aligning work cultures and director of operations skills beyond finance redesigning internal service models to if you choose” ensure we got the maximum benefit Outside interests from the new hospital. Kate enjoys relaxing with friends and ‘North Bristol NHS Trust is a family over a lovely meal with a fine complex health and social care glass of wine, or a cocktail, or two. stages. ‘Working in any role, you can system, where we work with two She’s a huge fan of cocktail-making find yourself getting entrenched. I clinical commissioning groups and classes. Kate is also a season ticket looked for individuals I trusted and two councils. Balancing the need holder at Bath rugby club. respected to mentor me,’ she says. ‘I for high-quality services for our local Anything by looked for people who had experience population, as well as delivering Favourite book John Grisham coaching and mentoring other people national specialist services is a working in the public sector, as well challenge. Favourite film Casino Royale as the private sector. It’s helpful if ‘Increasing demand for all services Favourite TV shows Comedies such they have an understanding of the requires us to develop new models as The Big Bang Theory NHS, but it is not always necessary.’ of care. Working in collaboration with Kate says her most successful our system partners is essential to Top three records Dancing Queen, mentoring experience was with a secure our long-term sustainability, ABBA; YMCA, Village People; GP who helped give her a different and to work towards our goal of being I Am What I Am, Gloria Gaynor perspective. a foundation trust. The challenge is Favourite food Mexican In 2009, Kate moved to Taunton immense but very rewarding!’ and Somerset NHS Foundation Trust, Kate has some clear advice for Favourite website Google where she was a divisional director people considering a career in the Alternative career Martial arts of operations within emergency and NHS. ‘There are lots of opportunities instructor urgent care. Later, she changed roles in the NHS, there are lots of different to become director of acute service types of finance roles and you can development, where she focused expand your skills beyond the finance on developing robust and effective team if you choose to,’ she says. ‘I’d partnerships with key stakeholders recommend finance is a good basis to develop and implement for a role in general management.’ NHS FINANCE 27 CAREER STORIES

Name: Andy Hardy

Job: chief executive officer, University Hospitals Coventry and Warwickshire NHS Trust ‘It’s an honour to work in the NHS’

Andy Hardy is a busy man. As well taste of general management. Andy important to have a good boss – as leading University Coventry and was quickly promoted to the role of choose to work for people who you Warwickshire NHS Trust (UHC&W), assistant director of finance, with can learn from and who can motivate one of the largest trusts in the responsibility for planning. He stayed you.’ country, he is also an HFMA trustee in this role for two years before a In 2004, Andy returned to UHC&W and a CIPFA council member. He’s secondment to the West Midlands as chief finance officer. Andy recalls: on the board of directors of not-for- Regional Office of the NHS Executive ‘It was a huge jump from my previous profit careers advisory service Right led to him to working in the regional role. It really should have been Step and the Albany Theatre in tier of the NHS for three years in a a role for someone who already Coventry, a registered charity. variety of roles. had experience of being a finance While Andy is now a committed He explains how his role as head director, but I applied for it and got it. public servant, it is not what he of finance at West Midlands Strategic I’m really grateful to Dave Roberts, had planned. With his degree in Health Authority came about. ‘I the then chief executive who took a economics, he expected his future applied for a job as a PCT director of chance on me.’ would be in the City, but when he finance but didn’t get it. graduated in 1990 jobs were Kevin Orford was on the interview Recruiting skills scarce and he found himself Andy puts some of his success down applying for a trainee accountant to his skill in recruiting good people post with North East Warwickshire and putting fantastic teams together. Health Authority. ‘Two of my initial associate directors Unusually, it was a part of a local of finance are now finance directors training scheme and Andy benefited themselves. Having a strong team from undertaking a wide range of enables you to do your job better,’ he roles within the finance department. says. He became CIPFA qualified in The role of deputy chief executive 1994 and the same year took up was added to Andy’s portfolio in the substantive post of purchasing/ 2008. He says: ‘I was thrilled to be locality accountant within the health expanding my role. It gave me an authority. opportunity to have more involvement He recalls it being a challenging in the clinical side of the organisation time with the introduction of GP and to move outside my finance fundholding. Keen to continue his comfort zone.’ studies, he undertook an MBA at When the post of chief executive Birmingham University. ‘The MBA became available in 2010, Andy really helped give me a broader jumped at the chance to lead perspective and I think it helped to the organisation, now one of the mark me out from other qualified panel, as he was the finance director country’s largest tertiary acute trusts. accountants,’ he says. at the strategic health authority, and His application was successful and he offered me a role working for him. since then he has been working with Provider move ‘I learnt a lot from Kevin. He has a colleagues to continue the success of Recognising the need to get some natural coaching style and went out the organisation and move towards provider experience on his CV, Andy of his way to develop people. Looking the achievement of foundation trust took up his first post at UHC&W in back it was a good thing that I didn’t status. He has particularly focused 1998. It was the beginning of Andy’s get the PCT post – these things tend on developing relationships and joint long association with the trust. He to work out for the best.’ working with others in the local health started off as a directorate finance Andy says the best advice he has economy, which he sees as crucial manager/deputy general manager been given is ‘don’t do a job you for delivering high-quality, financially with responsibility for surgery and don’t enjoy’. ‘Some people do that sustainable services for local people. oncology and it gave him his first to build a CV,’ he says. It is more Although he is a chief executive, 28 NHS FINANCE CAREER STORIES

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Andy says he still considers himself are as committed to the delivery of Employment history a finance professional. He says one excellent healthcare as our clinical Qualifications CIPFA and MBA of the highlights of his career was colleagues. I firmly believe that we , becoming HFMA president in 2014. are lucky to work in the NHS – it is 1991 Warwickshire HA trainee accountant ‘From the start of my career in NHS an honour‘. finance some 25 years ago, the However, Andy says that while 1994 Purchasing/ locality HFMA always represented a focus for working in NHS finance is rewarding, accountant training and professional networking it is not for the faint-hearted. 1998 UHC&W NHST, opportunities. ‘These are tough jobs,’ he says. assistant FD, directorate ‘It is a fantastic organisation and ‘Nine years ago I went through finance manager/deputy it was an honour to be the president a particularly tough time with the general manager last year. I know that I personally building of a new PFI hospital and gained from the experience and so needing to make big efficiency 1999 Assistant FD did my trust.’ savings. I got through it and was 2001 NHS Executive, West Among other highlights, he toured better for the experience. Midlands Regional the country speaking to members in ‘The pressure can be relentless and Office, deputy special how you respond is the true test. NHS projects manager finance staff need to be resilient as the financial position is not going to 2002 West Midlands South “Being an get any easier.’ SHA, finance manager accountant 2003 Head of finance Coping with pressure in the NHS To help him cope with the pressure, 2004 UHC&W NHST, Andy tries his hardest not to work chief finance officer is different to during his time off. 2008 Deputy chief executive As he explains: ‘I sometimes look at officer/chief finance being an accountant emails and try to reduce my reading officer pile in the evenings, but I try really anywhere else. hard not to work at weekends or 2010 Chief executive officer We’re not dealing when I’m on holiday. It’s important to recharge the batteries and to give Outside interests with widgets, it is all yourself time to reflect.’ Andy likes to make the most of his Andy has a wide range of free time. He is passionate about about people” hobbies that help him to switch off amateur dramatics and recently – particularly when he is performing starred as Bill Sykes in Oliver! in an amateur dramatic production. He keeps fit and in 2011 completed the branches, attended the US HFMA ‘You cannot think about anything else the London Marathon. He supports annual conference and was called when you are on the stage’ he says. the Leicester Tigers and England to represent the HFMA at the Public Perhaps surprisingly, given what rugby teams. Accounts Committee, an experience he has achieved so far, Andy doesn’t he says he will not forget. consider himself naturally ambitious. Favourite TV show EastEnders and Andy recommends a career in ‘I like a challenge and hate being Mad Men NHS finance. ‘Being an accountant bored.’ he says. ‘This is what drives Favourite film Love Actually in the NHS is different to being an me more than ambition.’ accountant anywhere else. We’re not Looking ahead, Andy doesn’t Favourite book The Great Gatsby dealing with widgets, it is all about anticipate leaving UHC&W any time Favourite songs Too many to list people and making a difference to soon. ‘We’ve made lots of progress their lives. Anyone who works in but there is still more to do,’ he says. Favourite food: Everything from fillet the NHS, whether they’re a clinician ‘We’ve got great staff and ambitious steak to Heinz beans or not, is in a job that makes a plans to integrate services and to Alternative career choice ‘A spy like difference,’ he says. work with others so the patients get James Bond’ the best possible care. Core values ‘I think we’ve got the building blocks ‘As well as technical accounting in place to become one of the best skills,’ he continues, ‘you also need to trusts in the country. It is a genuine share the core values of the NHS. It is privilege to lead such a fantastic so much more than just numbers. organisation, especially as it is in the ‘I’ve had the privilege of working community I live in. I wouldn’t want to with many great accountants who do anything else’. NHS FINANCE 29 CAREER STORIES

Name: Gemma McGeachie

Job: senior manager – financial strategy, NHS England Sailing the high seas of finance

As a senior manager in NHS perfect for me. Fortunately, I had a how they could continue to get the England’s financial strategy team, mentor at EY who was supportive benefits of the reviews without going Gemma McGeachie provides and helped me to think about my through intensive assessments financial input to NHS England’s career and what I wanted to do next.’ every few months.’ strategic projects, including the new Gemma was looking for new roles Bitten by the sailing bug, Gemma models of care work. in EY when her mentor pointed to took a sabbatical from Monitor in Gemma studied economics at a vacancy at Monitor. ‘He knew I 2008 and took part in the Clipper university and had a place on the wanted a change,’ she says, ‘and I round-the-world yacht race. She government economic service thought the interview would give me spent five months sailing from China graduate scheme, which she turned an opportunity to compare roles.’ to Liverpool via Hawaii, Santa Cruz, down to follow a career as an At the interview she was the Panama Canal, Jamaica, New accountant. ‘I was on a summer impressed. ‘I worked in financial York, Canada and Ireland. During her internship at EY at the same time I services and insurance at EY adventure Gemma had time to think applied for the government economic and Monitor was willing to take a about her career. service,’ she says. ‘During the risk despite me not having health seven weeks I spent at EY, I got Nautical time out involved in a wide variety of projects ‘Life on the boat was basic and I and enjoyed it more than I was spent a lot of time thinking,’ she says. expecting.’ ‘With little electronic communication, Faced with two opportunities, you got into a routine of eat, sail and Gemma sought advice. ‘My lecturers sleep. I learnt so much about team advised me that the public sector dynamics and personal motivations would always be there and that it from living in such close quarters with would be good to get experience my team mates.’ working elsewhere first and then While on her sabbatical, Gemma move to the public sector and apply realised she wanted to focus her what I had learnt,’ she says. career more on health operations, So Gemma returned to EY full-time policy and strategy and less directly in 2002 and studied the Institute of on traditional finance. As a result, she Chartered Accountants of Scotland completed a postgraduate certificate (ICAS) exams. When she completed in health economics at the University her accountancy training, she didn’t of Aberdeen and a short course on have a traditional celebration, instead organisational management in health signing up to participate in a yacht experience. I left the interview systems at the University of London. race around Ireland. wishing I had done more preparation.’ After three years at Monitor, ‘I wanted to challenge myself and Gemma was successful and Gemma looked for her next to do something fun’ she says. ‘I started working at Monitor in 2006. challenge and she embarked on a couldn’t swim and I’d not been sailing In her role as an assessment year’s secondment to HM Treasury before. We set sail from Plymouth manager, Gemma was involved in as a policy adviser in the health and I had until we reached Ireland assessing more than 30 foundation team. The culture and dealing with to learn the ropes. I was hooked trust applications and reviewing ministers directly was different to her immediately.’ transactions in existing foundation previous experience. She gained an Gemma enjoyed her time at EY, trusts. She got satisfaction from the understanding of strategic policy and but did not see herself staying at the support she was giving. decision-making during the Budget firm long term. ‘The accountancy ‘After the assessment process, and in the run-up to an election and firms are a great way to get skills and finance directors would tell me that forged strong relationships with key experience in a range of services,’ they really understood the activities contacts across the Department of she says. ‘While my role was and performance of their trust a Health, Treasury, NICE, the NHS challenging and rewarding, it wasn’t lot better’ she says. ‘They asked Institute and Cabinet Office. 302 NHS FINANCE CAREER STORIES

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In 2011 Gemma left Monitor after market assessments, funding pitches Employment history five and half years to undertake and grant applications as well as Qualifications ICAS voluntary work at Partners in Health, client relationship management. 2001 University work a not-for-profit organisation that aims Then, confident the organisation experience at EY to facilitate the provision of modern would continue to thrive, Gemma and Larking Gowen healthcare to those in most need. left in 2012 to join University College She worked at its headquarters in London Hospitals NHS Foundation 2002 EY, executive Boston for a month, before spending Trust (UCLH). It was at here that she 2006 Monitor, four months at its sister organisation started to take a more strategic role, assessment Zanmi Lasante, which runs clinics by leading on the development of key manager, including and hospitals at 12 sites in Haiti. business cases in A&E and working secondment to Gemma carried out an organisational on the reconfiguration of services HM Treasury as review for Haitian and US-based across north London and beyond. a policy adviser staff, focusing on reducing fraud and corruption risks. Joint venture experience 2011 Partners in Health, Before Gemma returned from her Her experience working at a start-up voluntary work in US was put to good use as she led on the and Haiti commercial aspects of establishing a 2011 Beacon Health pathology service joint venture. “I knew that Strategies UK, ‘I had a lot to reflect on from business manager the Beacon my experience with the joint venture,’ she says. ‘While some 2012 University College Health elements of our approach worked London Hospitals well, it demonstrated to me that NHS FT, senior Strategies organisational form is a byproduct of manager defining the outcomes we want and 2013 NHS England, start-up was high getting the model of care right.’ senior manager – While at UCLH Gemma found the financial strategy risk, but also that the time to complete a masters degree in health policy at Imperial College. opportunity wouldn’t In 2013 she moved to NHS Outside interests come along again” England. ‘The director I worked for at Gemma enjoys hill-walking, running UCLH was moving to NHS England (for charity) and sailing. She also and he asked me to join his team,’ provides financial governance voluntary work, she started thinking she says. ‘I wasn’t looking for another mentoring to charities and career about her next role. ‘When I returned role at the time but I knew we worked mentoring to fellow ICAS members. from Haiti a friend of a friend asked well together and the team would Favourite film Cinema Paradiso me to join an organisation she was be focusing on the type of strategic starting up,’ she said. ‘At the time, I issues I am really interested in. Favourite book Pride and Prejudice, had been looking into roles in NHS ‘At the moment, we are Jane Austen provider organisations. I knew that investigating the potential impacts of Favourite TV show Borgen the start-up was high risk, but also the spending review for the NHS by that the opportunity wouldn’t come speculating on a range of possible Top three records Black Sands, along again.’ scenarios that may be announced by Bonobo; All is Full of Love, Bjork; Consequently, Gemma became the government.’ 500 Miles, The Proclaimers (Glasgow business manager at Beacon Health Gemma is also a member of the Clipper boat song) Strategies UK in 2011. She played a national new models of care team, Favourite food Avocado key role in establishing and growing looking at different ways of delivering Google maps its privately managed mental health clinical outcomes and sustainable Favourite website care advisory services. Beacon aims finances. ‘We are working with the to improve outcomes for people with first wave of vanguard sites to mental health problems by working understand what level of support they as a consultancy service for NHS need and address the barriers they partners to translate principles and face for implementing new care theory into models of care. models,’ she says. ‘Finance input is Working directly with the chief essential in any service redesign, so executive, Gemma gained experience that services are designed in a way of creating a new organisation. She that will meet clinical outcomes and supported all aspects of strategy, be affordable.’ NHS FINANCE 31 CAREER STORIES

Name: Gill McKetterick

Job: project manager, Mersey Care NHS Trust Manufacturing meets the Mersey

At Mersey Care NHS Trust, Gill worked as an accounts assistant. ‘I have always had a good moral McKetterick supports the redesign of Gill was supported to study for the compass and wanted to do a role the trust’s finance and procurement CIMA qualification. that would be of benefit to people. My services. But a project management She explains: ‘I didn’t complete the parents and friends said joining the role is not something she thinks qualification at the time, and it wasn’t NHS would be a good thing to do.’ she would have looked for earlier in until later, when I was working in the Gill’s career very nearly took a her career. ‘It has been a massive NHS, that I realised the importance different path when, within the first change from my previous roles,’ of professional expertise for patients six months of working in the NHS, she says. ‘But I am relishing the and my colleagues, so I decided it Gill remembers being approached to opportunity to make a difference would be a good thing to complete.’ go back to work in manufacturing and and have embraced the prospect of She believes becoming a qualified was tempted by the variety of work personal development.’ accountant is one of her greatest offered within a smaller organisation. Undertaking several roles in career achievements. Gill says she ‘The deputy director of finance the finance department has given always knew she would complete the at the time would not accept my Gill a broad range of skills and resignation,’ she says. ‘I suppose experiences, as well as familiarising they saw more in me and the her with constant change. opportunity to develop. Looking back, This is useful in her current role, I’m really glad I stayed. It took me a as she can relate to colleagues while to realise that my background affected by the changes at Mersey in manufacturing brought something Care. Having performed many of the different and added value. roles herself, she knows what it’s like to change. She tries to get the best NHS support network possible solution for everyone. ‘Also the good things about working Encouraged by her grandfather in the NHS are the support you only to ‘get a good job’, Gill initially receive and the opportunities to looked at the legal profession. ‘I develop. Over time, my work became didn’t have any particular desire to more rewarding, I could see I was become an accountant,’ she says. doing a good job and having a ‘I always wanted to be a lawyer – I positive impact. enjoyed watching LA Law when ‘Working with clinicians and I was younger. CIMA qualification at some stage and understanding clinical services ‘The foundation course I studied wishes she had done so initially. helped put into perspective what is involved law, but I was surprised to ‘Not having a qualification hadn’t important and what working in the find that I enjoyed the accountancy affected my career development NHS is all about.’ aspects of the course and had the directly at that point, but I was Settling into the NHS, Gill worked option to continue to complete a starting to feel my luck would run out,’ across a range of finance roles at 12-month access to finance course.’ she explains. ‘When I returned to the Walton Centre before moving After completing her foundation complete my studies, I had a family, to Mersey Care NHS Trust in 2009 course in 1994, Gill took a temporary which created additional pressure as financial accountant. Her focus role through an agency as a finance and meant making sacrifices. changed again in 2014, when she assistant at Emerald Airways. It was ‘On the upside, my children have became a project manager to lead quite an investment for Gill as she been able to see how hard I have the development and transformation needed to buy a car to get to the worked and this has undoubtedly of the finance and procurement offices. been a good thing for them.’ department as part of a wider Her first permanent role came Gill joined the NHS in 2001, as corporate services review. the following year, working at T&D an assistant financial accountant at Gill recognised the different skillset Industries, a manufacturing company the Walton Centre for Neurology & required to be successful in her new that makes steel drums, where she Neurosurgery NHS Trust. role and was keen to develop herself 30322 NHS FINANCE CAREER STORIES

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further. ‘A project management people about a whole range of topics, Employment history qualification was within the desirable so there is something different Qualifications CIMA criteria when I applied for the role,’ every day, which is the complete 1994 Emerald Airways she says. ‘In my interview, I identified opposite to my substantive financial finance assistant the need to learn a formal project accountant post. management framework and was ‘There is a lot more writing, with 1995-1999 T&D Industries keen to pass as the role is very briefing papers and monthly blogs to accounts assistant different to what I am used to.’ help keep staff up to date. Sometimes 2001 Walton Centre for She completed the PRINCE2 I do miss my numbers though!’ Neurology & foundation project management Now Gill is not managing a team in Neurosurgery course shortly after changing roles. the finance department, she values NHST, assistant The course gave her the confidence the strength of relationships and the financial accountant, and skills to undertake the role, unofficial support network at the trust. then accounts but it was not the first time Gill had supervisor, office looked for external support to aid her Broader engagement manager, financial development. ‘In my previous role, my accountant ‘While I was studying for CIMA, I conversations would have mainly had a coach to support me,’ she says. been with the financial services staff I 2009 Mersey Care ‘I placed so much pressure on myself managed, but this project means I am NHST, financial to pass and it was helpful to have the engaging with the entire finance and accountant, project support of another person to ensure I procurement functions. manager ‘I have similar conversations to before, about where things are up to, Outside interests but I now spend a lot of time seeking In her spare time, Gill likes to take “I have lots people’s feedback. I try to capture to the road in her touring caravan. of meetings their ideas and opinions as well as It’s only small and because all the their concerns, to make sure we tidying up is done in a few minutes, with a variety respond to them.’ that leaves her more time to spend While enjoying her role, Gill is with her two children. of people looking forward to working with clinicians more. ‘At the moment, I Favourite film Mamma Mia about a spend very little time with clinicians,’ Favourite TV show Strictly Come she says, ‘but I anticipate this will Dancing whole range of change as the project begins to engage with stakeholders external to Top three records Copa Cabana, topics, so there is finance and procurement. Customer Barry Manilow; Always a Woman to engagement will be critical to the Me, Billy Joel; Uptown Funk, Bruno something different success of the project, as it is the Mars intention to further improve the quality Favourite food Chinese every day” of service provided.’ Gill is grateful for her career in the health service. ‘There are focused my efforts on the right things. lots of opportunities available ‘The coach helped me to press within the NHS. When I worked in pause on my day job to allow me to manufacturing, it felt like the only think about what I really wanted and incentive to progress was for more what things were preventing me from money; in the NHS, it feels different. achieving success.’ It is about expanding your skills and Gill is putting her formal training adding more value,’ she says. and experience to good use in her ‘Throughout my career, the NHS current role, where she engages has always been going through a with stakeholders on a daily basis. period of change of some kind or Leading a change programme was a other. My advice is that there is no challenge that interested her. need to panic as this offers new ‘A lot of my time is spent planning opportunities. and monitoring against programmes, ‘You have to want to take the which involves nagging people for opportunities when they present progress updates,’ she says. ‘I have themselves and be open to trying lots of meetings with a variety of something different.’ NHS FINANCE 2933 CAREER STORIES

Name: Dinah McLannahan

Job: senior business consultant, NHS Trust Development Authority Pulling out all the stops for health

Dinah McLannahan is no stranger time as a nurse, it became evident are mainly about money, but also to working into the small hours to it wasn’t the career for her. The about improving quality and safety of make finances work. Recently she structure of nurse management was services and getting better outcomes worked through the night on a major too hierarchical and if she wanted for patients.’ infrastructure project at a trust, and to progress, the jobs would take her Successfully putting forward a she recalls staying up til 3am to away from patients. ‘I felt like every business case on a trust’s behalf balance the till for a student job at shift was an eight-hour adrenaline will benefit patients, she says. ‘I am a hotel. ‘I had to balance the books rush. You’d take a breath walking the one who puts these cases to the on a paper ledger using a computer onto the ward and then let it out Independent Trust Financing Facility. and a till. I would be up until 3am eight hours later. My senior nursing It’s almost as if I’m working for that sometimes trying to find every last colleagues didn’t seem very happy trust to make the case, so it goes penny. I always felt really comfortable and that didn’t attract me to stay in forward and makes a difference to with numbers – although I am no nursing,’ she adds. patients. mathematician!’ ‘Finance is a support function, It was that memory, together whether within the TDA or a trust, with an encounter with an NHS and it can be a blocker as well as an accountant, that brought her to NHS enabler. That’s an important balance finance. She already had a career to strike. It’s difficult in a risk-averse in the NHS as a nurse, a profession culture, but we must not lose sight of she admits to ‘falling into’. ‘I went to innovation as well as safeguarding a really good school, one of the top public money.’ 10 in the country in terms of results. It seemed everyone knew what they Wide-ranging work wanted to do – doctor, lawyer – but Dinah looks after 11 trusts in the I didn’t. My mum was a nurse at the West Midlands – a mix of acute, time, so I sort of fell into it.’ community and mental health trusts. While she was a nurse, the unit ‘I have a tremendously privileged accountant would attend the ward role,’ she says. ‘There’s variety in as a patient from time to time. They the work and I am also able to talked about his role and, having interact with a diverse group of enjoyed her previous job at the organisations with different styles hotel, she decided to train as an While NHS finance and her current of doing things. I could be doing a accountant. role as senior business consultant at financial recovery plan in one trust A careers teacher was a big the NHS Trust Development Authority or on the business case for a new influence, but not in a positive (TDA) are always going to be a step hospital. I also get the whole system sense. She told her to choose a removed from the front line, Dinah view and I feel I’ve learnt a lot.’ practical career rather than anything believes she is having a direct effect She says her biggest challenge academic. That hit hard, as it would on patient care. ‘When I was a nurse is developing and maintaining good any 16-year-old, she admits, but there were lots of life and death relationships with the organisations. she was determined to prove the situations, but also lots of occasions ‘You must ensure this is translated teacher wrong. ‘I knew I wasn’t going when I was able to make someone’s into something tangible so you can for four As at A-level and a degree life a little easier. That stays with make a measurable difference. from Oxford or Cambridge, but I was you forever. It drives what I do as a Ultimately, boards are accountable, capable and bright,’ she says. finance professional, having had this but you can put a lot of development But even during her three years’ experience,’ she says. support into an organisation and see training, she admits she still did not ‘I like to think I help trusts to be the effects that has,’ she says. know what she wanted to do. financially and clinically sustainable. Looking after a variety of While proud of the standards of When I work with a financially organisations has a flip side – it can care she helped deliver during her challenged trust, the conversations mean life is hectic as she goes from 30342 NHS FINANCE CAREER STORIES

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trust to trust, meeting to meeting. ‘You in applying? In the early stages of Employment history have to be creative with your time pregnancy, she felt she could not take Qualifications Dip HE (RGN) management, but logistically it can be the job. But when she was ready to nursing studies; a challenge to manage the diary.’ go back to work after maternity leave, associate ICAEW With such a busy life, she is grateful the post was still available. 2003 NHS South for her husband’s support. ‘We had many achievements at Birmingham, On leaving nursing for accountancy, Dudley and Walsall, but the one that finance and she got a training job at a three- stands out for me is that we built such business manager partner practice in Worcester, before a fantastic finance team under my joining Baker Tilley for a year, working leadership. 2007 Birmingham and chiefly on auditing small businesses. ‘We were just a small Black Country Solihull MH ‘Working outside the NHS taught mental health trust and when I started NHS FT, finance me the value of not wasting time. you could cut the office atmosphere and business I had to account for every six with a knife. By the time I left, we manager minutes of chargeable time and was had been shortlisted for two national 2010 Dudley and Walsall only allowed 30 minutes of non- awards, delivered surpluses year on MH Partnership chargeable time a day. It is a good year, we had a good relationship with NHST deputy commissioners and had progressed director of finance significantly towards foundation trust status, passing Monitor’s financial 2013 Acting director of “Working viability assessment.’ finance and outside the She stayed there more than four performance years, including a spell as acting 2014 NHS Trust director of finance and performance, NHS taught Development before moving to the TDA in 2014. Authority senior me the value ‘The NHS is good at offering business consultant development opportunities and I of not wasting time. have never shied away from taking those opportunities,’ says Dinah. ‘I Outside interests I had to account for haven’t had a clear, defined career To maintain a work-life balance, plan; I just went with the flow, taking Dinah likes to keep fit with Les Mills every six minutes of opportunities as and when they body combat classes. The mixed presented themselves to me. But I am martial arts exercises are ‘really chargeable time” grateful for the chances I have been therapeutic’, she says. Exercise and offered and I don’t take them spending time with her family mean for granted.’ she has little down time discipline. Time has to be used well.’ Many colleagues have played Favourite film Short Cuts It was always Dinah’s intention a key part in her career. One is to move back to the NHS, so she Jonathan Tringham, who was head of Favourite book Catch 22, Joseph jumped at the chance to join South commissioning finance when she was Heller Birmingham Primary Care Trust in at South Birmingham PCT. Favourite TV shows Breaking Bad 2003, looking after 11 Sure Start ‘I came into NHS finance thinking and Great British Bake Off programmes as well as a financial it would be a little bit old-fashioned, reporting role. but he showed me it absolutely was Top three songs Let It Be, Labrinth; She qualified in 2005 and moved not. I could see how talented he was, Ordinary People, John Legend; into a financial management post in how much detail he knew and how Everybody’s Changing, Keane the PCT children’s and community he was in command of everything Favourite food Poached egg on services team. Two years later she he did.’ toast moved to Birmingham and Solihull Dinah also mentions Ian Baines Mental Health NHS FT as a finance (former director of finance) and Gary Favourite website Facebook and business manager and was then Graham (chief executive) at the Alternative career choice Doctor promoted in that trust. Dudley and Walsall mental health Immediately, another opportunity trust. ‘They taught me so much. came up. On her first day following Development isn’t always comfortable promotion, she received a call from a and, though I’ve always pushed former boss who was at Dudley and myself, if I don’t want to do something Walsall Mental Health Partnership – I think, “yes, it will be scary but I will the deputy director of finance job was get to a better place”. These leaders vacant and would she be interested have helped me do that.’ NHS FINANCE 2935 CAREER STORIES

Name: Loretta Outhwaite

Job: chief finance officer, Isle of Wight Clinical Commissioning Recipe for being Group an all-rounder

From the age of 10, Loretta accountancy books,’ she says. favourite reading material.’ Outhwaite so wanted to be a nurse The hard work paid off. ‘I loved Life on the front line was that she spent much of her teenage my job, working with NHS clinicians interesting. She was given a years with St John Ambulance and, helping them to manage their desk in an old sluice cupboard, later, as a Red Cross cadet. ‘My little budgets, build business cases to an abandoned operating theatre, brother spent much of his childhood develop their services and find a microbiology lab (‘I can still pretending to fall off his bike and out ways to make their ever-shrinking remember the smell,’ she says) and, of trees so that I could put him in the allocations stretch to see ever- her favourite, a children’s outpatient recovery position or tie him up with increasing numbers of patients.’ clinic. ‘I worked a shift in each clinical slings and splints,’ she laughs. Several promotions meant she department, so I could understand But her life didn’t turn out quite as worked in nearly every service area what they did – mopping floors in the expected. After taking her A-levels, urology operating theatre, providing Loretta got married and had her first support to A&E staff and reassurance son a year later. ‘In those days nurse to patients and relatives.’ training wasn’t very family friendly The experience and insight gained and it wasn’t something I could as an operational finance manager pursue, particularly as my husband remains important. ‘As a chief worked shifts,’ she explains. finance officer in a commissioning Nursing’s loss was accountancy’s organisation, it can be a challenge gain, and now Loretta is chief to make the connection between the finance officer at Isle of Wight work I do and the impact on patient Clinical Commissioning Group. care. It is critical I do make that ‘The variety is something I very connection to ensure I understand much enjoy,’ she says, ‘along with what services people need, what the complex, ever changing and the people providing the services somewhat unpredictable environment need and that what’s being delivered of the NHS. The aspects I enjoy meets those needs. I therefore spend are also the ones that provide the time with service users, clinical most challenge in the role. I love a colleagues and providers of services challenge.’ in the organisation, giving her a to keep patient care at the heart of Working with public and voluntary good understanding of how acute, everything I do and every decision I sector colleagues is key to this. ‘We community, mental health and public make.’ have a common bond. We all do health services worked. our jobs because we are passionate The time had come to go to a larger Value of secondments about providing people in need with organisation and she moved to what Not afraid to work outside her finance great services,’ she says. is now Heatherwood and Wexham comfort zone, Loretta’s career Loretta joined the NHS when her Park Hospitals NHS Foundation Trust has featured three very different son was a year old and her mother as a directorate accountant. secondments, the first two in her time spotted a job in a local paper for a ‘I was part of the service team at Heatherwood and Wexham Park. trainee management accountant post rather than the finance department, After a year there, she was at the local district health authority bringing me closer to the front line,’ selected to take part in its annual (later an NHS trust). says Loretta. ‘My favourite task was two-day residential management Working full-time with a young developing costing, which had just development course. She made a family while studying for her been introduced. I created my own good impression and was asked accountancy exams was exhausting. cost collection sheets for the top to cover the contract manager’s ‘I can remember waving off my diagnosis/procedures and worked maternity leave. husband and toddler son every with clinicians to write the “recipe” for ‘I was launched into the world of Sunday to play in the sunshine while an average patient. The BNF [British performance information,’ she says, I was stuck indoors poring over my National Formulary] became my ‘managing external relationships with 30362 NHS FINANCE CAREER STORIES

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commissioners, setting, negotiating national media attention. It was one Employment history and monitoring contracts with multiple of the hardest things I’ve had to deal Qualifications CIMA GP fundholders and five health with in my career,’ she recalls. 1989 Wycombe District authorities. Incredible experience.’ ‘After 12 months, I was given HA, liaison accountant When the post-holder returned 12 the opportunity of the post on a months later, Loretta was given the permanent basis, but declined – I did 1995 Heatherwood and opportunity of a permanent post, not want to continue with the media Wexham Park but she declined, opting instead to management aspect of the job.’ Hospitals NHS FT, increase her finance experience. She then spent four years leading directorate account’t, The secondment had given her the the trust’s National Programme for women’s and confidence to apply for promotion in IT project, including the procurement children’s services the finance team and she took a post and implementation of an electronic 1996 Contracts manager in financial accounting and treasury patient record and picture archiving (secondment) management. and communication systems. Loretta’s new role included her Despite enjoying the role, Loretta 1997 Directorate account’t first foray into commissioning, as decided to further her finance career (emergency, it included being finance lead for and became the trust’s head of diagnostic, surgical an education consortium. The strategic financial development. 1998 Finance manager This included leading on the trust’s (accounting, treasury) foundation trust bid and a private “The aspects I enjoy finance initiative project to replace its 2000 Head of corporate estate. communications are also In 2010, Loretta relocated to (secondment) the Channel Islands to work for 2001 NPfIT project the ones the States of Jersey in its health manager and social services department. that provide Through promotion, she then went 2005 Head of strategic the most on to corporate finance director for financial development the treasury, chief minister, income 2006 States of Jersey, challenge in the role. tax and economic development health acting FD/ departments. ‘It was a difficult assistant FD; corpor’te I love a challenge” decision to break my NHS service, FD, deputy lead CSR but I felt strongly I needed wider public sector experience to be an 2010 Isle of Wight PCT, consortium focused on workforce effective finance director.’ deputy FD, acting planning with provider organisations Loretta’s third secondment was to chief finance officer to identify their clinical workforce Jersey’s comprehensive spending 2013 Isle of Wight CCG, needs, translating them into training review (CSR) team, where she led chief finance officer places to purchase from universities the reviews of the courts, home and managing the contract delivery. affairs, education and health and Outside interests Loretta’s second secondment – as social services. head of corporate communications – Before the CSR was completed, As well as spending time with her came a few years later. On her first she took the difficult decision, for family – she has two sons – Loretta is day she received a call telling her family reasons but also because she a keen runner and baker. that the prime minister and health missed working within the NHS, to Favourite film Sleepless in Seattle secretary would visit the hospital a move back to the UK. , week later and she would have to She believes secondments are key Favourite book Birdsong Sebastian Faulkes organise the visit. to getting the experience to progress It was a sink or swim moment, up the career ladder. ‘My advice is to Favourite TV shows Dr Who; and she counts the visit as one of grasp every opportunity given to gain Location, Location, Location; Sherlock her most significant work-related additional experience, especially if Anything Italian achievements. ‘I decided that if I it is in another operational area or a Favourite food could cope with that on my first day related organisation or industry. Favourite website Twitter in a job, I could probably cope with Well-rounded experience is anything,’ she says. invaluable. If you’re in a management Other tough days followed. ‘Several position, you should seek to offer months later there was a police people secondment opportunities to investigation into suspicious deaths enable them to do this or support (later dropped), which attracted them to find such opportunities.’ NHS FINANCE 2937 CAREER STORIES

Name: Yarlini Roberts

Job title: chief finance officer, Kingston Clinical Commissioning Group ‘It’s not just about the numbers’

After passing her A levels, Yarlini see I was making a difference.’ carry out a senior management role. had planned to do a maths degree She also found the diverse nature She recalls one particularly tough at Warwick University, but had a of her role enjoyable – ‘one minute I time. ‘The finance director was on last-minute change of heart. ‘I wasn’t was helping sort out the milk tokens, a month’s development course and entirely sure that maths was for me the next I was balancing the ledger’. the other deputy was off because of and also whether it was something I A year later, in 1993, she moved to a family bereavement. I was on my wanted to do for the next four years,’ the Bethlem and Maudsley Hospital own and thought I wasn’t up to it. But she explains. This was disappointing to gain a promotion to senior financial I threw myself into it, and I certainly news for her parents, who were clear accountant. The trust was just about didn’t get everything right, but nothing that staying at home and not studying to receive trust status and Yarlini went really wrong either.’ or working was not an option. recalls it as an exciting time When the deputy finance director This tough love resulted in Yarlini ‘I loved it,’ she says. ‘There was so returned to work after her maternity enrolling on a year’s accountancy much going on and the finance team leave, Yarlini looked for the next step foundation course at the local was fantastic. We had to work hard, on the ladder. In 1995 she joined university. ‘My father and uncle were Kingston and District Community accountants, but it wasn’t something NHS Trust as chief accountant, I was really considering as a career. where the challenges were different. It’s fair to say that I fell into it’. ‘It was a small trust and there was After enjoying the course and a question about whether it was finding it relatively easy, she decided viable on its own,’ she says. ‘There to continue with accountancy and was also a range of skills in the in 1989 gained a training post finance department, which tested my with McIntyre Hudson, a top 20 management skills’. accountancy firm. Yarlini says this was one of the best decisions she’s Family values made. ‘It was a fantastic three-year Starting a family in 1997 changed training programme, with different Yarlini’s priorities. ‘I returned to placements every six months. It gave work four days a week after my first me a good grounding in several child was born, but my career had different areas and made me realise to take a back seat,’ she says. ‘My there were aspects of accountancy husband, who’s also an accountant, I found interesting.’ Audit, however, and the main breadwinner, had a job was not one of them and Yarlini was that involved travelling overseas, so soon looking for her next role. we were not able to equally share After she passed her ACCA exams, but we also played hard.’ childcare responsibilities.’ Yarlini successfully applied for the Again, it was the range of activities After the birth of her second child, post of assistant financial accountant that appealed. ‘Every day was Yarlini decided not to return to at Croydon Community NHS Trust. different,’ says Yarlini, ‘from large work and focus on her family. ‘I just Undertaking the audits of a private capital schemes and treasury couldn’t manage it all. I felt as if I hospital had sparked her interest in management to final accounts. I wasn’t being fair to my family or my healthcare and prompted Yarlini’s knew if I was working in the private colleagues,’ she explains. move to the NHS. sector I wouldn’t get exposure to Having a third child led to a three- ‘At the time I wasn’t entirely sure I such issues.’ year career break. But it wasn’t long was doing the right thing, but I knew Not long after she joined the before she was missing work. ‘I loved that I could not stay in audit,’ she trust, Yarlini received a temporary spending time with the children, says. The move turned out to be a promotion to deputy director of but I needed more. I needed to be good one and the start of Yarlini’s finance to cover a maternity leave. It intellectually challenged’, she says. career in the NHS. ‘While there were was a steep learning curve, but was A solution presented itself in the challenges at the trust, I could really vital in giving her the confidence to form of a two-day-a-week short- 382 NHS FINANCE CAREER STORIES

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term role working at the Queen been doing the work of a CFO but Employment history Elizabeth Hospital NHS Trust (now not necessarily getting the credit Qualifications ACCA part of Lewisham and Greenwich for it,’ she says. ‘Also, the children 1989 McIntyre Hudson, NHS Trust). A former colleague at were of an age where they were trainee the Bethlem and Maudsley had needing me less and less’. As a recommended Yarlini for the role. result, she became head of finance at 1992 Croydon She joined the trust in April 2002 and Wandsworth CCG. ‘I’d been working Community Unit, her first task was putting together the at Kingston for such a long time,’ she financial accountant 2001/02 final accounts. says, ‘I realised I needed to get senior 1993 Bethlem and ‘I worried whether I was up to it commissioning experience elsewhere Maudsley NHST, – for the past three years my head in order to get a CFO position.’ senior financial had been full of Teletubbies and the Wandsworth CCG was particularly accountant Wheels on the Bus. But it was great attractive because it is the host of the to be properly using my brain again.’ South West London Collaborative 1995-1999 Kingston and While the work was enjoyable, the Commissioning, with all six CCGs District Community commute proved difficult and at the in the area working together to NHST, chief end of 2002 she moved to Kingston transform services so that they are accountant Primary Care Trust, again on a two- sustainable and provide high-quality 2002 Queen Elizabeth day-a-week basis. The role initially care for patients. Hospital NHST, focused on providing commissioning Yarlini particularly enjoyed working assistant FD finance support for learning on the estates modernisation disability and mental health, but the consultation across mental health 2002 Kingston PCT, introduction of the new GMS contract trusts in the area – ‘it is really various roles, inc important to create buildings fit for the assistant FD 21st century, so that patients are safe 2013 Wandsworth CCG, “Things are and make a full and speedy recovery’. head of finance When Kingston CCG advertised constantly for an interim CFO, Yarlini knew 2015 Kingston CCG, she had to apply. She secured the chief finance officer changing and job in January 2015 and since then her appointment has been made I really do permanent. Outside interests She is optimistic about the future. As a mother of three teenagers, think that it is a great ‘Things are constantly changing and Yarlini says she has little free time. time to be working in I really do think that it is a great time But she keeps fit by taking her to be working in commissioning. dog for long walks in the Surrey commissioning” At the moment, we are focusing on countryside and attends a regular co-commissioning, which will result pilates class. She also likes in much needed changes to patient holidaying in Cornwall and France. provided Yarlini with an opportunity to pathways. It is essential so that the Favourite book A Town Called Alice, immerse herself in the intricacies of local health economy is sustainable.’ Nevil Shute primary care commissioning. Yarlini is just as clear about her As her children got older, she took contribution. ‘My role is to evaluate Favourite film The Godfather on additional responsibilities and the opportunities, help to manage Best career advice ‘It is good to be increased her hours – a flexibility the risks and make sure that the open and honest, but think before she believes would not have been necessary governance frameworks you speak – I don’t always remember possible in the private sector. ‘The are in place,’ she says. ‘It doesn’t to do this’ NHS has treated me well and enabled always make me popular, but I think ‘I would like to me to develop my career alongside my colleagues respect that I am Alternative career have my own vineyard, but I’m not bringing up my children,’ she says. always open and honest.’ sure that there would be enough By the time of the PCT’s demise She concludes: ‘When you become wine left to sell’ in March 2013, Yarlini was assistant a CFO the accountability suddenly director of finance. She helped to lead hits you. It’s a huge responsibility, the establishment and authorisation but also a huge honour. I would of Kingston CCG. recommend working in NHS finance It was at this point that Yarlini began to anyone considering a career in to think seriously about whether she accountancy. It’s not just about the wanted to become a chief finance numbers; it’s about doing the best officer (CFO). ‘I realised that I had for the patients.’ NHS FINANCE 2939 CAREER STORIES

Name: Adam Sewell-Jones

Job: director of provider sustainability, Monitor Financial path to a general role

Adam Sewell-Jones admits he had Healthcare NHS Trust gave him the what he thought he’d be doing. no plans to be an accountant while opportunity – looking after its learning ‘We were introducing the 12-hour he was at university studying maths disability and community services. maximum wait in A&E and there and statistics. The course had been A year later, the head of the trust’s were real hands-on challenges a natural progression for someone separate management accounts in finding beds so that we could good with numbers, but he signed up department left and Adam added this meet the new target,’ he says. ‘It with no particular career in mind. role to his responsibilities. was really operational – lots of bed ‘Most people on the course were ‘This turned out to be quite management and firefighting – and headed towards an accountancy significant – it helped me realise that not much time to focus on the career and lots of them wanted to managing the department was more strategic changes we were keen to work for the big firms,’ he says. ‘But interesting to me than being a finance progress.’ the thought of being an accountant manager,’ he says. The idea was didn’t excite me and I had no cemented when he added a business Work pressures intention of pursuing it. In some manager role for a private patient unit Adam found it harder to switch off ways, I felt I was just going down this to his growing responsibilities. when he left work. ‘In management route without any control.’ ‘It made me recognise that when accounts, there are pressure points But then a family friend, working as particularly around the outturn where a finance director in the NHS, pointed people would work late and come in him in the direction of the NHS at the weekend,’ he says. ‘But you’d national finance training scheme. go home and know that nothing was ‘All of a sudden I realised that doing going to happen to the accounts until accountancy in something like the the next morning. NHS, where the accountancy wasn’t ‘When you went home on a the end goal, could be exactly what I Friday night as general manager of wanted,’ he says. medicine, you’d be worried whether With a massive oversubscription to the agency registrar would turn the scheme in the year he applied, he up and, if not, what was going to didn’t secure a place. But the seed happen. The 24/7 nature of the role was sown and he applied for and got was quite tiring, because I took a trainee management accounting on a lot of the worry of it. When I job at his local district general eventually moved on, my wife was hospital, Basildon and Thurrock quite relieved.’ General Hospitals NHS Trust. While he’d actively looked to step It turned out to be a good decision. I moved again I wanted more away from finance, he wasn’t sure He liked his job and his day-release management in the role,’ he says. he was ready to turn his back on it CIMA training, but what he enjoyed This next step took him back to completely. He was concerned that if most was being in contact with Basildon as general manager for he spent too long away, his skills may clinicians and general managers medicine. He admits he was nervous not be viewed as current. from the outset. ‘My contact with of making the switch as all the other So he moved to University College trainees in the big firms, whom I met general managers at the trust at the London Hospitals NHS Trust as through studying, made me realise time had a background as senior finance manager for the specialist their experience was rather different. nurses. However, his financial hospitals division. He says the scale They appeared to be kept away from management skills transferred well and complexity of UCLH – more than clients at all costs.’ and the role worked out. His financial three times the turnover of Basildon Having qualified, and recognising track record, supported by the – was a ‘real eye opener’ requiring ‘a that the team at Basildon was pretty nursing background of his deputies, different type of leadership’. stable, he decided he needed to look proved a good combination. It was also his first exposure to elsewhere to progress his career. A He stayed for two years, but admits a devolved financial structure, with finance manager role at Redbridge that the job had veered away from finance managers embedded in 40 NHS FINANCE CAREER STORIES

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divisional teams – an arrangement month secondment to the SHA to Employment history he believes can present challenges help develop a patient experience Qualifications CIMA when finance managers have measure – this would become the to provide appropriate levels of friends and family test. Plans were 1992 Basildon and challenge to the service. made for his deputy, Andy Ray, to Thurrock General In 2004, he moved again, into his step into the director role. However, Hospitals NHST, first deputy finance director role. At just before the secondment started, a trainee accountant the time, he felt it might have been Care Quality Commission inspection 1996 Redbridge too soon in his career. But the job raised concerns about aspects of Healthcare NHST, was back at Basildon and, having Basildon and Adam was asked to finance manager sought his medical director’s advice, stay as improvement director. This he applied ‘to see what happens’. involved establishing a programme 2000 Basildon and After being offered the post, he management office and delivering a Thurrock General found himself ‘on a real learning turnaround plan. Hospitals NHST, curve’ supporting the organisation While initially viewed as a three-to general manager, through its early days as a first wave six-month role, further CQC concerns medicine and elderly foundation trust. Three years later, arose and it was a year before Adam 2002 UCLH NHST, outgoing finance director Trevor returned to his job as finance director. finance manager Smith suggested he apply to be his However, with the appointment of replacement. Adam was persuaded, a new chief executive and a focus 2004 Basildon and but was surprised when he was on demonstrating sustainability, Thurrock University offered the job. Adam was asked to become deputy Hospitals NHS FT, chief executive with responsibility for deputy finance running an ongoing transformation director “I didn’t programme. As part of this, he led 2007 Director of finance on performance management and and performance want to sit informatics and coordinated the trust response to being put in special 2012 Deputy chief in an office, measures under the Keogh review. executive work on tax In August 2015, he moved to 2015 Monitor, director of Monitor as director of provider provider sustainability sustainability, as part of the returns and never regulator’s plan to provide greater Outside interests see the light of day. levels of support to providers to address current service and financial Describing himself as a ‘keen Doing something challenges. but ageing footballer’, Adam plays in He is convinced that, as an a Sunday league team and supports that matters has accountant, there is ‘no better job Southend United. He plays the than in the NHS’. ‘Right from the euphonium in and conducts brass been great” outset I knew I didn’t want to sit in an bands and sings both in choirs and office, work on someone’s tax return as a soloist. and never see the light of day,’ he Favourite film Dead Poets Society He remembers it as an exciting says. ‘The ability to do something that time. ‘There were still only a handful matters has been great.’ Favourite TV shows Gogglebox, of foundation trusts and of FT finance He thinks the opportunity for finance Car Share and Match of the Day directors and you really felt part of managers to help improve frontline Top three records Say Something something that was breaking new services will only increase in the Pentatonix; Carnaval, Wynton ground – piloting payment by results, coming years. ‘It is tough financially Marsalis; Etherwood, Etherwood for example,’ he says. now and, if finance does its job well He adapted to the board role and supports people to do things Favourite website Twitter quickly – helped in part by his general more efficiently, you will genuinely be Alternative career choice Doctor management experience – and having an impact on patients.’ heeded advice about appointing the Drawing on his own career path, he right deputy, enabling him to focus on encourages finance managers to take strategy and scrutiny. any opportunities to broaden their In 2009, as part of a ‘stretch experience, through either assignment’ for a strategic health secondments or service manager authority aspiring chief executives roles. ‘Time in operational roles can programme, he organised a three- be absolutely invaluable,’ he says. NHS FINANCE 2941 CAREER STORIES Name: Justine Stalker-Booth

Job: head of financial management specialised vommissioning finance, NHS England national team Full circle with NHS England

Justine Stalker-Booth recently began accountant. Here, Justine had I received constructive feedback a new role as head of financial her first experience of costing by on my skills and behaviours, which management for specialised supporting the medical staffing team were assessed against the company commissioning finance in the NHS to cost the trust’s entire medical values. It was the first time I had England national team, which brings workforce. She moved back to been involved in this type of exercise her back to where she started. ‘It’s Colchester in 1990 and became and I realised the value of it for me 30 years since I joined the NHS and a directorate accountant leading personally.’ in my new role it feels I have gone a team of four staff to support the It was while working at Capio full circle and returned to London to financial management of three Healthcare she realised how continue working in an organisation clinical directorates and a support dedicated and hardworking people that I feel very proud of,’ she says. service. were, in the NHS and private sector. Justine knew she wanted to work in Staying at the Colchester-based She says that it gave her confidence finance. After completing her A levels, acute trust, her next role was in in the skills she had developed and which included studying accounting, costing. Justine improved the that we can sometimes be too self- she went to see a careers adviser to way costing was done when she critical. Ultimately she missed the get ideas about what was next. NHS and planned her return. ‘My sixth form work experience included lots of filing in St Mary’s Reaping the rewards Hospital eye department. I didn’t Justine admits her career has necessarily want to work in not always been planned but her healthcare finance despite my initial job changes felt right at the time. connection to the NHS. But as my Working hard pays off, she believes, family have a history of working in and puts you in a good position when the NHS, I guess it was inevitable.’ opportunities arise. She lived in Colchester at the time Changes in the structure of and didn’t know where she wanted the NHS have led to several job to work. The careers adviser gave changes. ‘Reorganisations in the her a list of London-based vacancies. NHS can be tough though because She says: ‘I applied for jobs at the big the day-to-day focus changes, new accountancy firms, but the interview organisations at Westminster Hospital was first.’ are established and people are Her application to Westminster worried about where their future may Hospital was successful and Justine be,’ she says. moved to London. ‘I stayed in implemented a new system. This role Justine’s current role as head nurses’ accommodation and lived was to have a significant influence on of financial management in NHS in St Stephen’s Nurses’ Home,’ she Justine’s career in the years to come. England’s specialised commissioning recalls. ‘I don’t think it exists now, In 2000, she decided to experience finance team came about as a result but it would have been on the site of life outside the NHS and joined Capio of one such restructure. As she Chelsea and Westminster Hospital.’ Healthcare. She found her skills were explains: ‘I knew the finance director Justine really appreciates the start directly transferable to the new role and the role suited what I was she had and the support she had in as a regional accountant working looking for next. I wanted to use my her training role, which enabled her with two private hospitals. knowledge of NHS payment systems to take day release to complete her ‘At the time, there was more focus and have the opportunity to work with ACCA qualification. on management skills in the private clinical staff to influence how the tariff She worked at Westminster sector,’ she says. ‘As a result I develops.’ Hospital for three years as a trainee received formal training, learnt more Moving roles hasn’t always been management accountant and and became a more accomplished as easy, however, and Justine recalls progressed in 1988 to St George’s manager. The training was really an early experience. ‘I moved to St Hospital London as a management focused on patient experience and George’s Hospital and after a couple 42 NHS FINANCE CAREER STORIES

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of weeks, the finance director asked anxious to start off with, but if people Employment history whether I was enjoying myself. They ask me nicely I don’t seem to be able Qualifications ACCA said that whilst I was technically very to say no.’ It turned out that Justine’s 1985 Westminster Hospital, good, they were worried about how initial anxiety was well placed – the trainee management quiet I was. Looking back now I’m session ended up being attended by accountant sure they can’t believe they actually 160 delegates. said that! Sometimes it just takes a ‘I remember practising for the 1988 St George’s Hospital little more time to settle in.’ month before in the car, at home, London, management A typical day for Justine really everywhere! Fortunately the session accountant depends on the programme of work. went really well, I presented it in a 1990 Essex Rivers ‘We may be reporting and analysing way I thought the GPs would relate to Healthcare NHST, variances – I was monitoring a £1bn and that wouldn’t be patronising. directorate accountant, budget in East Anglia and the extra ‘The audience were really good and costing accountant zeros really make a difference! afterwards the organiser described ‘Otherwise, I generally work with the room as buzzing while they 2000 Capio Healthcare, service leads to understand how talked between themselves about the regional accountant money is being spent, what we are NHS payment regime. They felt they 2003 Uttlesford PCT, commissioning and how services are understood how and why the NHS assistant FD changing.’ pays for things and that it isn’t kept a She jokes that a lot more time is closely guarded secret.’ 2007 NHS Mid Essex, spent on email communication now. The best advice Justine has been assistant director of given for her NHS career is to focus commissioning finance on the next steps. Justine has been 2013 NHS England “I am really able to work in different organisations East Anglia area team, and she recognises this has been an head of specialised interested important part of her development. commissioning finance ‘Having worked in hospitals, I have in the NHS a really good relationship with my 2015 National team, head of provider colleagues and feel I am a financial management vanguard better commissioner’ she says. specialised ‘I’ve worked with one finance commissioning finance programme. There director across a number of organisations who has had a Outside interests is the opportunity to significant influence, initially by Justine is a keen darts player, and be part of something guiding and encouraging me. I was the ladies singles champion for given a chance to learn and I now clubs in Colchester. She enjoys the that makes a real always try to give people the best social side and plays darts with her chance to develop. You have to play partner a few times a week. When difference” a role in any team and can achieve not competing herself, she supports so much more than working as an Essex Cricket Club. individual. I was encouraged to join ‘When I first started working, there the HFMA’s national tariff group and Favourite film August Rush were no personal computers. I still have met lots of different people Favourite book PbR Guidance; prefer to speak to people and make working together and learning by The World According To Bumble; sure I use technology effectively.’ sharing issues and solutions.’ Start The Car, David Lloyd There is so much happening in the Justine has some advice for those NHS Justine is excited about. ‘I am considering a career in the NHS. Favourite TV shows Pointless and really interested in the NHS vanguard ‘Sometimes it can be hard to break Holby City programme. There is the opportunity into the NHS, but I think it is more Top three records Baker Street, to be part of something that makes about skills than the history’ she says. Gerry Rafferty; How Soon Is Now?, a real difference, where clinical ‘When I’m interviewing, I look for The Smiths; Keep The Customer considerations of how we work and transferable skills. There are often Satisfied, Simon and Garfunkel the financial considerations of how we internal candidates who are very pay for it are brought together.’ strong, so to break in you need to Justine is clear about the work accentuate how your skills and she is most proud of. ‘I was asked experiences are relevant. I’d definitely to deliver a session on the national recommend a career in NHS finance. tariff to 60 GPs during the transition to It’s incredibly rewarding and you get clinical commissioning groups. I was to work with so many great people.’ NHS FINANCE 2943 CAREER STORIES

Name: Paul Stocks

Job: deputy director group finance – financial control, Department of Firm focus on Health joined-up finance

Paul Stocks is not entirely clear how after coming to the realisation that experienced working in local his first job came about. He had been the chief finance officer and chief government and the NHS, he planning to go to university to study executive weren’t going anywhere decided to add central government public policy but, out of the blue, he anytime soon, I started to look to his CV and joined the Benefits received a phone call from Doncaster elsewhere,’ he says. Agency as its head of financial Metropolitan Borough Council. In 1995, Paul became deputy planning. ‘I don’t know how they heard about director of finance at Scunthorpe and The scale of the numbers involved me,’ he says. ‘But they asked me Goole Hospitals NHS Trust. Again, increased significantly with the new whether I was interested in applying he was responsible for the day-to- job – he was responsible for planning for a trainee position. They promised day management of the finance and budgeting for the agency’s to support my accountancy training department. He joined the trust just income of £2.5bn. and, as I knew I wanted to work in as it was undergoing a period of But although he was still in the the public sector, it seemed too good structural change – it was this that public sector, Paul missed health. an opportunity to pass by.’ attracted him. ‘There is something special about the Paul quickly knew he had made the NHS – it matters to people,’ he says. right choice. As part of his training ‘At the agency, I felt too removed at Doncaster MBC, he spent time from the frontline and from the people in different departments, including we were trying to help. I thought that payroll and internal audit. It gave him perhaps being a civil servant didn’t a good grounding and a thorough suit me. But I decided to give understanding of all aspects of local it another go and applied for a job authority finance. During his time at with NHS Estates.’ Doncaster, he passed his accounting Paul started working at NHS technician and CIPFA exams. Estates – which was an agency of After eight years – which ‘flew by’ the Department of Health – in 1999, – Paul decided he should widen his as deputy director of finance. Straight experience and he applied for, and away he felt more at home. secured, the job of chief accountant at the neighbouring local authority, Estates frontline Selby District Council. ‘The organisation was very frontline Paul recalls starting the new post. facing,’ he says. ‘There were two ‘The change was mindblowing. key parts to the agency’s work. I was responsible for the day-to- The first was the policy aspect of day management and control of ‘It was an opportunity to reform NHS estate management, working the accounting, payroll, payments, the finance function and to make with the Department of Health. There housing benefits and administration sure that we had the right systems in was also a commercial aspect to the functions,’ he says. ‘I went from place,’ he says. role, which involved working with having no staff to having 24. It was A difficult financial position meant NHS organisations and advising a shock at first, but before long I that Paul’s focus was on ensuring the them on how to make the best use realised I was really enjoying myself.’ trust returned to financial balance. He of their estates. It was at Selby that Paul believes did this by building effective working ‘My role covered the financial he really started to develop his relationships with clinicians and aspects of our policy work and, management skills. ‘I focused on heads of departments and working again, managing the day-to-day getting the right people into the with them to identify areas where running of the finance department. right roles and on supporting their efficiency could be improved. He also I was also responsible for human development,’ he says. instigated a programme of finance resources and information After four years in the post, Paul training for non-finance staff. technology. It was really useful to decided to look for his next role. ‘I Five years later Paul was looking broaden my skill set beyond finance. really enjoyed myself at Selby, but for his next challenge. Having I was happy to be working in health 44 NHS FINANCE CAREER STORIES

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again and I realised that I was suited and introducing a learning and Employment history to being a civil servant.’ development culture. Qualifications CIPFA In 2002, Paul made the move to Paul sees the experience he 1981 Doncaster MBC, various the Department of Health. Two of the gained at the start of his career as accountancy/internal audit five roles he’s had there were not valuable grounding for his work at the posts based in the finance directorate. One Department, but he says he’s also was a finance role in the corporate had to learn new skills. 1989 Selby District Council, affairs directorate. The other was as ‘Being able to write well is a chief accountant deputy director in the commissioning prerequisite of being a good civil 1993 Scunthorpe and Goole directorate, leading on performance servant,’ he says. ‘It is a skill Hospitals NHST, deputy FD reporting and system design. This that doesn’t come naturally to all involved collating and reporting accountants, so if you are working at 1998 Benefits Agency, head performance information from the the department you need to develop of financial planning strategic health authorities. the skills yourself or surround yourself 1999 NHS Estates, deputy FD ‘While it was still about reporting with people who can write well.’ numbers, it was very different Paul’s current role could be seen 2002 Department of Health, from working in finance,’ he says. as one of the most challenging in corporate affairs head of ‘It was a bit scary for the first few healthcare finance. As deputy director finance and business months. Leadership and stakeholder group finance – financial control, he planning management were the skills I used oversees financial management and 2003 Strategy and business reporting across the Department – head of finance that’s more than 400 bodies, revenue “Spending budgets of £110bn and capital 2005 Head of performance budgets of £4.8bn. And 2014/15 was reporting and system design time outside a particularly challenging year. 2007 Deputy director group The job might seem removed finance – financial the finance from patient care, but some of management and partnering Paul’s work is directly relevant. He department was recently involved in setting up 2014 Deputy director group financial arrangements to support the finance – financial control and out of your treatment of ebola, working closely comfort zones really with the Ministry of Defence. Outside interests Paul has also taken part in the Paul spends much of his spare does help with your initiative to reconnect civil servants time as a taxi service for his three in the Department with the frontline daughters, but he likes socialising development” of health and social care. He spent and watching football and is a keen five days working in an accident and supporter of Sheffield Wednesday. emergency department. most. Spending time outside the ‘It was a reminder about what we Favourite book McCarthy’s Bar: A finance department and out of your are here for,’ he says. ‘Connecting Journey of Discovery in Ireland, Pete comfort zones really does help with with clinicians and managers helps McCarthy; CAMRA Good Beer Guide your development.’ you to see the challenges they face Favourite film Brassed Off; After a couple of years, Paul and how the work we do has an Life of Brian returned to the finance directorate to impact on them. I’d recommend ; lead the finance business partnering finance staff do something similar Favourite TV show Blackadder

function, as well as financial planning – it really does give you a different Match of the Day and budgeting across the Department perspective.’ Top three songs That’s and its arm’s length bodies. Paul may not have started his Entertainment, The Jam; Trampled A serious illness in 2013, however, career with a plan, but he knew he Underfoot, Led Zeppelin; Hope resulted in Paul taking three didn’t want to take the same route as Street, The Levellers months off work and gave him a his class mates. He grew up in a Something chance to take stock. On his return South Yorkshire mining village, where Alternative career football-related or a politician to work, he had a shift of focus a large majority of his school friends and worked on the Department’s went to work in the pits. Even then, financial management improvement he knew qualifications and ambition programme. It involved looking at would give him choices. ‘You always the way finance was delivered in the need to be in charge of your own Department, re-engineering some destiny,’ he says. ‘Be proactive and processes, improving the capability don’t just let things happen to you.’ NHS FINANCE 2945 CAREER STORIES

Name: Ray Thomas

Job: assistant chief finance officer, Countess of Chester Hospital NHS Foundation In touch with the Trust technical side

Ray Thomas joined the NHS from moved house around the same were challenges: the trust was in the private sector and has worked at time and I wanted a better balance a turnaround situation at the time the same trust for 17 years. between my work and home life.’ The and I had to get involved early on to At university Ray studied challenges of spending time at work, ensure the trust had sufficient cash to mathematics and, following his having a new baby and settling into continue operating.’ degree, he wasn’t clear on his next the new house prompted Ray to look Changes to the structure saw Ray steps. ‘I enjoyed myself at university for a different role. take on additional responsibilities. and spent a lot of time socialising’ ‘There was a job advertised at ‘I worked for a deputy director of he says. ‘When I graduated I didn’t the Countess of Chester Hospital finance, who later became the want to be an actuary like many of NHS Trust,’ he says. ‘It is my local director,’ he says. ‘She tweaked the my classmates and I faced a shock hospital and where my children were organisation structure to remove that I had to grow up and get a job. born. I knew the care there was the deputy role and I took on The next natural step for a maths excellent and I wanted to build on responsibility for financial systems.’ graduate seemed to be a career as my good experience on secondment an accountant.’ previously at the Cardiothoracic Changing roles Ray took a training role at Deloitte Centre.’ Ray became assistant director of Haskin & Sells in Chester. It was finance for financial services and a small regional office of the firm systems (later retitled assistant chief and had the training culture of a finance officer) and recruited his big accountancy firm. Shortly after successor into the chief financial joining, the regional office was sold accountant role. Supported in as part of an organisation-wide the day-to-day activities, he was rationalisation. ‘Our office became able to focus on developing and Conway & Co,’ he explains. ‘But implementing a new e-procurement despite things changing, the new system, which he describes as one of organisation still had links with the the highlights of his career. large firms and access to training.’ ‘I was helping design a new system Ray completed his ICAEW studies with the developer of our financial and joined another local firm as ledgers. Other large enterprise an audit manager. ‘I joined Hacker system developers offered something Young in 1992 and worked there for Ray Thomas, right similar but it made sense to develop a few years until I moved to KPMG,’ our own integrated solution for our he says. ‘At KPMG, I worked in the financial ledger,’ he says. owner-managed business practice Ray joined the trust as the ‘Our new e-procurement system before moving into corporate chief financial accountant with was implemented at the trust and transactions.’ responsibility for financial reporting. shared by the developer with other Ray’s first experience working in ‘The role was particularly attractive NHS clients. There is no doubt our the NHS was on a secondment from because of its technical nature. procurement improved and it set a KPMG to the Cardiothoracic Centre It suited my experience and my course for continued improvement.’ in Liverpool. ‘It was a small and well introduction was spent bringing The trust was successful in its run centre. I took an operational a number of controls checks and foundation trust application and role for six months and it was really reconciliations up to date ready for became one of the first 10 in the interesting. I could see the benefit the preparation of the final accounts.’ country. Ray saw his skills play a key to the community and the intangible Ray describes the transition to the part in the application process. ‘Cash benefits of working in the NHS.’ NHS as straightforward. ‘The people was king,’ he says. ‘The long-term Ray returned to KPMG but not for working at the trust were brilliant and financial strategy challenged us to long. He and his wife had just had very supportive. This continues to set out what our future financing their second baby, as he explains. be my experience working across requirements were. At this time, the ‘It was a very busy time for us. We the NHS more widely. But there NHS had not been used to thinking 46 NHS FINANCE CAREER STORIES

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about cash in this way, as much of benefits to the trust from improved Employment history the focus had been on the bottom procurement but these come at a Qualifications FCA line. There was a perception of a price. The challenge in my role is to 1989 Deloitte Haskins & commercial skills gap in the NHS and assess whether making the capital Sells/Conway & I was able to bring experience of the investment will pay back and promote Co, ACA training corporate side of accounting to the sustainable improvement to our finance team. NHS trusts had been financial position.’ 1992 Hacker Young, good organisations but they were The focus of Ray’s role is audit manager becoming more business-like.’ increasingly on managing cash as, 1996 KPMG, manager Ray has experienced a number of like many other trusts, the financial including a technical changes in his time working position at Countess of Chester has secondment to the for the NHS. He says keeping his deteriorated in recent years. ‘The trust Cardiothoracic professional competence up to plans to play its role in transforming Centre in Liverpool date is essential. ‘There are a large the local health economy. We number of NHS training courses are projecting a financial deficit. 1998 Countess of available and, more recently, Future- Working with the council, CCG and Chester Hospital Focused Finance [FFF] has played community trusts, there is a desire for NHS FT, chief a role. The NHS finance profession stabilisation (sorting out the deficit) financial accountant has a good reputation and there and transformation (taking the longer and assistant are great opportunities for personal view of service development). My director of finance/ development. FFF builds momentum challenge is helping the trust manage chief finance officer its short-term financing requirements as well as investing in the future.’ Outside interests Ray sees effective treasury Ray enjoys cycling and achieved one “There management and investment in of his childhood ambitions when he the correct projects as the key to bought a Dawes ultra galaxy touring are great maintaining quality of services. bike to ride to work. He describes opportunities ‘Carrying on as we are won’t fix the himself as a gadget freak and drives deficit,’ he says. ‘If we under-invest an electric car, which he says is the now, we risk making the situation best gadget he’s ever had. for personal worse. We have invested in a development. FFF number of modern wards and new Favourite film Shaun of the Dead departments that really add value Favourite book Daemon by Daniel builds momentum for to the patient experience, maintain Suarez service quality and help control improvement” infection. Investments like these are Favourite TV shows The Walking an opportunity to generate a return Dead for the patient, rather than simply Top three records The Rake’s Song, increasing the cost base.’ The Decemberists; Scare Away the for improvement on the platform Ray also sits on national technical Dark, Passenger; 36D, Beautiful that already exists.’ issues groups to influence the South As assistant chief finance officer, direction of the NHS finance Ray’s role involves much of the profession. He is a founding member Favourite food Reasonably spicy day-to-day leadership of the finance of the HFMA Foundation Trust curry department and ongoing system Finance Technical Issues Group – a Alternative career Architect development. For example, his role key forum during the development involves aligning the trust’s system of the foundation trust regime. He is development to the Department of also a member of the Department Health’s e-procurement strategies. of Health Bodies’ Accounts Liaison He says: ‘Changes to national Group, where issues affecting annual strategies will have an impact on how accounts are discussed, as well we work as a trust. I have to consider the NHS Pension Scheme Advisory the implications of a potentially large Board, which considers how the systems upgrade to ensure we can pension scheme operates. continue to work with our suppliers. ‘It’s a great way to help the NHS at ‘We are a member of the cohort a national level,’ he says. ‘My trust of 22 involved in the Carter review benefits, as the issues we discuss are of procurement and efficiency in relevant, and it helps my continual the NHS. There will be financial professional development.’ NHS FINANCE 2947 CAREER STORIES

Name: Alison Tonge

Job: NHS England (North), regional director of specialised Letting numbers services tell the story

Alison Tonge’s life was changed by pieces of work, such as the private ‘It has the same challenges and a book, leading to a career in NHS finance initiative, capital development issues, so you can transfer your finance, general management and and writing business plans. experience and knowledge from the healthcare commissioning. ‘I went ‘I was interested in the numbers NHS. However, it is really important to sixth form to do archaeology and telling the story – and still am. to understand the context. Canada languages and I hated it,’ she says. ‘I For me, it’s about using financial is a massive country – you can’t was some way into my A-levels, but I information and knowledge to make assume a change that works in one decided to change tack.’ improvements.’ area will work in another.’ She bumped into a business Commissioning fitted well with On Alison’s return to the UK, studies teacher, who gave her a these interests and she worked in she went back into commissioning book on Keynesian economics. ‘I several primary care trusts. ‘I was organisations, arriving in her current got hooked on understanding how working in providers on big strategic role – NHS England (North) regional things work in the economy and then projects and when commissioning director of specialised services went down the road of business, came along, it felt like it was a good commissioning – early in 2015. economics and law at A-level.’ fit,’ says Alison. There, she leads a team of three From there, she studied economics operational units, with a budget of at university, and retains an interest £4bn and 90 contracts. in the subject to this day. Local ‘It’s an opportunity to improve government offered the best way to quality and equity by improving apply her economics degree, she access for patients. At the same decided, and she got a job as a time, we have massive financial trainee accountant at Manchester issues to deal with in specialised City Council, studying for the CIPFA commissioning,’ she says. ‘It’s qualification. innovative work – which I like – improving the offer to the public and Heading to health patients by achieving better access She moved to health in 1987, first and better value for money in a with the regional health authority as sophisticated way. Delivering both of a financial planner, then to North these motivates me.’ Manchester Health Authority as a Many colleagues have influenced financial accountant. her. ‘I try to seek out people who I With the introduction of the can learn from. Things stick in your purchaser-provider split and NHS ‘Commissioning as we know it mind – phrases or approaches to trusts, she shifted to the provider doesn’t exist anywhere else. The meetings. One colleague told me sector in 1990. For the next eight nearest thing everywhere you go to go into meetings with trust rather years, she was deputy director of is to do with strategy, performance than mistrust – the more I look back finance at Stockport Healthcare NHS and planning – I’ve always worked in on it, the more I see how right he Trust, setting up and managing the these areas.’ was. new organisation’s finance function Nevertheless, between 2009 ‘People teach you things and often and leading on a first-wave private and 2012, Alison served as executive they don’t know they’re doing it. For finance initiative scheme. vice-president, strategy and me it’s usually the way they approach A two-year spell in consultancy performance, at Canadian integrated things rather than knowledge – how at SECTA/Tribal followed. ‘From care provider Alberta Health they tackle issues with personal early in my career, I worked on Services. Despite the nation’s lack resilience and knowledge.’ strategic initiatives and, going into of familiarity with commissioning – Alison says the best piece of career consultancy, I was involved in issues ‘they would not know what you advice she has been given is to work such as service change. I’d always were talking about’ – she was outside your comfort zone. ‘When I been interested in the bigger picture able to bring a range of skills and worked in consulting in particular, I and making changes through specific experiences to the job. was amazed by how much you can 48 NHS FINANCE CAREER STORIES

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learn very quickly. I always tell people happened during her time at Employment history now that if you are going into a job Stockport PCT. ‘I worked with Qualifications CIPFA and feeling comfortable it’s probably the doctors on a forerunner to 1990 Stockport Healthcare not the best job for you if you want to CCGs, setting up an innovative NHST, deputy FD be stretched and to learn.’ membership structure based on a Development opportunities tend social enterprise. PCT resources 1998 SECTA/Tribal, to happen when there is something were devolved to this structure. This senior consultant with a glaring need to be done, she was 10 years ago and I still see the 2000 North Stoke PCT, says. ‘I think I have made my own doctors now. It was really innovative deputy CEO/director opportunities. When I see something and cutting edge at the time. It went of finance and estates that needs improving, I get fired up slightly against the grain.’ and from that comes a development 2002 Stockport PCT, director opportunity.’ Patient focus of finance and estates Alison singles out three major Alison has recently been involved in 2005 Deputy CEO career achievements, one of which projects that will have a direct impact is coming back from Canada and on patients’ lives – solid accountancy 2007 NHS North West, exec re-establishing herself in the NHS. work on patient pathways and director, health system location of services. She has and development helped develop new collaborative 2009 Alberta Health Services “Moving to commissioning structures across (Canada), executive VP, the North of England and taken a strategy and performance lead role nationally in developing Canada and and supporting collaborative 2012 NHS South East London being able commissioning partnerships. Cluster, finance director She is also leading the 2012 NHS England (Cheshire to apply my development of a strategy and Warrington and Wirral, service review programme for the North West Specialised knowledge is an North and with a national group. Services), area director/ Having worked inside and outside director commissioning achievement. People the NHS, in the private sector, in commissioners and providers, in 2015 NHS England (North), still contact me now finance and general management, as regional director of about work I did” well as in another healthcare system, specialised services she has a perspective that is rare. From NHS England (West ‘Outside the NHS, it’s less about Nov 2015 Midlands), director of the constraints of governance; it’s commissioning operations ‘It could have gone wrong. I didn’t all on delivery and achievements. plan anything and thought I would You learn a lot about the importance Outside interests do some contract work, but I knew I of delivering to a timescale and Alison enjoys spending time with her wanted to join the service again and cost to meet clients’ expectations. family and hiking and yoga. start contributing. It has been a hard In contrast to that, in the NHS slog and I think I’m not quite back to delivery isn’t always the number Favourite film Groundhog Day the level where I left.’ one thing – there’s also relationship Favourite book A Short History of Not that she regrets her time management, politics with a small p Nearly Everything, Bill Bryson in Canada. In fact, she sees it as and long-term collaboration.’ Homeland, 24 another of the top achievements in Alison may have moved away from Favourite TV shows and Would I Lie To You? her career. ‘Moving to Canada and day-to-day NHS finance, but she being able to apply my knowledge believes it is important for all Top three songs My Aim Is True, and be successful is an achievement. managers to keep services to patients Elvis Costello; New York, New York, People still contact me now about in mind, no matter how far from the Frank Sinatra; Rolling in the Deep, work I did there,’ she says. front line of care. ‘You are three steps Adele ‘In the end, my post was back from the service change, but Favourite food Thai – and my restructured and I didn’t have a you have to get that reassurance that husband’s wonderful lasagne role there. That could have been a what you are doing helps – that it’s setback, but I am proud of myself for pushing us forward rather than Alternative career Lawyer not letting it set me back. I always try dancing around or outside of it. You to take the positive out of things and have got to ask people, “Is this have kept my network over there.’ helpful?” Sometimes bright ideas do A third standout career point not reflect what’s needed.’ NHS FINANCE 2949 CAREER STORIES

Name: Richard Wheeler

Job: director of finance, East Midlands Ambulance Service A path of support NHS Trust and innovation

Richard Wheeler always wanted a ‘There was a lot of money available his next opportunity. Richard professional career that gave him at the time for the right projects was attracted to the NHS by the the opportunity for further study. After and we were involved in many diverse range of organisations and completing a degree in mathematics, different activities,’ says Richard. services it provides. He also had a he embarked on a path to become an ‘For example, we managed land and desire to improve business practices accountant in the private sector. Now property and supported education and put the NHS onto a better director of finance at East Midlands services, creating a regional identity financial footing. Ambulance Service NHS Trust, he working with the tourist board.’ He became head of finance at has a track record of developing He sees another success during his Leicester, Northamptonshire and services and supporting innovation. time with the agency as renegotiating Rutland Strategic Health Authority Richard started work in 1989 at a change to a VAT methodology that (SHA), where he gained a good Rawlinsons Chartered Accountants, resulted in a £1m repayment. understanding of the NHS and a small firm in Peterborough. His The agency had a track record developed an overview of what was clients were mainly small to medium- for embracing technology and its going on in the area. sized enterprises, private companies financial system was doing a lot more and their subsidiaries and housing FD ambitions associations. ‘Despite the great He used this role to start the training I received, which enabled me transition to becoming a director of to pass my ACA exams and become finance. ‘At the time, there were a an audit manager, I couldn’t see my lot of mergers and changes to the long-term future as an accountant structure in the NHS, which reduced within a firm,’ he says. the number of job opportunities In a competitive job market, available to me,’ he says. ‘Also, Richard became finance manager adverts seemed to require 20 years’ at Isle College Further Education NHS finance experience. I knew my Corporation. The college had just skills were transferable and arranged transferred from being under local for an existing director of finance to government control and Richard be my mentor.’ spent six years there, eventually Richard’s work at the SHA as finance director. ‘We grew the strayed into education, where he business to about £6m turnover,’ was involved in medical, nurse he says. ‘The college operated in and undergraduate education and a small, rural and deprived area, training. ‘We worked with universities, so we knew it was important to the university hospital trusts and local community. Young people who than Richard had seen happening in education confederations [similar had attainment below the national other organisations. to today’s local education training average when they joined were ‘Budget holders had access to boards] to establish undergraduate leaving with excellent qualifications.’ financial information that was run in programmes,’ says Richard. There were lots of challenges along real time and operational managers ‘Our university partner described the way, which gave Richard good were able to make updates directly us as leading the country in what problem-solving experience. They in the system,’ he explains. ‘This use we were setting up. There had been also helped him move to his next of technology gave us the platform little work in joining up finance and role as East of England Regional to have confidence in the financial outcomes before.’ Development Agency’s head of decisions we were making and the In 2006, Richard moved to East finance. The agency was a start-up projects we invested in.’ Midlands SHA as deputy director formed from different government When the organisation of finance. He describes it as agencies. Located in a new building, restructured, the finance director transitioning people and bringing the revenues grew from £30m to moved on and Richard covered the two former organisations together £105m in five years. role for six months before looking for into new business premises. The 50 NHS FINANCE CAREER STORIES

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organisation experienced a period changes complicated the production Employment history of instability but Richard was able to of the accounts, but they were Qualifications FCA focus on the opportunity for change. successfully delivered on time. 1989 Rawlinsons Chartered He recalls outsourcing of a number Richard remembers considering Accountants, trainee to of services to NHS Shared Business carefully whether a director of finance audit manager Services (SBS). ‘We were the very role was right for him. ‘It is something first in the East Midlands to do so,’ I’d always wanted to do,’ he says. 1993 Isle College Further he says. ‘We streamlined support ‘When the time came, I had coaching Education Corporation, services and it was a big success. around my skills and abilities to see finance manager, then FD This achieved 30% cost savings. whether it was important to me and 1999 East of England ‘From there, we had an opportunity something I was still interested in. Regional Development to work across organisations for I’ve worked with really good finance Agency, interim FD and bigger economies of scale and we directors and have a good personal head of finance supported others to do so as well. network to take advice from.’ This led to nine out of the 10 PCTs in Richard made the transition to 2005 Leicester, the area transferring services to SBS, director of finance and sees the Northamptonshire and as well as a number of trusts.’ mentoring support he had from a Rutland SHA, head of Part of Richard’s time at East successful chief executive as key. finance Midlands SHA was spent on He has seen an interesting change 2006 East Midlands SHA/ secondment to United Lincolnshire in his working pattern since 2014, Midlands and East SHA when he became director of finance Cluster, deputy director at East Midlands Ambulance Service of finance SHA Cluster NHS Trust. ‘I have responsibility for “When I can I finance, procurement, logistics and 2011 secondment to United estates,’ he says. Lincolnshire Hospitals get out of the ‘Ambulance service staff are on the NHS Trust, associate office, riding road most of the time and it can be a director of finance challenge to catch up with people. I 2012 Oxford University out with prefer to speak to colleagues rather Hospitals NHS Trust, than wade through emails, so when deputy director of finance ambulance crews I can I get out of the office, including riding out with ambulance crews and 2014 East Midlands and visiting premises visiting our different premises to keep Ambulance Service NHS in touch with life at the sharp end. Trust, director of finance to keep in touch with ‘My office time is spread across the day-to-day financial operations and Outside interests life at the sharp end” catching up with projects with the Outside work, Richard spends team, maintaining relationships with time with his family. A keen cyclist, auditors and regulators and working he enjoys the Tour de France and Hospitals NHS Trust as an associate with my executive colleagues.’ mountain biking with his son. director of finance. ‘It was a great Looking back, Richard says: ‘I have opportunity to work in a provider seen my level of experience increase Favourite film A fistful Of Dollars organisation,’ he says. ‘I had a good and I have a much greater awareness Favourite book Anything by James knowledge of the sector from my time of what to focus on, how to measure Patterson at the SHA and this role gave me an the real impact of things and whether opportunity to apply my experience they really are a big issue. Favourite TV shows Football on differently and improve the business ‘There is a lot of excellent support BT Sport and Suits activities of a provider.’ and advice for finance staff working in Top three records Closer, Joy In his next role, at Oxford University the NHS – Future-Focused Finance Division; Under The Iron Sea, Keane; Hospitals NHS Trust, Richard was aims to build a platform and develop Diamond Life, Sade named HFMA Deputy Director of the role of the finance team. It’s good Fish and chips Finance of the Year 2012, partly in to have this support network across Favourite food recognition of completing the 2012/13 multiple organisations. Building up merger accounts of Oxford Radcliffe contacts is a great way to know who and Nuffield Orthopaedic Centre. to talk to and get advice on how to This was the only trust merger approach aspects of our work – there in that year – a complex year with is a terminology, structure and culture technical accounting changes taking to the NHS that can take time to learn place alongside the merger. The when you first join.’ NHS FINANCE 2951 CAREER STORIES

Name: Robert White

Job: health director (value for money audit), National Audit The right gear to Office make a difference

A career in management and finance found healthcare roles, initially in mental health, learning disability always interested Robert White. in Wimbledon and then central services, regional rehabilitation, And it quickly became clear that London as financial controller of a general acute, teaching hospitals healthcare was where he was to private hospital offering general and and supporting commissioning and pursue it. However, having grown specialist services. primary care at a health authority up in the Canadian province of It was here he became aware level. For 10 years he was on the Saskatchewan, it wasn’t initially of the growing opportunities in the board of Midtech Innovations, the obvious he would spend the vast NHS’s emerging internal market. He intellectual property hub for the NHS majority of his career in the NHS. took advantage of these in 1992, in the West Midlands, and spent a Being the offspring of a finance joining Southmead Health Services similar amount of time on the HFMA’s director and a matron may have had NHS Trust in Bristol as senior finance national Financial Management and an influence on his choice of career, manager. Part of the attraction was Research Committee. He also found but Robert declared his healthcare the potential to further his career – time to complete a masters degree in ambitions at the University in even at this point, he had his sights accounting and finance. Saskatoon, one of the province’s two set on a finance director role. ‘I could Robert says he has learnt from major cities. He chose a healthcare some influential leaders. Stephen administration major for the last two Day (former HFMA chairman) and years of his bachelor of commerce Steve Webster (former HFMA finance degree. He even set up, and became director of the year) were both in president of, the business school’s Bristol when he started (and on his healthcare administration society. interview panel). He later worked with His first job saw him become Mark Britnell and Peter Shanahan at general manager of a continuing University Hospital Birmingham. And care organisation, which involved he also singles out John Adler, his ‘doing everything but the healthcare’. chief executive at Sandwell and West He feels lucky to have had early Birmingham Hospitals NHS Trust. experience of working closely Having seen leaders successfully with clinical staff, residents and distinguish between the issues relatives and, more widely, with and programmes that require their the department of health and trade direct input and those that can be bodies. delegated, Robert has attempted to ‘Everything’ also included preparing put this into practice himself. the year-end accounts, a task made From Bristol, Robert moved to easier after he installed an integrated see a significant career progression Barnet Healthcare NHS Trust as accounting system to replace the opportunity in the NHS,’ he says. deputy finance director for three paper-based ‘books’. It was during He admits it took a while to settle years before taking the same role in this role he started studying towards into the service, with its unique Solihull Health Authority, moving up his certified management accountant language and, most significantly, to acting finance director. qualification, which he finished in its high degree of central direction the UK – proving his dedication with – something he hadn’t experienced Scaling up flights home for exam preparation in the independent sector. He In 2000, he joined major teaching weekends! The recent unification of remembers a number of accountants hospital University Hospitals the three main accountancy bodies in were making the switch from the Birmingham NHS Trust (UHB) as Canada has created a new chartered private sector to the NHS at the time head of financial management professional accountant designation, and that not all of them could adjust. and planning. He became finance so he is getting used to being ‘R Robert was advised to get as director in 2003, leading on finance, White, CPA, CMA’. much experience as possible of all contracting and procurement. With ties to the UK, an opportunity parts of the service. He has taken This was a big shift in organisation to relocate overseas arose. Robert this to heart, working over the years size. At close to £400m turnover (at 52 NHS FINANCE CAREER STORIES

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the time), UHB was one of the biggest pilot for the new PF2 funding scheme Employment history trusts in the country and was in the and was approved to proceed by the Qualifications Chartered first cohort of teaching hospitals to NHS Trust Development Authority Professional Accountant (Canada) be given foundation status. Robert and Department of Health in 2014. 1989 Churchill Clinic, was heavily involved in the trust’s FT The trust is working towards an financial controller application, with authorisation in July opening in about four years. 2004. The new status brought new Robert believes the part he and his 1992 Southmead Health challenges for NHS finance managers team played in the improvement of Services NHST, senior – a payment system in the form of the trust’s efficiency and elimination finance manager payment by results, new flexibilities of its financial deficit was his most 1994 Barnet Healthcare and regulatory requirements. But the notable work-related achievement. NHST, deputy trust was also in the throes of working The trust’s £5.7m deficit in 2005/06, director of finance up a major capital project, financed his first year, was to be its last in under the private finance initiative, to his stay at Sandwell and all support 1997 Solihull HA, deputy build a hospital that would open as loans were repaid. ‘We had some director of finance – the new Queen Elizabeth Hospital in external assistance to identify the acting finance director 2010. problem areas and were told we were 2000 University Hospitals In 2005, staying in the West inefficient everywhere. The upside Birmingham NHS FT, Midlands, Robert moved to was that it became everyone’s issue head of financial the £435m Sandwell and West to resolve,’ he says. management and Birmingham Hospitals NHS Trust as In 2014, the attraction of working planning; director of in a national capacity drew him finance to the NAO, but he could also see that the work would sustain a 2005 Sandwell and West Robert connection to health and social care Birmingham Hospitals believes services as well as with NHS finance NHST, director of professionals. finance and being asked He believes the NAO has a major performance part to play to support the NHS in management to lead meeting its challenges through the 2014 National Audit Office, influence and authority drawn from director, health projects outside his its independence. He points to its autumn 2014 reports on Public Health Outside interests area of expertise England’s grant to local authorities A keen cyclist, on and off road, created opportunities and the financial sustainability of NHS Robert competes in the occasional bodies as important early outcomes sprint triathlon. He plays tennis – his to learn new skills in his new role. ‘It is a privilege to double-handed back hand is a work work for this organisation and I fully in progress. ‘It’s an age thing’ he appreciate the responsibility to uphold says. He supports a local Scouts its high standards.’ group as treasurer, despite his boys director of finance and performance Robert insists that continuous having long since left. management, where he was to development is vital for NHS stay for more than eight years – a accountants. He says he can still Favourite book The Last Crossing, result of being part of a ‘well-led remember key moments, such as Guy Vanderhaege stable senior management team being urged to realise his potential, Favourite TV programme with a shared objective to modernise along with other delegates, at the The Thick of It healthcare services in the area’. HFMA Fincare campus in 1993 by His experience of the UHB PFI then NHS Executive finance director Favourite meal Pasta puttanesca project was to stand him in good Gordon Greenshields. He also Alternative career choice Brewing stead – Sandwell had already started says being asked to lead projects real ale on a journey towards its own new outside his area of expertise created hospital, the Midland Metropolitan opportunities to learn new skills. Hospital, replacing two district general Over his career, he has become hospitals. After a strategic business convinced that meeting service and case assessment in 2006, there were financial challenges is best done significant revisions and then a pause collaboratively across whole health while the PFI process itself was systems – and this is where financial subject to national review. staff have an opportunity to make a The scheme came out of this as a real difference to patient care. NHS FINANCE 2953 CAREER STORIES

Name: Kate Whiting

Job: Finance director – specialist medicine, Central Manchester NHS Foundation Trust Manufacturing a career change

The finance profession was always I didn’t want to become like that Adelphi was a fantastic experience on the cards for Kate Whiting. A myself,’ she says. and I could have stayed there for career advisory questionnaire at Attracted by the idea of working ever, but I felt I needed a new school identified accountancy as for a smaller company, in 2002 challenge,’ she says. So when the profession for her, based on her Kate joined the Adelphi Group – a Kate received an email from CIMA aptitude for mathematics and desire medical communications agency about job opportunities in the NHS, to earn a good salary. This led to her whose primary role is to support she thought seriously again about studying accountancy and finance pharmaceutical companies with working in healthcare. at university, and six months before market research and bringing new She saw an advert for a divisional she graduated she started to think drugs to market. ‘There were only accountant at Salford Royal NHS seriously about what to do next. 600 employees and at the time it Foundation Trust and applied straight She researched the prospect of felt like my career moved from one away. She was attracted by working working for one of the large audit extreme to the other. What really in the public sector and fulfilling her firms but decided industry was the attracted me was the opportunity to passion to make a difference. way to go. It was at this point she first have a much broader role to expand considered the NHS. ‘I could see the my skills,’ she says. New chance to flourish real benefits of being an accountant As well as being responsible The culture at Salford enabled in the NHS and being part of an for the traditional aspects of Kate to flourish. ‘The flat structure organisation that had an impact on meant that there were always new people’s lives, but at the time the opportunities for the finance team. If NHS training scheme professional there was a project going on, people body of choice was CIPFA. At that were encouraged to put their hands stage, the risk of limiting my career up and get involved. The divisional choices to the public sector was too accountants were involved in key big,’ she explains. developments as well as monthly Straight after graduating, Kate management accounts’ she says. began to work for ICL, which was A highlight for Kate was leading later acquired by Fujitsu Services. the financial work on the creation ICL was a large British computer of Salford’s urgent and emergency company that manufactured care village. ‘Working with clinicians, hardware, developed software and managers and commissioners to set provided professional services to a up the village was a privilege and wide range of clients. As a graduate seeing it up and running was a real trainee, she spent six months in thrill,’ she says. a variety of finance roles. As Kate In 2011, the FT took over recalls ‘while the ICL training scheme management accounts, Kate also responsibility for providing community was a great grounding, the perks led on negotiation of client contracts. services in Salford, which increased were nowhere near those of the NHS ‘It was great experience. We didn’t the size of Kate’s portfolio. It also scheme. All the studying happened at have a legal team, so I dealt with any coincided with Kate having her weekends and I only had time off to contractual issues, including drafting daughter and taking maternity leave. take the exams.’ contracts, negotiating with clients, On her return, there was some By 2002, ICL’s turnover was £1bn agreeing confidentiality and non- restructuring within the team, which and it employed more than 20,000 competition clauses. meant that Kate’s old job no longer people. Kate began to feel like a ‘It was the first time I’d done existed and she was given a different very small cog in a big wheel and something other than pure role – senior business accountant, was getting little job satisfaction. accounting and I loved it!’ she projects and corporate. ‘Our purpose was clear, but there remembers. It was a promotion that Kate did was very little passion from the staff. After six years, Kate started to think not want at that time. ‘I felt that I People just saw jobs as jobs and about making a move. ‘Working at would be one step removed from 54 NHS FINANCE CAREER STORIES

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the divisions, and working with them opener. ‘I can’t explain how hard it Employment history was what I really enjoyed. But it was was’ she says. ‘It was absolutely Qualifications CIMA presented to me as a development relentless, especially when you add 2000 ICL, finance opportunity and the finance director the on-call commitments into it. The graduate trainee was very persuasive. He wanted responsibility weighed heavily on someone in the post who knew the my shoulders and sometimes I felt 2002 Adelphi Group, organisation well and had a good I couldn’t leave until patients were project/ commercial reputation for working with clinical safe. I found myself working longer accountant colleagues. Looking back, it was the and longer hours, which is difficult 2008 Salford Royal best thing that could have happened.’ with a young family. I rarely felt like I NHS FT, business As part of her role, Kate led large could switch off.’ accountant trust-wide projects, such as the There were positives. Kate costing work that fed into the HFMA’s earned the respect of her clinical 2012 Senior business report on seven-day services. colleagues for trying something accountant Kate credits Tony Whitfield, the outside her comfort zone and it gave 2013 Senior manager – former finance director at Salford, for her exposure to the pressures her acute medicine influencing her career and how she colleagues were facing. ‘I thought approaches her work. ‘Tony made we worked hard in finance, and we 2014 Central Manchester it clear what he expected from his do, but it is very different in general NHS FT, finance management,’ she says. ‘Finance has director – specialist its peaks and troughs but generally medicine speaking we know that when we go “I was sad home we can switch off’. Outside interests Kate completed the secondment Being a mother to a nearly four- to leave and while she was glad she’d done year-old daughter with a full-time job Salford, but it, she was keen to move back to doesn’t leave much time for hobbies. finance, but not to forget about her Kate keeps fit by chasing round I needed operational experience. after her daughter and running when The role of finance director, she can. She has also just moved to experience what specialist medicine at Central house and is getting more involved in Manchester NHS Foundation Trust village life. the rest of the NHS ticked the boxes. ‘I was sad to leave Salford, but I needed to experience Favourite book We Need to Talk was like and get a what the rest of the NHS was like and About Kevin, Lionel Shriver get a different perspective. The role is Favourite film Dirty Dancing different perspective” finance but based within the division, so is a perfect balance for me,’ she Favourite TV shows Strictly Come says. Her role is in the specialist Dancing; Location, Location, finance team and what our purpose medicine division and she reports in Location; and Masterchef was. He led by example and always to the director of financial strategy but Top three songs Greatest Day, Take put patients first. He encouraged us with a dotted line into the division. That; Sit Down, James; Ain’t Nobody, to deliver financial viability through She has relished the challenge of Rufus and Chaka Khan engagement with clinicians to do the working at Central Manchester. ‘The best for patients and get most value trust is over twice the size of Salford Favourite food Moules-frites from our money’ she says. and is an amalgamation of several Alternative career choice ‘I’d love to Spurred on by Tony and keen hospitals. The budget for my division have my own wedding dress shop – to get closer to the action, Kate alone is more than £150m. Getting I’d sell shoes too’ applied for a general management to understand how things work has post with responsibility for Salford’s been a challenge – eight months after acute medical specialties. ‘I wanted joining, I am getting there’ she says. to explore whether I should take Central Manchester too is benefiting my career in a different direction. I from Kate’s experience. As she was offered the post on a one-year explains: ‘I now know I am asking the secondment basis. It was a risk, but right questions. I can see where the there was comfort in knowing that if I problems are likely to arise and can didn’t like it I could go back to finance’ suggest ways to overcome them. I’d she says. recommend spending time in an For Kate working in general operational role, it really does make management was a real eye- you a better accountant.’ NHS FINANCE 2955 CAREER STORIES

Name: Paul Williams

Job: research manager, HFMA Finding the right chemistry

With a degree in chemical people. I thought it really represented the transactional elements of the engineering, Paul Williams is well the values of the public sector. I was work we were doing,’ says Paul. equipped to grasp technical detail delighted to be successful. ‘It was where I got my interest in both in the scientific field and in his ‘On my first day in finance I didn’t working in the management of a chosen career, accountancy. But know what a debtor or creditor was. finance team to improve the team as well as developing his analytical My colleagues were key in supporting itself, focusing on systems and skills, chemical engineering also my development alongside my processes.’ gave him an aptitude for redesigning professional studies.’ He spent six years at Havering and streamlining processes. He worked predominantly in before moving into health, at Great That’s not been lost on those adult and children’s services – Ormond Street Hospital NHS interviewing him for jobs over the challenging areas with high demand Foundation Trust. He says this was years and it has led him to roles that and tight budgets, so greater risk of another natural step. ‘There are lots have developed these skills. overspending. Havering was seen of transferable skills, although health At school he enjoyed science in funding allocations as a relatively has a lot of specific practices I had and maths – learning how to solve affluent London borough, so grant to learn,’ says Paul. ‘At the time I problems and understand how things got the role, my colleagues were work. He was encouraged to turn his saying it was difficult to make a move interests into a ‘real world’ job, but into health, so I was grateful for the he also wanted a vocation with travel opportunity. For a number of years, I prospects. ‘My parents were in the had worked with pooled budgets and diplomatic service and I lived in India partnerships across social, health and Barbados, so I was seeking a job and third sectors.’ that offered the chance to travel.’ But, while he relished the practical Joining the HFMA aspects of chemical engineering, He subscribed to the HFMA, and its he admits he ‘did not quite enjoy it publications and events helped get enough’. He knew he wanted to work him up to speed quickly. ‘It was good in the public sector, so Paul decided to see patient-level costing being to do a business management course talked about and used, as well as (European business management at service line reporting,’ he says. ‘This Manchester Business School). is something we’d tried to do in the He then applied to and was local authority in terms of segmental accepted into the local government money was constrained. He quickly reporting and unit cost of service. and CIPFA-supported graduate gathered skills in assessing and But it did seem to be more widely finance scheme, Finance the Future, practically implementing savings regarded as a good thing in the and he trained at the London initiatives. NHS.’ Borough of Havering. ‘It was good experience. The risk Having spent time looking at ‘It struck a chord with me,’ he says. of overspending meant the focus the impact of schools becoming ‘They wanted people to help change was on delivering value and almost academies, he had experience of the agenda across the public sector always within existing resources. I costing for a couple of years before and in local government in particular. worked with some excellent service he moved to health. They were looking for people who managers who could relate to While at Great Ormond Street, wanted to change services in a financial considerations, even if they Paul worked closely with clinicians positive way to achieve value for didn’t always adhere to them.’ and general managers. ‘Some of that money. Having done the business His process redesign skills shone was about recognising that not every course, and with my experience through and he was heavily involved service is going to be the same. In designing and improving processes, in leading the operational finance addition to ensuring sustainable I went to the assessment centre and team’s implementation of new ways and viable services, the role was enjoyed the dynamic with the other of working. ‘It included stripping out supporting innovation in treatments 56 NHS FINANCE CAREER STORIES

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and the way hospital services were manager at Havering. ‘He spent a lot Employment history delivered. I worked with a very good of time producing great outcomes. I Qualifications CIPFA team and we had a wide range of saw him as a role model. In my early 2006 London Borough of experiences, not all health, which days he gave me a lot of strategic Havering, including complemented each other,’ he says. work – big things like analysis and three years’ training After almost two years, he moved high-level finance reviews for reports with Society of on. ‘I wanted to go to Deloitte to see he was writing.’ London Treasurers’ if there was a better way of doing At Great Ormond Street, he had a graduate finance things,’ he says. ‘I enjoyed it. There mentor who was a GP. ‘It was really scheme was a broader range of problems important to me as I was new to at different public sector clients and healthcare and wanted a different 2012 Great Ormond a more standardised approach to perspective. She helped me see Street Hospital NHS reaching a solution. past finance to why we were doing FT, finance manager ‘The private sector does things something: the benefits or outcomes and then senior differently. In the value for money for the patient, their families and finance manager work I did at Deloitte, I learned that the taxpayer. She was invaluable in 2014 Deloitte, manager if there is a barrier to progress, challenging my thinking on how the – finance operations it is recognised and addressed finance team operated.’ and support, audit more quickly using an established advisory framework to assess the what, why Pace yourself and how.’ Paul says the best piece of career 2015 HFMA, research advice he has received is to keep manager developing yourself and be patient. ‘When the right job comes along you “I’ve always have to be ready to take it,’ he says. Outside interests ‘You could go and find it for yourself, As well as playing golf when he can, chosen to but don’t stress yourself out by Paul and his wife spend their free work in tough swimming against the current.’ weekends and holidays travelling He sees one of his greatest around the country in their beloved areas to achievements as returning to lead Volkswagen camper van. They are the team where he first trained three also in the process of renovating challenge myself … years earlier. ‘Before I went back, their house. I thought about how I would be Favourite film Enemy of the State so I was progressing” perceived – maybe people there had wanted the role themselves or had Favourite book The Shepherd, been there a long time. Frederick Forsyth He also spent time producing ‘It was a really great opportunity Favourite TV show Scrubs information to be used by finance and although the relationship teams to support their work, including changed with my colleagues, they Top three songs Title and an analysis of the impact of an acute were instrumental in developing my Registration, Death Cab for Cutie; trust estate reconfiguration as part of approach to management.’ Multi-Love, Unknown Mortal an integrated business plan. Would he do anything differently? Orchestra; Lampshades on Fire, This attracted him to the HFMA ‘I’d take more time and enjoy things Modest Mouse research manager post. Speaking just more,’ he replies. ‘I have been quite Favourite food South Indian over a week into the job, he says: ‘My determined in terms of working hard career focus now is on softer skills – and trying to get as much experience Favourite website Google EQ-type development for myself and as I can.’ He admits this has affected the people around me to support the his work-life balance at times. ‘I am technical learning I traditionally follow. exceptionally grateful to my family, I’ve known of the HFMA for years and particularly my wife, who have been am proud to be working here. very patient and understanding.’ ‘I have always chosen to work in But for those considering a job in tougher areas to challenge myself. I the NHS, he has a clear message. have always made sure there was a ‘There are many opportunities in development opportunity, learning or the NHS, so many exciting experience so I was progressing.’ developments. It’s a great place to His parents, wife and friends have develop yourself and do a good job been a big influence on his career. He for those who will benefit. This could particularly recalls an interim finance be someone you know.’ NHS FINANCE 2957 CAREER STORIES

Name: Janet Wood

Job: non-executive director, South Essex Partnership University NHS Foundation Trust Finding the right work-life balance Janet Wood is working hard on committee,’ she says. ‘We don’t just English literature, but instead took behalf of patients, not currently talk about financial systems and business and accountancy.’ as an NHS accountant but as a risk management. We also look at After graduating, she took a job non-executive director and audit clinical systems, how to improve, with Deloitte in Edinburgh, which she committee chair. adopt best practice and do things describes as ‘a great three or four She came into the role at South better for patients.’ years’. She was involved in the audit Essex Partnership NHS Trust in Under Janet’s leadership, the of large companies, insolvency, value 2005, bringing a wealth of NHS committee looks at compliance with for money and accounts preparation, and private sector experience. The mental health legislation and also working with a variety of clients, trust was bidding for foundation commissions work from its internal including small businesses, pension status at the time and, while it had auditors, the board and clinicians to funds, district councils and banks. ‘It refreshed its non-executive team, it give it assurance. was a good grounding for running a had not found a non-exec with an ‘It’s about always trying to put finance department,’ she says. accountancy background. the patient at the forefront of the In 2006, the trust became one of conversation. Potentially there are Chartered path the first mental health and learning She passed her Institute exams disability foundation trusts. first time. ‘I decided to become a Asked whether it is difficult to be a chartered accountant as I thought former NHS accountant whose job is then the world’s your oyster – it’s a to hold her executive colleagues to good qualification and you can go account, she replies: ‘Having been where you want.’ on the other side, I take the She decided to move to London supportive route, but when I get and the first job she got was in the worried about something, I will give NHS – at Redbridge Health Directly them a hard time. But they know it’s Managed Unit. She admits this because I’m worried that I’m giving wasn’t by design. them a hard time.’ For someone coming into the However, she adds: ‘We have NHS as a qualified accountant been incredibly lucky – we’ve never with experience of the private and been in deficit and we’ve met all our voluntary sectors, as well as other financial targets.’ parts of the public sector, this was a That’s not to say she does not frustrating experience at first. believe improvements could be too many conversations where the ‘Some of the people I worked for made. ‘In the early years, the patient does not come into it, but we were working towards qualification buildings were not really fit for try very hard to come back to the and they didn’t, to my mind, purpose. One of the things I have patient. I or another non-executive understand how to keep accounts been really proud of is helping director or the finance director will or prepare business cases. The drive through investment on new be saying, “But what about the unit was trying to become a trust buildings.’ patients?”.’ and it was struggling without project This includes a Procure21 scheme Janet started in accountancy when management skills,’ she says. and private finance initiatives, which she was at school. ‘It was probably a But it improved. A finance director have delivered a new hospital and bit more like bookkeeping but I found was recruited from KPMG in the first secure unit. it very easy. At the time I was thinking year she was there. Nevertheless, Janet was also keen to link quality about hotel management, but I went she decided to move on, becoming and financial strategies, introducing for accountancy,’ she says. chief accountant at South Essex quality impact assessments before ‘At that time, to go to the Institute Health Authority. they were introduced nationally. [of Chartered Accountants of ‘The team was great,’ she recalls. ‘We came up with the concept Scotland], you had to have a relevant ‘I had a straight line to the finance of widening the remit of the audit degree. I wanted to do history and director and the staff were excellent. 58 NHS FINANCE CAREER STORIES

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It was also only 10 minutes walk from and audit; financial management Employment history my home.’ and reporting; and accounting and Qualifications ICAS It was a friendly workplace, with standards – she also worked on 1998 Deloitte (Edinburgh) less than 100 staff, and she made the HFMA events and publications, friends in and out of the finance team. including the Introductory guide to 1992 Redbridge Health ‘When the authority took on the NHS finance, the Audit committee Directly Managed family health services authority, I handbook and preparing a monthly Unit, special projects was lucky enough to be promoted to email bulletin for HFMA members. accountant and capital become a locality finance manager, accountant taking on budget-setting for GP Key influences 1993 South Essex Health fundholders and contract negotiation Janet says there are two main Authority, chief with the acute. I was starting to move influences on her career. The first accountant to the front office.’ was a teacher during her first year in Was this a natural career accountancy who was able to bring 1993 Locality finance progression? ‘There is pressure the subject to life. She is still in touch manager to take that step, but some people with her. 1996 Primary care group, are better at the technical stuff. I The second was a chief executive finance manager think if you are happier being chief of the health authority. ‘It struck accountant, be one.’ me that he never took credit for 1999 Career break As national health policy evolved something that someone else 2000 HFMA, committee did. If it was a paper to the board, secretary for example, he always let them present it themselves. In too many 2005 South Essex “I don’t want organisations, a director will present a Partnership University paper when someone else has done NHS FT, non-executive to be a chair. all the work.’ director She is grateful for the development It would have opportunities she has been offered. Outside interests a lot more ‘At the health authority, the director of Outside work, Janet is very involved finance was keen to encourage us to in her children’s schools – she set impact on my work- get involved in the HFMA. I went to up and chaired the primary school the HFMA spring school a couple of PTA and is currently a director of life balance. But if I times, which were great development their secondary school, sitting on the opportunities. finance committee. had to cover, I’d be ‘In my current role, I go to a lot of NHS Providers events and I did a Favourite film The American happy to do it” course for aspirant chairs two or three President, Moonstruck years ago. However, the one thing Favourite book Crime thrillers by that showed me was that I don’t want Karin Slaughter, Linda Fairstein and her role became one of primary care to be a chair. It’s higher profile and it Marc Giminez group finance manager. But in 1999 would have a lot more impact on my she took a career break. ‘I broke the work-life balance. But if I had to cover Favourite TV shows CSI, NCIS, mould after my first child. Potentially a chair’s role for an interim period I Masterchef and Modern Family I was moving towards becoming a would be happy to do it.’ Top three songs The Winner Takes it primary care trust finance director, but Janet is in her third term as a All, Abba; Stars from Les Misérables; it’s difficult to ensure you are caring non-executive at the trust. Under Anthem from Chess for your child in those sorts of jobs, as foundation trust rules, a non- Mexican you can’t just walk away. I didn’t want executive can be appointed for two Favourite food to pay someone to bring my children terms. They can go for a third, subject Favourite websites Amazon, up for me.’ to board and governors’ approval. BBC News An opportunity came out of the ‘Once in the third term, provided you Singing on the blue in 2000, however, when she was have satisfactory performance and Alternative career West End stage offered a job as HFMA committee demonstrate independence, you can secretary. This fitted well with her be reappointed annually,’ Janet says. family commitments, as the job only ‘I had no intention of doing a third took up two and a half days a month. term, but the post was advertised and As well as supporting the they couldn’t find anyone. The association’s three standing technical governors asked me if I was willing to committees – corporate governance reapply, which I did.’ 2959

Next steps

If you are interested in a future working in NHS finance, please contact Future-Focused Finance for further information at [email protected]

Acknowledgements

The authors of this briefing were: Steve Brown, Healthcare Finance editor Richard Edwards, independent consultant Emma Knowles, HFMA head of policy and research Seamus Ward, Healthcare Finance associate editor Paul Williams, HFMA research manager We are grateful to all the individuals who took part in this project, for sparing the time and for being willing to share their personal experiences.

@ Future-Focused Finance and the Healthcare Financial Management Association, 2015 About Future-Focused Finance In February 2014, the six heads of the finance profession in the NHS came together to form the Finance Leadership Council and to initiate Future-Focused Finance. Future-Focused Finance is about ‘Making People Count’ by ensuring that everyone connected with NHS finance has access to the relevant skills, methods and opportunities to influence decision making in support of the provision of high-quality patient services. It offers a vision for NHS finance to aspire to over the next five years. That includes everyone who works in finance, in every role at every level, those we work with to deliver services and the patients and communities that use and support those services. Any enquiries should be sent to [email protected] or [email protected] or posted to the address below.

About the HFMA The Healthcare Financial Management Association (HFMA) is the professional body for finance staff in healthcare. For more than 60 years, it has provided independent and objective advice to its members and the wider healthcare community. It is a charitable organisation that promotes best practice and innovation in financial management and governance across the UK health economy through its local and national networks. The association also analyses and responds to national policy and aims to exert influence in shaping the wider healthcare agenda. It has a particular interest in promoting the highest professional standards in financial management and governance and is keen to work with other organisations to promote approaches that really are ‘fit for purpose’ and effective.

HFMA 1 Temple Way Bristol BS2 0BU T 0117 929 4789 F 0117 929 4844 E [email protected] www.hfma.org.uk www.futurefocusedfinance.nhs.uk

Healthcare Financial Management Association (HFMA) is a registered charity in England and Wales, no 1114463 and Scotland, no SCO41994. HFMA is also a limited company registered in England and Wales, no 5787972. Registered office: 110 Rochester Row, Victoria, London SW1P 1JP