NHS Finance Career Stories

December 2015 2 NHS FINANCE CAREER STORIES 3

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 of Health 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 Join the conversation www.futurefocusedfinance.nhs.uk Partnership University NHS FT

@nhsFFF | #futurefocusedfinance [email protected] 42 NHS FINANCE CAREER STORIES 5

working as a statistician in a regional health authority In the next section we explore in more detail the routes Introduction 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 Future-Focused Finance commissioned the HFMA to produce this data analysis capacity was not within his department. series of NHS finance career stories to support its Great Place to orkW Consequently, he tapped me up to apply for a job in his Why choose a finance career workstream. Our joint aim is to highlight different career pathways department.’ Andrew initially turned it down, thinking in the NHS? and the attractions of working in NHS finance. The stories promote finance didn’t really appeal, but he says a call from the the benefits to people considering their career options at all points finance director changed his mind. Andrew went on to Working in the NHS has been a rewarding and diverse in the spectrum – for example, from students and schoolchildren sign up for CIPFA’s senior entrants course and says career choice for our interviewees, packed with thinking about what they might do in later life, to finance directors that he ‘owes a huge debt of gratitude’ for being opportunities for career development and providing a working in other industries. They will also be of interest to NHS finance encouraged to do so. strong sense of job satisfaction. Several of the people professionals considering what their next step might be. featured in our career stories have family members Adam Sewell-Jones, director of provider sustainability working in the NHS – not necessarily in finance – and The series of 25 stories captures a diverse mixture of careers that at Monitor, also admits he had no plans to be an so working in the NHS was a familiar choice. Others showcase the range, opportunities and appeal of working in NHS accountant while he was at university studying maths expressed their desire to work in the public sector at finance. They highlight the ability to have a successful career at any and statistics. A family friend, working as a finance an early stage and have combined their NHS careers level and the opportunities for wide-ranging personal and career director in the NHS, pointed him in the direction of the with spells in local government and other public sector development. They show that time spent in NHS finance can enhance a NHS national finance training scheme. ‘All of a sudden institutions. Others had a different perspective on the career that spans other sectors or even non-finance careers. 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. This summary is intended to be of interest to a wide range of be exactly what I wanted,’ he says. audiences, from NHS staff, to school leavers and graduates, Kate Hannam, director of operations at North Bristol commercial sector employees and those in the wider public sector. It For others, the appeal of accounting is the professional NHS Trust, joined the NHS finance training scheme draws on the individual career stories and summarises the key themes qualification. NHS England chief finance officer (CFO) in 1994 after completing an accounting and finance common to them all. 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 When talking to people considering a career in the NHS, one of our to me, you have to have a profession. And I thought family. ‘I always had public sector values,’ she says. interviewees gives the following advice: ‘There are lots of opportunities finance would give me the best opportunity to exert ‘I considered working for one of the big accountancy for you in the NHS – for example, you may want to work as a technical broad influence across the whole range of things that firms, but I felt the NHS would give me a greater accountant, a management accountant, an internal auditor or a contract Unilever did.’ Unilever’s view of the finance role – it had opportunity to make a difference, I didn’t know exactly accountant. The NHS offers you this and you can expand your skills a commercial function rather than a finance department what I wanted to do within the NHS. I was quite beyond the finance team if you choose to.’ – 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 Why become an accountant? as the NHS.’ trainee, while working as a student during university holidays in NHS administrative jobs, she realised she Our career stories show the many different reasons Gemma McGeachie also works for NHS England, quite liked working in a hospital. Her belief in the need people have for wanting, or just ‘falling into’, an as senior manager – financial strategy. She studied for finance to put patients at its heart springs from this accountancy career. In this section we look at how the economics at university and had a place on the early work experience. On passing her degree, she went people we interviewed became professional accountants government economic service graduate scheme, which back to the NHS, first in the outpatient department and and senior managers in the organisations they work for. 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 For some it is the extension of their studies at school the same time I applied for the government economic Trust. During this time she applied to the national and university that lead them to pursue a professional service. During the seven weeks I spent at EY, I got graduate management training scheme. qualification combining business, numbers and people. involved in a wide variety of projects and enjoyed it Caroline Clarke, finance director and deputy chief more than I was expecting.’ 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 62 NHS FINANCE CAREER STORIES NHS FINANCE 37 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 is ‘fascinating’ and even though his focus is primarily on The focus on developing skills, not just becoming better was planned. Jamie Foxton, deputy director of finance the next section we look at what makes them stay and finance, process and governance, it is a far cry from his accountants, is key to our interviewees’ experiences of at Hull and East Yorkshire NHS Trust, says he’d never what they love about their jobs. narrower accountancy training. the NHS. In the next section, they share what they have thought about working in the public sector. He was learned. conscious of a view across parts of the commercial For Mark Brooks, CFO at Southern Health NHS world, where he started his career, that public sector What drives NHS finance professionals? Foundation Trust, the best things about working for the finance managers were little more than budget NHS are ‘the dedication from the clear majority of people. How can your career develop accountants. ‘My perception had been that the NHS was Our interviews highlight the huge range of opportunities Working in an organisation that makes a difference to in the NHS? 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 people’s lives is genuinely attractive’. As well as finance, says. But he was keen to continue his career by staying find most rewarding about their work. Many spoke about Mark is responsible for procurement, IT, estates and In this section we summarise the advice that people in the local area and when a job came up in 2010 at the personal satisfaction achieved from meeting tough corporate assurance. He says: ‘When in the office, I work have received as their careers progressed and what the local hospital, he thought he should take a look. His challenges. For others it is the opportunity to work with with a fantastic finance team that undertakes much of they have learned. As Yarlini Roberts, Kingston Clinical view had also started to change over the past year as clinicians and see the impact of their work on improving the day-to-day work. There is no typical day for me and I Commissioning Group CFO, says, she’s found that being his wife’s pregnancy had brought the couple into more patient care. enjoy a wide range of aspects in my role.’ a good accountant is taken as read. The skills she now contact with NHS services. ‘The more time I spent at the relies on most are negotiation and relationship building. hospital, the more fascinated I became,’ he recalls. Loretta Outhwaite is CFO at Isle of Wight Clinical Gill McKetterick, project manager at Mersey Care Yarlini explains: ‘When you become a CFO, it suddenly Commissioning Group. She says, ‘the variety is NHS Trust, speaks highly of the opportunity to develop. hits you that you are accountable for everything. Similarly, Ray Thomas was drawn to the NHS by positive something I very much enjoy, along with the complex, She says: ‘There are good support networks in the NHS It’s a huge responsibility, but also a huge honour. I experiences – of finance staff and NHS care. Now ever changing and somewhat unpredictable environment and opportunities for those that want to take them. would recommend working in NHS finance to anyone assistant director of finance at the Countess of Chester of the NHS. The aspects I enjoy are also the ones When I worked in manufacturing, it felt like the only considering a career in accountancy. Also it’s not just Hospital NHS Foundation Trust, he initially joined the trust that provide the most challenge in the role. I love incentive to progress was for more money. In the NHS, about numbers, it’s about doing the best for patients.’ as chief financial accountant. ‘It is my local hospital and a challenge.’ When starting out her career Loretta it feels different. It is about expanding your skills and where my children were born. I knew the care there was deliberately chose to get some experience of life on the adding more value.’ Paul Williams, the HFMA’s research manager, says the excellent and I wanted to build on my good experience front line, in clinical services working as a directorate best piece of career advice he has received is to keep on secondment to the NHS.’ He had previously been accountant. ‘I worked a shift in each clinical department, While NHS finance and Dinah McLannahan’s current developing yourself and be patient. ‘When the right job working at KPMG, specialising in corporate transactions. so I could understand what they did – mopping floors in role as senior business consultant at the NHS Trust comes along, you have to be ready to take it,’ he says. ‘The role was particularly attractive because of its the urology operating theatre, providing support to A&E Development Authority are always going to be a step ‘You could go and find it for yourself, but don’t stress technical nature’, says Ray. He describes the transition staff and reassurance to patients and relatives.’ removed from the front line, Dinah believes she is having yourself out by swimming against the current.’ For those to the NHS as straightforward, ‘the people working at the a direct effect on patient care. She is in a better position considering a job in the NHS, he has a clear message: trust were brilliant and very supportive.’ Alison Tonge, regional director, specialised services than most to be able to say this, having previously been ‘There are many opportunities, so many exciting commissioning for NHS England (North), has always a nurse. ‘When I was a nurse there were many life and developments. It’s a great place to develop yourself For Richard Wheeler, East Midlands Ambulance Service been interested in the bigger picture and making death situations, but also lots of occasions when I was and do a good job for those who will benefit. This could NHS Trust director of finance, it was the range of changes through specific pieces of work, such as able to make someone’s life a little easier,’ she says. be someone you know’. 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 Kavita Gnanaolivu is a doctor who now works as a Robert White, health director (value for money audit) at NHS onto a sure footing financially. the numbers telling the story – and still am. For me, it’s manager at EY. She started her NHS finance career as the National Audit Office, joined the NHS as a senior about using financial information and knowledge to make a graduate trainee and was able to develop a range of finance manager, after previous experience in private Finally, Andy Hardy, chief executive officer, University improvements.’ management skills, in addition to finance, while retaining healthcare. He remembers a number of accountants Hospitals Coventry and Warwickshire NHS Trust explains the connection to patients she wanted. Kavita says: ‘I were making the switch from the private sector and that what makes an NHS finance career really stand out Kate Whiting recently joined Central Manchester NHS applied to the NHS graduate financial programme at a not all of them could adjust. Robert was advised to get as from other sectors. ‘Being an accountant in the NHS is Foundation Trust as finance director, specialist medicine. time when the general management programme was much experience as possible of all parts of the service. different to being an accountant anywhere else. We’re ‘The role is finance, but based within the medical not being provided. I didn’t have any prior experience He has taken this to heart, working over the years in not dealing with widgets; it is all about people and division, so is a perfect balance for me,’ she says. Kate in finance or accountancy, but luckily for me the many different part of the NHS. making a difference to their lives. Anyone who works has relished the challenge of working at a large hospital graduate assessment looked for the right transferable in the NHS, whether they’re a clinician or not, is in a and is making good use of her general management skills and ability for applicants to develop the required job that makes a difference,’ he says. Andy says that experience. As she explains: ‘I now know I am asking the competencies. I had a great time developing my while working in NHS finance is rewarding, it is not for right questions. I can see where the problems are likely management and finance skills and all the time I was the fainthearted. ‘These are tough jobs,’ he says. ‘The to arise and can suggest ways to overcome them. I’d very conscious not to lose the link to patient care.’ 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 8 NHS FINANCE CAREER STORIES NHS FINANCE 9 CAREER STORIES

Name: Siân Alcock 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 Job: NHS national graduate finance director of his local NHS trust more than 20 years to the board, for example, he always let them present it management ago. He has continued to work at that level in several themselves,’ says Janet. trainee 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 Learning to focus 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 on the patient 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 Siân Alcock was late for work on degrees and my mum worked in and then to the audit committee.’ perspective’. break into the NHS, but I think it is more about skills than her second day as a trainee on the a hospital. She handed me an Working with the finance director the history,’ she says. ‘When I’m interviewing, I look for NHS national graduate management application form for the staff bank and led her to choose finance when she Janet Wood, currently non-executive director, South transferable skills. There are often internal candidates 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 Essex Partnership University NHS Foundation Trust, who are very strong, so to break in you need to She came across an elderly lady home. I did loads of [NHS] bank work scheme. She believes her varied says there are two main influences on her career. The accentuate how your skills and experiences are relevant. who couldn’t find the renal unit. And while at home and during university background, including time spent in first was a teacher during her first year in accountancy, I’d definitely recommend a career in NHS finance. It’s because Siân didn’t know her way holidays and I realised I quite liked customer service and close to the who was able to bring the subject to life. She is still in incredibly rewarding and you get to work with so many around the hospital either, she found working in a hospital.’ front line of NHS care, has helped her touch with her. The second was a chief executive of the great people.’ 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 Conclusion and patient experience. sharp end of the NHS had a huge ‘You have to remember the influence on her thinking. Our finance career stories showcase 25 individuals with experience of patients. It would be easy to spend ‘When I left the outpatient working in finance teams in more than 500 NHS organisations. But as well as your life not seeing anything of the department at Taunton, the staff there providing an intriguing insight into personal journeys of career development front line. The finance department is told me never to forget where I had and hard work, our stories uncover values and attitudes found across the often in a separate building and if you come from. I have worked on the NHS. 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. The first is the public sector ethos shared by so many. A career in NHS patients at all,’ she says. ‘It’s important to people to finance is about more than just accounting. Our interviewees were either Her belief in the need for finance understand what they do. There are attracted specifically to the NHS or determined to do something in public to put patients at its heart springs managers who don’t know everything service. The timing was earlier for some than others, but was always borne from her early work experience, about what their staff do on a day- out of their experiences and interactions with the NHS, which continue to when she spent holidays and to-day basis. They don’t understand drive and motivate them. 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 Second, accountants really can see how their roles add value to patients’ outpatients. to find out.’ experiences. The NHS accountant is shedding the label of ‘bureaucrat’ as ‘I have worked in jobs where I have Her mum has been another finance staff increasingly work in partnership with clinicians to develop high- spoken to patients every day and I influence, both by instilling a hard quality services for patients that provide the best possible value for money. 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. And finally, there is real job satisfaction to be had from a career in NHS a lot of customer service roles and so of finance and nursing at Taunton Siân adds that Rebecca Harriott, finance. Our interviewees, in common with thousands of their colleagues, I know the importance of being nice and Somerset NHS Foundation the chief officer of Northern, Eastern thoroughly enjoy their work, want to help patients and can see how their to people.’ Trust. During this time she applied to and Western Devon CCG, gave her work contributes to that. 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. What is clear is that NHS finance offers huge variety. Not everyone has a Work experience with a doctor told The executive assistant post came ‘She asked me to think about what defined career plan in their head at the outset but the range of roles available her clinical work was not for her, but up after a director advised her to I like doing,’ she says. ‘I like working and the portable skill set of the NHS accountant mean that lots of different she stuck with science, gaining a bolster her management credentials with people, for example, so she got opportunities for a well-rounded and rewarding career are likely to arise. 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 NHS FINANCE 11 CAREER STORIES

CURRICULUM VITAE Name: Paul Baumann Job: chief financial officer, scheme since September 2013 and ‘I have worked in every band from Employment history NHS England 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 Commercial road 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 to NHS home 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 There are few examples of finance finance career. The firm provided flows to support the new process- bank) On the move does has an impact on patient care in managers who have made the switch the perfect context. ‘Unilever is driven structure. Moving around so much can make life some way. It is important to see the 2012 Executive assistant from the private sector to the NHS completely international, and even Knowing the business was key, and challenging, Siân acknowledges, but bigger picture. at the most senior level. The sector- more interesting to me was the fact Paul says a lot of time was spent on 2013 NHS graduate it is helpful to experience the different She cites as a recent example her specific knowledge and experience that it respects local cultures, the factory floor and with marketing management aspects of an NHS accountant’s experience of a trust board meeting. needed on both sides of the divide drawing its strength from applying teams ‘helping them to construct trainee (finance), ‘It was helpful because it put my work are often seen as too big a barrier. its values in a local context,’ says their innovations to deliver the best including into context and brought everything NHS England chief financial officer Paul, ‘You can also see the roots of possible value for consumers and placements at together,’ she says. Paul Baumann is proof that you can a business that really cares about shareholders’. “You can feel North Bristol She will spend an extended period make the transition, and he believes its employees. That is instilled in the In the mid-1990s, Paul moved to NHST; Northern, in a management accounting role at the differences – at least between way it does business – and that’s Dublin for four rewarding years as like a cog in Eastern and the trust, after spending June and some parts of the commercial sector important to me.’ finance director for Unilever Ireland Western Devon a big system, July with the Department of Health in and the NHS – can be exaggerated. His CIMA training took slightly before moving back to Hamburg CCG; Royal London as part of a national scheme After 23 years with global food and longer than expected (three and in 2000 as finance and IT director Devon and Exeter but what of short placements outside local household goods business Unilever, a half years), as a series of rapid for Unilever’s largest European NHS FT; and the NHS organisations, including at the Mr Baumann joined the NHS in 2007 promotions cut into his study time. subsidiary, UDL. He sees this as Department of everyone does has Department and accountancy firms. and is convinced the switch – to his biggest operational challenge – Health (financial It is an exciting time to work at the the ‘most interesting, exciting and ‘helping to revive what had become policy and strategy) an impact on patient Department, as the new government compelling’ part of the public sector – something of a slumbering giant’. care in some way. It finds its feet. ‘I will be in the financial is likely to be permanent. policy and strategy team working on Outside interests Paul insists he has never followed Dream job is important to see the spending review and learning In the limited time Siân has outside a detailed career plan. But planned This paved the way for his next about the wider health system. It’s a work and study, she enjoys going to or otherwise, a degree in modern and role – a ‘dream job’ – as vice- the bigger picture” great opportunity,’ says Siân. gigs and is also renovating a house. medieval languages doesn’t seem president for financial excellence. It Becoming a Future-Focused the most obvious launch pad for brought him and his growing family Finance value-maker has also proved Favourite film The Lion King becoming one of the health service’s back to the UK while allowing him work. ‘It helps you see areas you to be a big opportunity, giving her a most senior finance directors. to experience first hand the wide Favourite book The Great Gatsby, want to work in and areas you don’t, chance to help present a workshop F Scott Fitzgerald A gifted linguist – he studied both variety of international businesses in though I haven’t yet found anywhere I at the national HFMA annual German and French at Cambridge Unilever. The role involved leading wouldn’t want to work. The end of the conference, for example. ‘I am also Favourite TV shows Game of – Paul says he saw possible career Unilever’s global ‘Finance of the graduate scheme is still a while away, on the HFMA qualifications board, Thrones, Homeland, Sherlock paths in the diplomatic service or an future’ programme, which reinvented but I feel ready for a proper job with which has led to further opportunities.’ Top three songs The Wolves (Act international business. Both options the finance function to deliver more work and responsibility now.’ Her work with the HFMA and FFF I and II), Bon Iver; We Looked drew on an enthusiasm to see the benchmark efficiency and bring The scheme has also enabled her has widened her vision, she says, Like Giants, Death Cab for Cutie; world, inspired perhaps by Swiss the best evidence-based decision- to surprise herself. Working in income adding: ‘It’s easy to get stuck in your Mountains, Biffy Clyro grandparents and far-flung family At the age of 28, Paul became making techniques to major choices and costing, she was faced with own little bubble. Being a value- connections. The global business divisional controller of a large facing the business. databases that presented several maker has given me the chance to Favourite food Pad Thai option simply came along first, in agribusiness company, preparing With six years in post, it was challenges, including technical break out of that bubble and meet Favourite website Pinterest – ‘mostly 1984, as a commercial management what had become a non-core a rare chance to see the project programming. ‘But with the help of people from all over the country. for ideas for renovating our house’ traineeship with Unilever. business for sale in 1991. After a through to conclusion, from devising a colleague, I learned to do SQL ‘I’ve received countless words But why accountancy? ‘It seems to year in head office, he moved to the strategy to creating a finance programming, which I didn’t think I’d of wisdom and career advice from me, you have to have a profession. Hamburg as financial controller academy to implementing the new ever be able to do,’ she says. more experienced colleagues, And I thought finance would give me of Unilever ice-cream company model across the whole business. Would she change anything about which has really emphasised to me the best opportunity to exert broad Langnese-Iglo. But in 2007, Paul decided it was her career? ‘I wish I had found what the importance of supporting and influence across the whole range of The company was in the midst of time for a change. Recognising that I wanted to do earlier. I started the developing those around us.’ things Unilever did,’ he says. a major modernisation programme another move would most likely take graduate scheme when I was 29. But, She summarises her experiences Unilever’s view of the finance role and Paul, who was responsible for him abroad again – at a time that at the same time, if I had not had all so far: ‘There are some really great – it had a commercial function rather performance management, set would have been disruptive to his these different experiences I don’t people in NHS finance that we are than a finance department – helped about adapting the approach to children’s education – he started think I would have got where I am. lucky to have.’ him see this broader potential of a finance and management information thinking beyond Unilever. A call from 12 NHS FINANCE CAREER STORIES NHS FINANCE 13 CAREER STORIES

CURRICULUM VITAE Name: Ben Bennett Job: director of business recruitment consultants put the NHS director of finance, he focused on Employment history planning and in his sights, with newly appointed rolling out a pan-London financial Qualifications CIMA resources, NICE 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 Pacing can be the 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 key to success 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 Careers last a long time, so enjoy introduction to health service finance. with a health background,’ he says. finance director success in whatever you undertake,’ budget jump from £15bn to £95bn. what you do at each stage and don’t Despite this, he ended up leaving ‘What attracted me was the wider he says. ‘The role sounded exciting While NHS England nominally 2000 UDL, finance and IT be in a rush to take the next step. before he qualified. Having recently experience of lots of different things. and Ruth was assembling a great has a commissioning perspective, in director This is the advice from Ben Bennett, started a family, Ben was keen to So while I was recruited for my group of people. It was a recent start- reality the view is much wider. director of business planning and move into a substantive role. So he knowledge in health, I moved to do 2001 Unilever, vice- up, which appealed, with big strategic ‘The objective is not to make the president financial resources at the National Institute finished his CIPFA qualification at lots of things in local government, issues to be tackled – Ara Darzi’s commissioning system successful, excellence for Health and Care Excellence. He Wandsworth Health Authority, where housing and even outside finance.’ but to use the commissioning system says he has followed no firm plan in he was promoted to unit finance He specialised for a time in to make the NHS as a whole more 2007 NHS London, his career and, like many people, has manager, with responsibility for devising and carrying out bespoke “You wouldn’t successful,’ Paul says. Working with director of finance taken opportunities as the right ones advising the continuing care unit. reviews of housing management other national finance leaders (from and investment arose, rather than forcing the issue. The role had him rubbing issues in London boroughs, having a do this in a Monitor and the Trust Development 2012 NHS England, Ben admits he did not leave school shoulders with more senior finance particular impact on the improvement Authority, for example) gives useful chief financial officer with a burning ambition to be an NHS professionals undertaking the of rent arrears management in one corporate perspectives and makes the task accountant. Nor was accountancy equivalent role for the bigger acute south London borough. In another ‘richer, if at times complex’, he says. foremost in his mind while studying example, reviews of a London NHS environment Three years in, and Paul says the Outside interests for his economics and computer trust’s energy and maintenance finance profession has achieved a A classically trained musician from science degree at the University of arrangements led to major changes – changes at every huge amount – not least the launch an early age, Paul is an organist and Keele. ‘The choice of finance went to the management arrangements for level, no dry run. But of the new commissioning system member of various chamber choirs. with the economics and computer its estates functions. in April 2013. ‘You simply wouldn’t He says playing the organ – he has science territory,’ he says. But even if it was the broader the NHS pulled it off” do this in a corporate environment one in a crowded ex-dining room, But if he simply followed a line of value-for-money work that most – switching literally overnight, with plus a grand piano and other musical least resistance into accountancy, attracted him, the financial audit work changes at every level and no paraphernalia – is the perfect daily he was perhaps more destined to was also rewarding – Ben believes Healthcare for London review was opportunity for a dry run – but the antidote to any work-related stress. pursue his profession in the NHS. there would be benefits for all finance just getting under way, for example.’ NHS pulled it off,’ he says. He met his wife through music and Looking back, he admits that student staff to do some audit. For example, Paul admits he had a ‘massive As the service faces the challenge says his three children are now ‘more jobs – as a cleaner in a small it provided an opportunity to observe learning curve’, but says he was of delivering sustainable services accomplished musicians than I will orthopaedic hospital and a kitchen and work with top managers in allowed a couple of months to using new models of care, he singles ever be’. He even lays claim to some porter in a large psychiatric hospital audited bodies. ‘I saw a range of soak up as much knowledge as out faster progress towards fairer thespian credentials, having featured – had been ‘formative experiences’. different chief executives and finance he could before assuming his full allocations as a change that will have as a singer in the first episode of TV And various members of his family directors with different styles and responsibilities. Other national a big and lasting impact. detective series Morse. worked in the NHS, so it seemed units such as St George’s Hospital. approaches, and you pick up different leaders – notably Richard Douglas Paul’s commercial experience, Favourite book Chocolat, a natural choice. He had never There were significant development things from all of them,’ he says. and David Flory – helped him to with its focus on applying new Joanne Harris contemplated applying for chartered opportunities: responsibility outside The audit role also helped him integrate into the broader finance business models across complex accountant positions with major finance (for supplies); working with a develop skills in delivering difficult function and understand some of the environments, is proving a Favourite TV show Morse (see firms and, if nothing else, he says clinician as his unit general manager; messages in a constructive way and system’s ‘quirkier financial dynamics’. good foundation for his work on above) his NHS ‘background’ helped with and even personally laying the cable taught him the importance of keeping Perhaps surprisingly, he did not find transformation in the NHS. And Favourite music Anything written applications. to plug the office’s one computer into issues in perspective and ensuring a major culture gap between Unilever his background in modernising the before 1750 Gaining a place on the South East the mainframe! you look at the big picture. and the NHS. He suggests there are finance function at Unilever has made Thames Regional Health Authority A year with the Blood Transfusion However, with changes to the greater cultural differences between him a driving force for the NHS-wide Favourite food Brownies (made by graduate training scheme in 1983, Service at South West Thames scope of the Audit Commission’s Unilever and other consumer goods Future-Focused Finance initiative. his children) he studied for his CIPFA exams while Regional Health Authority was work, the opportunities for carrying companies than between Unilever Paul is clearly in a job he enjoys serving placements in the South followed by a change in Ben’s career out non-mainstream audit work and the NHS - the similarities being and says he has no plans to move on East – from Guy’s and St Thomas’ in path – a job at the Audit Commission. narrowed and Ben decided it was based on ‘deep seated roots in any time soon. London to the Royal Victoria Hospital While the role would involve some time to move back to the NHS. communities’. ‘I think I’ve made the move to the in Folkestone. He recalls these as financial audit, the chief attraction for So, after 13 years at the Audit Politics (with a capital P) and the public sector for good. It is difficult to great experiences, with several days Ben was supporting the watchdog’s Commission, where he rose to senior accompanying media spotlight were conceive of any parts of the sector attached to a senior registrar in growing value-for-money study work. manager, Ben made a move to NICE. perhaps the biggest differences. that are as interesting, challenging or Ashford Hospital fresh in his memory. ‘The commission was expanding He had had some insight to the In his five years as NHS London’s fulfilling as the NHS,’ he says. He says the scheme was a brilliant into health and wanting people organisation, having audited its first 142 NHS FINANCE CAREER STORIES NHS FINANCE 15 CAREER STORIES

Name: Mark Brooks CURRICULUM VITAE Job: chief finance officer, Southern Health set of accounts (1999/2000) while widening of its role. Last year, for Employment history NHS Foundation still at the Audit Commission. Since example, it produced the first safe Qualifications CIPFA Trust 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 Accountant with a 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, technical edge 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 Before joining the NHS in 2009, role, so in 1990 he moved to Smith the strategy was correct and the in an organisation that now spends The NICE expansion has come with RHA, unit accountant Mark Brooks spent almost 20 years & Nephew, a firm manufacturing benefits delivered.’ £70m and has five times the staff. significant pressures to reduce costs (blood transfusion working in the medical device medical devices with a global market. Mark returned to mainstream Again, he says it is the breadth – a 10% cash reduction in the current service) industry in a range of UK and The division he worked for was 20 finance at Smith & Nephew and of the role that appeals. His planning period. Ben has led on this, international finance roles. His first times larger than his previous one at worked in two more financial control responsibilities extend beyond the taking a key role in relocating much of 1990 Audit Commission, NHS role was as director of finance Computype, and included spending roles at a time of great change for chief finance officer duties (with NICE’s work to Manchester and also various roles to and corporate assurance at Humber six months working in Milan and the company. He describes his overseeing mergers and transfers senior manager NHS Foundation Trust, a mental then Hamburg. ‘The culture of the experience as a key influence for of functions to NICE, such as the 2004 NICE, head of health and learning disability services organisation was key to me,’ says later moving to the NHS. National Prescribing Centre and finance and IT provider in Hull and East Yorkshire. Mark. ‘There was also a great focus It was here that Mark saw the role A committed some of the National Patient Safety He has been in his current role at on developing people. Accountants of medical devices in helping people Agency functions. 2007 Director of Southern Health NHS Foundation typically rotated between roles every to regain their lives. ‘The company cold water As executive lead for human business planning Trust since 2013. couple of years, which provided was incredibly customer focused,’ he resources, Ben has had responsibility and resources Mark always wanted to work in opportunities to develop and meet says. ‘I could see how my work was swimmer, for a range of challenging business and feels it was a natural your aspirations.’ having an impact despite not working Ben swims employment issues relating to Outside interests progression to study accounting at the front line.’ His move to the management of change, disciplinary A committed cold water swimmer and finance. ‘I saw it as a good NHS wouldn’t happen until later in his two to three times and grievance matters. And with (without wet suits), Ben swims two qualification that would allow me to career but the values and culture of responsibility for risk assurance to three times a week and competes be involved in business in some way the NHS was a key motivator. a week, competing and governance, he has sought to occasionally. He is also a qualified or other. I had a level of interest in instil high standards of business swimming teacher and cycles to finance, which developed while I was Stock Exchange ambition occasionally conduct probity and transparency keep fit. He is a self-taught guitarist studying,’ he says. Mark worked at Smith & Nephew for across the organisation – achieving and gigs occasionally in a local His first role after university was 17 years. He left to fulfil his aspiration consistently high ratings from auditors band with friends. He is currently at Computype, an organisation to become a finance director for a a relatively small 10-strong team) for the design and application of risk a trustee and honorary treasurer of that manufactured high-precison company traded on the New York to include business planning, management and internal control. charity Age UK Lambeth. barcodes. Mark describes the Stock Exchange, joining Symmetry human resources, IT infrastructure, He says he is happy at NICE with organisation as small but forward- Medical Inc in 2007. The company procurement, estates and facilities, a good work-life balance, but doesn’t Favourite book As I Walked thinking. He says the employees made medical devices, primarily governance and board support. While rule out a move back into frontline Out One Midsummer Morning, were well regarded and supported artificial hips and knees. he may not have formal qualifications healthcare. But it would need to be Laurie Lee by the organisation to achieve as It was at Symmetry Medical that in these areas, the accountancy the right opportunity. People can be Favourite film Brazil, Terry Gilliam much as they could. Mark liked its Mark faced his greatest challenge qualification provides transferable in too much of a hurry to make the organisational model. to date - leading the restructure skills and is recognised as doing so. next step, he says – a career is a Favourite food Japanese ‘It reflected a text book company,’ It was at Smith & Nephew that of a subsidiary that was a heavy He also plays a part in the marathon not a sprint. Alternative career choice Architect he says. ‘It was an American firm, so Mark gained his first experience of loss maker and faced accounting management and review of NICE’s Ben is enthusiastic about finance there was an overseas parent with a wide range of strategic initiatives challenges. ‘At Symmetry clinical, public health and social care staff lending their professional skills multiple subsidiaries and it operated across worldwide manufacturing Medical there was a clear drive outputs – its clinical guidelines and to voluntary roles, especially health in different markets.’ projects. for an improvement in financial technology appraisals. Ben says the and social care charities. He has held Managing directors were sent One key project was creating a performance and a focus on value for work is ‘fascinating’ and even though several honorary treasurer roles for from the US to the UK, one of whom new organisation as the company shareholders,’ he says. his focus is primarily finance, process clubs and charities and is coming to positively encouraged Mark and divested in manufacturing devices Mark successfully restructured the and governance, it is a long way from the end of his last possible term as helped him to understand the options that it did not consider to be part of finance department and along with his narrower accountancy training. treasurer at health and care services available to him if he became an its future. He describes it as ‘a great the chief operating officer significantly He says this involves working provider Age UK Lambeth. (It is accountant. He qualified with CIMA at project where all my financial skills improved the company’s financial closely with senior clinicians and seeking a replacement – for details the age of 23. were put to good use, with finance performance. other experts and having the email [email protected]). In planning his career, Mark has playing a crucial role supporting the While at the company, he made knowledge and confidence to ‘It’s not just a worthwhile thing to do, always been aware of the art of the focus on customers’. it a clear focus for accountants challenge them. NICE is widely it’s also great development for finance possible and what an accountant ‘We started with very little and to generate strong financial recognised as having been a success professionals,’ he says. ‘And for can achieve. After two years at quickly created a strategy,’ he says. management information and both in the UK and internationally – finance directors, it is a way of keeping Computype, he wanted to progress ‘Over two years we developed the develop an environment of proper a success that has led to a further in touch with the sharp end.’ into a bigger and more challenging business and it was great to see financial control. ‘It is important to 16 NHS FINANCE CAREER STORIES NHS FINANCE 17 CAREER STORIES

Name: Caroline Clarke CURRICULUM VITAE Job: finance director and deputy chief executive, Royal Free develop and maintain relationships the best possible care for the monies Employment history London NHS and really understand where available,’ he says. ‘Management CIMA Qualifications Foundation Trust 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 Public service, 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 local focus 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 The biggest lesson Caroline Clarke national finance training scheme, ‘Like Colin, he was very direct. listen to people, learn about the that is not readily available to the believes she has learnt in her NHS having been impressed by the He was happy to take risks – albeit 2007 Symmetry Medical organisation and remain confident in private sector. finance career is that you don’t recruitment process and one of her educated and informed risks,’ she Inc, chief finance his own skills and prior experience. ‘The NHS is lucky to have such rich know everything. It is much better to assessors, Colin Gentile. says. ‘And he taught me it was officer Europe He says it is important not be afraid resources and expertise available acknowledge this to yourself and to In fact, she was soon working with okay to do that, to be different and to challenge in a positive way what is to finance teams,’ he says. ‘The 2009 Humber NHS FT, others, says the finance director and Colin at Hampstead Health Authority, to speak the truth – to say it as opportunities for meeting people and director of finance deputy chief executive of the Royal where he was director of finance, as you see it. That is so important, networking are beneficial whatever and corporate Free London NHS Foundation Trust. her first placement on the scheme. especially in the highly politicised “There is a stage of career you are at.’ assurance But if there is one thing Caroline Describing herself as a ‘shaper, environment of the NHS.’ Now chief finance officer at did know, even as a teenager, it early adopter and innovator’, She was impressed with Keith’s 2013 Southern Health Southern Health NHS Foundation was that she wanted to work in the Caroline says Colin had a big ability to influence policy makers, role for us NHS FT, chief Trust, Mark is transferring his recent finance officer public services. influence both on her decision to join recognising that this was based not all to ask skills and experience from working in Having studied for her O levels at a the NHS and how she worked. just on what he said, but the fact that East Yorkshire. comprehensive school in Cardiff, he delivered in his day job. how finance, ‘There are a number of challenges Outside interests a scholarship gave her the chance nationally for the NHS that are Mark is a Hull City football fan and a to go to a well-renowned public Dealing with failure estates, IT and any being met in different ways and with keen sportsman. He enjoys cricket school for her A levels. And it was Shortly after starting at Kensington, different levels of success. I am really and when he can find the time he here that she believes she developed Caroline found out that she had corporate service enjoying working in the NHS and I is the opening batsman for his local a ‘real sense of the privileged elite failed her CIPFA project on charitable can support the best am enthusiastic about coming to work club side. and the under privileged’. From then funds and it hit her hard. when I get out of bed in the morning.’ on, she knew her future lay within the ‘It was the first thing I’d ever failed, Favourite film The Hunger Games possible care” public services. and I failed because I didn’t ask Work balance Favourite book Birdsong, Sebastian Four A levels later and she was enough people for help. So it taught This is important to Mark because Faulks at the London School of Economics me the power of consulting and happening. By looking objectively with he works 200 miles away from his Top three records Mr Brightside, studying economics, where she built asking at an early stage. You can business managers and clinicians, home. ‘There are challenges striking The Killers; Will You, Hazel O’Connor; on earlier bouts of political activism have a good idea, but it is really only Mark was able to improve the way a good balance between home and London Calling, The Clash by taking a year out to be treasurer good if lots of people share it.’ teams worked and the management work. It is as important at home of the student union. A new project was lined up, based information that was available. that you are engaged in quality Alternative career Archaeologist This was also where she first set on the large-scale transfer of nurses’ He joined Humber after the trust activities as it is when you are at her sights on accountancy as a homes to a housing association. A had made an unsuccessful initial work,’ he says. possible career. year and 10,000 words later, she had foundation trust application. As well ‘When in the office I work with a However, it wasn’t the beauty of her CIPFA qualification. as a desire to make a difference, fantastic finance team who undertake a well-balanced spreadsheet that ‘It was a good project, based it was the challenge of applying much of the day-to-day work. There attracted Caroline. Instead, on something I did in reality and it his skills in a different environment is no typical day for me and I enjoy identifying the links between what taught me the importance of talking that attracted Mark. Within a few a wide range of different activities. she was learning in final year to people,’ says Caroline. ‘You can’t months, the trust was successful in its As well as the financial aspects of psychology and her accountancy ‘He had a very direct approach – always think you know the answer – application. the trust’s activities, I am responsible modules, she was intrigued by how he was very practical and a doer,’ in fact usually you don’t. ‘Humber sought in me strong for procurement IT, estates and you could use numbers to influence she says. While at Hampstead, in ‘That is a good gift to have, and financial leadership and I was corporate assurance’ he says. people’s behaviour. the first leg of what was to be a it is perhaps easier to say now that fortunate to learn a lot from very good And the best things about working Accountancy also appealed return journey, she was involved with I am more senior, but it is difficult people in the NHS,’ he says. for the NHS? ‘The dedication to the – compared with, for example, the creation of the Royal Free as a when you are starting out. It is more Mark says working in a finance NHS and patients from the vast general management – as she saw freestanding NHS trust. credible to expose your ignorance team can mean that sometimes it majority of people. Working in an it as providing both a technical and Her first ‘proper job’ was and be honest with people, and that is difficult to see directly the link to organisation that makes a difference portable skill. This would serve as an at Kensington, Chelsea and is a good thing to learn.’ patient care. ‘There is a role for us to people’s lives is genuinely insurance policy if things didn’t work Westminster Health Authority as a A first deputy finance director role all to continuously ask how finance, attractive. Many people across many out with plan A. project accountant working under at Camden and Islington Health estates, information technology and organisations support excellent front This plan turned out to involve finance director Keith Ford – another Authority was followed by a first real any corporate service can support line services.’ the NHS, and a place on the NHS major influence. taste of provider-land at the Royal 18 NHS FINANCE CAREER STORIES NHS FINANCE 19 CAREER STORIES

CURRICULUM VITAE Name: Jamie Foxton Job: deputy director of finance, Brompton. Caroline then gained her patient record well ahead of the trend. Employment history Hull and East first director job at the new City and The trust’s success was built on Qualifications CIPFA Yorkshire NHS Hackney Primary Care Trust. it having a good team and good Trust 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, From farmyard 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 to finance 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 Having left school at 16 to work chip company, people weren’t too family-run environment of Portakabin. best from other people,’ she says. director role. director on his family’s farm in Yorkshire, a fazed by the age thing,’ he says. ‘I was in my mid-20s and She also chalked up some more career in accountancy was not really ‘I really enjoyed it, but I knew enticed by the career opportunities 2000-2001 Royal Brompton career firsts – signing the technically Learning from KPMG on Jamie Foxton’s radar. But 15 I didn’t want to pursue a career and potential for going round the Hospital NHST, challenging first LIFT scheme in East After five successful years at years on and now deputy director of in audit. I was more interested in world. And for six months or so I assistant finance London and – reaching outside her the Homerton, Caroline joined finance at Hull and East Yorkshire industry – I wanted to be influencing really enjoyed it. But after a couple director finance role – linking service and KPMG, initially as a director and NHS Trust, Jamie is sure he made what was going to happen, not of years, the culture of a really estates strategies. subsequently associate partner, to 2003 Homerton University the right move. looking back at what had happened.’ big profit focus didn’t fit with my Caroline says that location has help build a health practice within the Hospital NHS FT, He admits to stumbling into His first step towards this came personality and I started looking for always been important for her career. consultancy. finance director accountancy. Ill health as a teenager with a move to Portakabin in York. something different.’ She not only wanted to be in the She says she learnt a lot and brought his school days to a Although he started in internal audit, Jamie says he’d never thought 2007 KPMG, associate public services, but connected to her had two good years working with partner premature end after finishing his he soon moved into his preferred about working in the public sector. He own local services – and so pursuing some very bright people. But she GCSEs. But a year of farm work management accounting role in was conscious of a view across parts recognises now that the move ‘didn’t 2009 NHS North Central at his parents’ farm was enough the modular building company’s of the commercial world that public fit entirely with who I am’. London to convince him he wanted a more European division. sector finance managers were little She adds that it had always been Commissioning academic challenge. more than budget accountants. ‘My “Good her intention to return to the NHS, Agency ‘A job came up in accountancy in perception had been that the NHS which she duly did – armed with the a small local practice. I didn’t get it, was a bit of a backwater and it was management 2011 Royal Free London knowledge of how to be a better client NHS FT, finance but I had managed to get my name not viable for a career.’ and – in 2009. director and deputy onto recruitment agencies’ lists as a Then, in 2011, she made her return chief executive potential candidate for AAT-level jobs Local focus leadership journey to the Royal Free, this time in accountancy. And that led to a call However, he was keen to continue as finance director and later adding Outside interests for an interview with PwC in its Hull his career in the local area. When aren’t about control the deputy chief executive role to her Since becoming a mum two years office,’ he says. a job came up in 2010 at the local responsibilities. ago, Caroline says her diary is He says he ‘hounded’ the firm after hospital – Hull and East Yorkshire and power – they Now in her fifth year, Caroline says managed better to avoid so many the interview, desperate for a new Hospitals NHS Trust – he thought he she is proud of the work she has done long evenings at work. She cites career path. His persistence paid off: should take a look. His view had also are about getting at the organisation that originally music and theatre as her big outside he was offered a job and within 18 started to change over the previous trained her. ‘We’ve put a real focus on interests, though she doesn’t like months he had his AAT qualifications year as his wife’s pregnancy had the best from other safety, quality improvement and value musicals (with exceptions, see and had started on a fast-track path brought the couple into more contact people” for the patient,’ she says. songs below) and she attends gigs to being a chartered accountant. His with NHS services. ‘The more time This is an interest she has also where possible. AAT training cut down his required I spent at the hospital, the more pursued by heading the value training period to two years. fascinated I became,’ he recalls. workstream for the national Future- Favourite book Perfume, Patrick Thrown in with slightly older Despite being a big organisation, An interview with then finance her career in and around her home Focused Finance initiative. She also Süskind; The Checklist Manifesto graduates, Jamie acknowledges he with a group turnover now exceeding director John Barber further territory of north and east London has picked up the HFMA Finance Director (non-fiction), Atul Gawande felt he had something to prove given £220m, Jamie says it is still quite convinced him it was the right move. been a deliberate strategy. of the Year Award in 2012. Favourite song Gimme Shelter, his different academic path. But with definitely a family company with a ‘He was quite inspiring and he sold In 2003, she continued this However, Caroline insists that her Rolling Stones; Give a Little Love, an enthusiasm for learning, he found great ethos and one that values its the job well,’ says Jamie. ‘We talked connection when she moved to the achievements are all the results Bugsy Malone himself a fully qualified accountant by employees. ‘It was a great place to about the trust’s foundation trust Homerton hospital – a trust with of great teams, not individual the age of 22, picking up a regional work. I spent two years there and aspirations and the greater autonomy ambitions of becoming a first-wave performance. Alternative career choice prize in the ICAEW professional level really enjoyed it,’ he says. and commercial approach that foundation trust – where she stepped She returns again to the advice of Bass guitarist exams on the way. However, he admits to ‘being would bring. But there also seemed into her first provider director role. one of her mentors, Keith Ford: you Having become an assistant dazzled again by a big blue-chip to be such a great team-working She remembers a trust ‘punching don’t and can’t know everything, so manager at PwC, he soon moved plc’ and made a move in 2007 to environment, which was really massively above its weight’ in gaining get some help. into audit, where he found himself join multi-national consumer goods something I was looking for.’ its FT status, implementing the Any careers advice for other finance travelling and overseeing audits company Reckitt Benckiser. The The role was senior business unit fledgling payment by results system practitioners? A little humility goes a in major companies. ‘It was quite company, which produces health and accountant for one of three surgical and introducing a new electronic long way. 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 NHS FINANCE 21 CAREER STORIES

CURRICULUM VITAE Name: Andrew Geldard Job: chief executive, North Essex made it clear this would involve close provide more patient-focused care. Employment history Partnership work with clinicians. This would have involved bringing all Qualifications AAT, ICAEW University NHS ‘This was really appealing to me – elective activity onto a single site, but Foundation Trust 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, Gathering data 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 and recognition 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 Life could have turned out very sent to the DHAs. Frustrated by for the creation of the purchaser/ ‘But right from the off, I was going to relationships with clinicians. Yorkshire NHST, different for Andrew Geldard. He the lack of accessible information, provider split in the service. In business meetings and presenting the senior business admits he tried to avoid working for Andrew made a name for himself demand because of his database financial position and opportunities for Director shift unit accountant, as long as possible – and succeeded by producing a booklet that set and spreadsheet skills, he was savings and talking through finance A further role change has seen Jamie head of finance, until he was 25. out activity information for each of approached to help start the and non-finance metrics.’ become the trust’s deputy director deputy director of He graduated from the University the DHAs. thinking in the regional health of finance. ‘Moving to the NHS was finance of Wales with a degree in geography Luck played a part when he authority about commissioning the right thing for me,’ says Jamie. and American studies and was keen was asked to learn a spreadsheet services and to lead on the modelling “The ‘I’ve loved the learning over the past Outside interests to continue his studies. A lack of package known as Multiplan. of commissioning plans. five years.’ He says the opportunity With two children aged two and four, public funding in the UK sent Andrew Spreadsheets were in their infancy Andrew explains how he made his opportunity to pursue his career in his own local Mr Foxton says there isn’t a lot of overseas and he spent a year in and Andrew was one of the few move into the finance department. hospital has added to the experience. time for much else. He describes Canada at the University of Manitoba ‘The regional director of finance, to support ‘I’m a local person and I feel proud his hobbies as ‘holidaying’ and completing a masters degree in Stuart Welling, was unhappy that business of my hospital and the fact that my the seemingly polar opposites of geography. He was keen to stay in capital was not part of finance and family use it.’ ‘fishing and fast cars’. However, he Canada but he didn’t meet the criteria that the data analysis capacity cases that could Jamie is pragmatic about his future. also enjoys keeping fit and playing for obtaining a permanent visa. was not within his department. He remains career-minded and football for a trust five-a-side team. Andrew returned to the UK to Consequently, he tapped me up to realises he may need to leave to succumb to the inevitable and look apply for a job in his department. have a direct impact make the next step up. ‘I’m keen Favourite book Animal Farm, for a job, but it was the mid-1980s on patient care – that to broaden my experience and George Orwell and not any easy time to enter the Mixed feelings recognise my next career move may Favourite place Maldives labour market. He explains: ‘There ‘When I was offered it, I turned gave me a real buzz” need to be to a clinical commissioning was not much employment in the it down and explained that the group, a commissioning support unit Favourite song Can’t Stand Me north of England at that time, so I questions in the interview had made or more on the strategic side,’ he Now, Libertines had to be open-minded about my me realise that a job in finance did It helped that the clinicians were says. ‘Wanting to stay local clearly Best career advice A fulfilling career options. After a year of job hunting, I not appeal. Stuart then rang me to learning too. While many clinicians makes this more challenging.’ is a marathon, not a sprint spotted an advert for a statistician at explain the error of my ways. I’m so might do ‘maths as a hobby’, as He has changed his own initial South East Thames Regional Health glad he did.’ his clinical director put it, they ideas about the NHS and says Alternative career choice Probably Authority and applied for it.’ The job involved preparing weren’t experts in how NHS finance ‘accountancy in the NHS offers a journalist – I always enjoyed While at that time Andrew did not for the introduction of the NHS works and how the funding flowed as many if not more challenges creative writing have a particular interest in working internal market and included or costs accumulated. But they than dealing with finance in the in the NHS, his masters thesis was people at the regional health developing allocation formulas for were interested. ‘Most clinicians commercial sector. on accessibility to primary care in authority who could use them. commissioners in the region. appreciated honesty and a fresh Importantly, there’s an additional the Canadian city of Winnipeg. ‘Being able to use a spreadsheet It was in this role that Andrew perspective. I really liked the ethos payback in contributing to the This stood him in good stead – he enabled me to carve out a niche studied CIPFA. At the time, there was that we were doing this together.’ development of good and better got the job. for myself,’ he says. ‘In 1986, there a push for finance to be a core part A subsequent merger of the patient services.’ Andrew recalls that the regional was a big push on reducing waiting of NHS management and unqualified surgical units a year later saw Jamie says he would consider a statistics team provided support lists and I was able to do some finance directors were being Jamie promoted to head of finance move back into the private sector if for three district health authorities spreadsheet modelling, which helped encouraged to qualify. of the new, bigger group. ‘This was the right role came up. In his view, (DHAs). There were information to support what we were doing.’ Even though he was working in the a great role. It was a £120m unit – ‘the experiences gained in the NHS systems at district level but most Jobs in the capital planning and finance department, Andrew had no responsible for about a quarter of have made me a much more rounded of the analysis was carried out at public health departments of the intention of becoming an accountant. the trust’s cost base – and we had finance professional’. regional level. regional health authority quickly Things changed when he received our own ‘board’, including medical, ‘I now take a much more holistic Andrew recognises that there were followed and in both he continued another call from Stuart. nursing and operations directors plus view of business proposals rather two factors that had a significant to develop his data analysis skills, ‘He asked me why I hadn’t signed myself. We all had different strengths than just the bottom line,’ he says. impact on the direction his career including how to use databases. up for CIPFA’s senior entrants course – but we worked really well together.’ ‘The development of my influencing took – his personality and luck. At The 1988 white paper Working and explained that I would struggle In one notable initiative, the team skills and ability to take people with that time, data programmes were for patients brought about a big to go much further in NHS finance built up a £10.5m investment plan me has been essential in my run over night and printed off on change for Andrew as well as for the without being qualified,’ he says. ‘I to reconfigure surgical services to progression.’ continuous paper, which was then NHS. The paper set out proposals owe him a huge debt of gratitude.’ 22 NHS FINANCE CAREER STORIES NHS FINANCE 23 CAREER STORIES

CURRICULUM VITAE Name: Dr Kavita Gnanaolivu

In 1992, Andrew started what he director of finance and performance Employment history Job: manager, calls his ‘first proper finance job’. at Southend-on-Sea Primary Care Qualifications CIPFA Ernst & Young 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 Doctor with a 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 ‘go for it’ spirit 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 Kavita Gnanaolivu qualified as a to the UK with my husband and I shop floor, what we were doing well 1992 Brighton His data skills came to the fore financial footing and putting a doctor before training to become an applied to the NHS graduate financial and what didn’t work or was causing Healthcare NHST, again and he found ways to improve robust financial plan in place. The deputy finance accountant. At school, she had a programme at a time when the staff and patients frustration,’ she reporting at the trust by extracting improved performance at the trust led manager keen interest in space and research general management programme says. data from the ledger, which led to to it getting foundation trust status in and set her sights on working for was not being provided,’ she says. Kavita has sought mentors when better manipulation and analysis. 2007 and Andrew led on the financial 1996 Surrey and Sussex NASA, but in the end she decided ‘I didn’t have any prior experience she felt she needed to and, years aspects of the application. Healthcare NHST, to take a more traditional route, in finance or accountancy, but luckily later, still seeks the opinions of He recalls how his move to become deputy director of studying medicine. for me the graduate assessment mentors from her NHS training “I like to be very a chief executive came about. ‘I had finance and planning ‘Healthcare was exciting and looked for the right transferable skills scheme. One deputy director of no ambitions to be a chief executive. the alternative was probably an and ability for applicants to develop finance advised her to ‘go for it’ and 2000 Southend-on-Sea visible in my But when the then chief executive PCT, director of engineering degree,’ says Kavita. ‘I the required competencies. this has become her mantra. ‘I have went on long-term sick leave, I was finance and chose medicine because I realised ‘I had a great time developing my always been encouraged to say yes organisation. asked to fill the role on an interim performance it would give me the opportunity to management and finance skills, but to people and to help them,’ she basis. I felt I couldn’t say no. I was have a positive impact on people’s all the time I was very conscious not says. I walk the committed to the organisation and 2002 North Essex lives and healthcare is relevant all had to step up.’ Partnership around the world. Also, I tend to Go the extra mile wards, meet Andrew focused on addressing the University NHS FT, choose what I perceive to be the She encourages her colleagues to teams and issues that needed sorting and a year director of resources greatest challenge and medicine was work in this way, to spread ideas and later was permanently appointed into 2008 Chief executive a much longer course.’ challenge them not to become too service users, always the role. Studying at Stanley Medical comfortable. She was encouraged to As chief executive, Andrew says College in India, following her take on more when she was already Outside interests ask for feedback” he spends most of his time on schooling in Kuwait, Kavita qualified busy, not to take the easy route and customers. ‘There are two groups,’ Andrew makes time for his family by as a doctor and worked as a to go the extra mile. he says. ‘Our commissioners and being at work by 7am and leaving at house officer with a wide range of ‘I have witnessed occasions where Gaining in confidence and getting patients. I like to be very visible in 5pm. His hobbies include watching specialties. ‘The public health service finance colleagues have said no more serious about his career, he my organisation. I walk the wards, football (supporting Blackburn in India is very stretched and cannot because of cost pressures and it took up the post of deputy director meet the teams and service users. Rovers) and managing his son’s cope with demand,’ she says. ‘We can be perceived in a negative way of finance at Crawley Horsham NHS I’m always asking for feedback so cricket team now his playing days would see 100 outpatients in a and affect longer-term relationships,’ Trust in 1996. ‘It was a much deeper we improve what we are doing. I’m are over. morning and there was no regular says Kavita. ‘I’ve usually found there step into NHS finance’ he says. keen on patient surveys to give us Favourite book Trainspotting, Irvine follow-up. There were lots of good is a way of moving things forward, In 1998, the trust merged with East something concrete to improve on.’ Welsh doctors, but we had limited resources particularly if it improves the care Surrey Hospitals NHS Trust to form Andrew is in no doubt that a resulting in shortages of basic given to patients.’ Surrey and Sussex Healthcare NHS background in finance is a good Favourite film Italian Job equipment. We are lucky to have to lose the link to patient care.’ While the support of mentors Trust. Andrew was responsible for grounding for an NHS chief executive. Favourite TV show Top Gear such a great NHS.’ Having graduated from the has been important, Kavita the management accounting and ‘Being able to quickly understand She quickly realised that she scheme, Kavita joined Cardiff and has supplemented it with other planning side of finance. complex data and get behind the Top three songs London Calling, wanted to play a bigger part in Vale Health Board in 2004 boasting development activities such as While CIPFA had an impact on numbers of the organisation really The Clash; Anarchy in the UK, Sex improving healthcare. Kavita saw a relatively unique combination of leading the research work for HFMA Andrew’s work life, it also had an helps. It can give you a sense of what Pistols; Boredom, Buzzcocks – ‘I’m healthcare management as the way financial and medical qualifications – Wales. She is keen to understand unexpected impact on his love life. It is and is not important, but is only one still stuck in 1976 I’m afraid!’ to do this, taking her beyond the a combination that would stand her in how different healthcare systems was while Andrew was volunteering piece of the jigsaw,’ he says. Favourite website BBC Sport one-on-one interactions she had good stead for her career ahead. have evolved and the benefits as a P3 CIPFA project examiner The best piece of advice Andrew with patients and their families, and Kavita arranged with the medical and challenges faced by different that he met the woman who would has been given is to make the best enabling her to have an impact on a clinical director to attend some of countries and cultures. become his wife, Veronica Watson, use of other people’s resources. wider scale. the clinics taking place within the She has taken part in HFMA study also an NHS accountant. ‘Being a good finance manager in the It was a big decision to change board’s hospitals. It was similar to tours in America and Canada and It was his keenness to be closer NHS is not just about working with disciplines, but if it didn’t work Kavita the normal observerships that take facilitated the setting up of the HFMA to Veronica that prompted Andrew’s what you have,’ he says. ‘It is about knew she could return to clinical place in medical training, but it was UK-Australian exchange programme. next move. He decided to take a generating new resources, by working practice. The management skills she not hands-on nor did it maintain her ‘There are a range of development risk and experience what it was like with others, doing things better and was developing would not be wasted. medical CPD. ‘I wanted to make sure opportunities and support available in to be a commissioner, and became winning new business.’ ‘I had an opportunity to move I knew what was happening on the the NHS,’ she says. 24 NHS FINANCE CAREER STORIES NHS FINANCE 25 CAREER STORIES

CURRICULUM VITAE Name: Kate Hannam Job: director of operations, Kavita has found that her work streams and have worked on Employment history North Bristol background and approach has been redesigning clinical services so there Qualifications MBBS, CIPFA NHS Trust 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 Finance route key 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, to management ‘My clinical background gives me the disaggregation of services at Mid finance manager, an advantage and greater ability to Staffordshire NHS Foundation Trust commissioning Kate Hannam always wanted to was about working in partnership Trust. But she didn’t stay long in this challenge. I know how doctors are (MSFT), where EY was the special and performance make a difference and, as director with managers and clinicians. We post. She explains: ‘I enjoyed the trained to think and work. I offer administrator. improvement of operations at North Bristol NHS developed integrated reporting to link role back in finance, where I covered viable solutions in translating clinical Kavita describes this as the accountant; NHS Trust, she sees her accountancy workforce and activity information seven directorates and had good proposals into reality while getting as most challenging achievement in financial experience as having a positive with the traditional financial variety in my work. I didn’t stay too much value for money as we can and her career. ‘The safe transfer of management trainee support. management information,’ says Kate. long because I was keen to get back enabling clinicians to work to their full services, appropriate governance She joined the NHS finance training ‘All this is common now, but it wasn’t to general management.’ , and maintaining patient safety 2013 Ernst & Young scheme in 1994 after completing an back then.’ In 2002, Kate moved to Swindon manager could not have been achieved accounting and finance degree. Kate Her next opportunity came from and Marlborough NHS Trust as “I know how unless all clinicians were on board. had always wanted to join the NHS a close working relationship with general manager. In her new role, Disaggregating MSFT across two Outside interests and to follow in the footsteps of family the director of the directorate she Kate played a greater part in project receiving trusts and co-ordinating the members who worked in the NHS. supported. ‘The director asked management and completed her doctors are In her time off Kavita likes to relax change across multiple stakeholders ‘I always had public sector values. I me whether I would like work on a PRINCE2 project management on adventure holidays. She recently trained to was very complex.’ considered working for one of the big secondment basis, and cover the qualification. went to Machu Picchu in Peru and Kavita led the medicine work accountancy firms, but I felt the NHS ‘I was involved in a number of trekked across the Andes and think and stream, with the aim of ensuring would give me a greater opportunity large tender exercises and I really Amazon jungle. She also likes less sustainable services. ‘We had to to make a difference,’ she says. benefited from the experience,’ she physical activities, such as going work and I offer adhere to tight deadlines. Working While being attracted to the NHS, says. ‘Finance provides a great on cruises to experience different in circumstances with significant Kate was keen to keep her options platform to develop and learn a viable solutions in cultures and meet different people. operational and staffing challenges open and was attracted to both number of other disciplines if you translating clinical required a lot of sensitivity.’ Favourite film The Secret Life of finance and general management. want to. I aimed to manage the The project was completed but Walter Mitty ‘I didn’t know exactly what I wanted business guided by my experience Kavita says challenges remain. to do within the NHS,’ she says. as a finance professional. proposals into reality” Favourite book Outliers, Malcolm ‘Although the work was successful Gladwell ‘I was quite interested in general ‘While I had a clear focus on and the two organisations have management, but I felt the finance patients, I was still able to use potential, which is very satisfying.’ the best chance of success, the Favourite TV shows Sci-fi and training scheme would allow me to financial measures to gauge what While working within the NHS, underlying problems will take time to fantasy, currently watching Defiance transfer between disciplines more was happening. Nothing tends Kavita enjoyed the variety, the work through,’ she says. easily if I wanted to.’ to happen without a financial Top three records ‘I listen to most opportunity to change roles and She believes the NHS can learn kinds of music – maybe Third Day Having completed the training consequence, and that can be the number of interesting projects from private sector approaches. by Katie Melua’ scheme, Kate qualified as a CIPFA positive as well as negative.’ running at the same time. Keen to And a lot of good work in the NHS member. Her first substantive post Working in the women and progress her career and continue to can be shared more widely so that Favourite food Hot cookie dough was as a senior management associate director role,’ says Kate. children’s services directorate, Kate be involved in challenging projects, other organisations learn. ‘At EY, Favourite website Interesting posts accountant and she was involved ‘I think she saw the understanding stayed nearly six years. A highlight Kavita explored opportunities within when a new project is delivered or via Facebook or LinkedIn, such as in the merger of Frenchay and I had for the business and the was establishing an integrated and outside healthcare. In 2013, she a new concept is successful it is Wired, Harvard Business Review Southmead hospitals to create North good relationship I had with the children’s service as part of the took up a manager post with EY. quickly assessed and turned into a Bristol NHS Trust. ‘It was a great management team.’ children’s national service framework. As she explains ‘Moving to EY I methodology or framework that can experience to be involved in the However, on taking up her first ‘The work was incredibly interesting wanted to try something different. be rolled out in other teams and other finances of the merger and how to role in operational management, and I enjoyed myself. It involved lots My role in the NHS had lots of things types of work,’ she says. realise cash-releasing savings at that she found her skills needed to be of partnership working – for example, happening and I took advantage of Working in finance keeps options stage of my career,’ she says. ‘Much developed. ‘My finance background with social care as well as other lots of opportunities, but broadly the open, says Kavita. ‘There are so of what I did then is relevant today.’ naturally suited more analytical acute providers – and it really made core work was cyclical and followed many roles in the NHS that could fulfil Kate worked as a finance business approaches to management. There a difference to what we were doing.’ the financial calendar. At EY I have your career. Your skills are valued,’ partner in the newly merged was a lot for me to learn and I was seen a shift in my working pattern, so she says. Her advice is to be open North Bristol NHS Trust. The trust lucky that I had great support from Long-term view the focus is on what the client needs. to anything that comes your way. pioneered an approach where the my colleagues.’ Kate says a few people questioned ‘After 12 months I started to get ‘Providing the best possible value management accounting team was After a successful secondment, whether staying at one place and in into the rhythm and pace of work for the patient often involves getting embedded in the clinical directorates Kate moved to back into finance and one role for so long was a good idea. and balance my work, development the best possible value for yourself,’ with an equal voice at directorate a new role as assistant director of She feels one really good outcome of and personal life. I support clinical she says. management boards. ‘My role finance at United Bristol Healthcare her time at Swindon and Marlborough 26 NHS FINANCE CAREER STORIES NHS FINANCE 27 CAREER STORIES

Name: Andy Hardy CURRICULUM VITAE Job: chief executive officer, University Hospitals Coventry was having the opportunity to learn a integrated pathways of care. ‘My Employment history and Warwickshire single organisation very well. personal objective was to take the Qualifications CIPFA NHS Trust ‘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 ‘It’s an honour to 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 work in the NHS’ 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 Andy Hardy is a busy man. As well taste of general management. Andy important to have a good boss – make when you are new into the role.’ a high-performing smaller trust with as leading University Coventry and was quickly promoted to the role of choose to work for people who you It is clear Kate has focused on her a number of specialised services. It 2001 United Bristol Healthcare Warwickshire NHS Trust (UHC&W), assistant director of finance, with can learn from and who can motivate personal development throughout her was a unique opportunity for me and Trust, assistant FD one of the largest trusts in the responsibility for planning. He stayed you.’ career and has engaged help from a great experience.’ 2002 Swindon and country, he is also an HFMA trustee in this role for two years before a In 2004, Andy returned to UHC&W mentors and coaches at different She has since moved back to North Marlborough NHST, and a CIPFA council member. He’s secondment to the West Midlands as chief finance officer. Andy recalls: Bristol NHS Trust. ‘I never moved general manager and on the board of directors of not-for- Regional Office of the NHS Executive ‘It was a huge jump from my previous away from Bristol,’ Kate says. ‘I have project director profit careers advisory service Right led to him to working in the regional role. It really should have been always lived within the area and Step and the Albany Theatre in tier of the NHS for three years in a a role for someone who already “There commuted for work – it is nice to only 2009 Taunton and Somerset Coventry, a registered charity. variety of roles. had experience of being a finance are lots of have a 20-minute journey into work.’ NHS FT, director of acute While Andy is now a committed He explains how his role as head director, but I applied for it and got it. Now in a different role working service development, and public servant, it is not what he of finance at West Midlands Strategic I’m really grateful to Dave Roberts, opportunities with new services in a state-of-the- divisional director (ops), had planned. With his degree in Health Authority came about. ‘I the then chief executive who took a art hospital, Kate faces different then director of acute economics, he expected his future applied for a job as a PCT director of chance on me.’ in the NHS, challenges every day. ‘When I service development would be in the City, but when he finance but didn’t get it. returned to North Bristol NHS Trust, 2013 Salisbury NHS FT, chief graduated in 1990 jobs were Kevin Orford was on the interview Recruiting skills lots of finance roles. the two main hospitals had relocated operating officer scarce and he found himself Andy puts some of his success down the majority of their services into a applying for a trainee accountant to his skill in recruiting good people You can expand your brand new hospital,’ she says. ‘We 2014 North Bristol NHST, post with North East Warwickshire and putting fantastic teams together. focused on aligning work cultures and director of operations Health Authority. ‘Two of my initial associate directors skills beyond finance redesigning internal service models to Unusually, it was a part of a local of finance are now finance directors if you choose” ensure we got the maximum benefit Outside interests training scheme and Andy benefited themselves. Having a strong team from the new hospital. Kate enjoys relaxing with friends and from undertaking a wide range of enables you to do your job better,’ he ‘North Bristol NHS Trust is a family over a lovely meal with a fine roles within the finance department. says. complex health and social care glass of wine, or a cocktail, or two. He became CIPFA qualified in The role of deputy chief executive stages. ‘Working in any role, you can system, where we work with two She’s a huge fan of cocktail-making 1994 and the same year took up was added to Andy’s portfolio in find yourself getting entrenched. I clinical commissioning groups and classes. Kate is also a season ticket the substantive post of purchasing/ 2008. He says: ‘I was thrilled to be looked for individuals I trusted and two councils. Balancing the need holder at Bath rugby club. locality accountant within the health expanding my role. It gave me an respected to mentor me,’ she says. ‘I for high-quality services for our local authority. opportunity to have more involvement Anything by looked for people who had experience population, as well as delivering Favourite book He recalls it being a challenging in the clinical side of the organisation John Grisham coaching and mentoring other people national specialist services is a time with the introduction of GP and to move outside my finance working in the public sector, as well challenge. Favourite film Casino Royale fundholding. Keen to continue his comfort zone.’ as the private sector. It’s helpful if ‘Increasing demand for all services studies, he undertook an MBA at When the post of chief executive Favourite TV shows Comedies such they have an understanding of the requires us to develop new models Birmingham University. ‘The MBA became available in 2010, Andy as The Big Bang Theory NHS, but it is not always necessary.’ of care. Working in collaboration with really helped give me a broader jumped at the chance to lead Kate says her most successful our system partners is essential to Top three records Dancing Queen, perspective and I think it helped to the organisation, now one of the mentoring experience was with a secure our long-term sustainability, ABBA; YMCA, Village People; mark me out from other qualified panel, as he was the finance director country’s largest tertiary acute trusts. GP who helped give her a different and to work towards our goal of being I Am What I Am, Gloria Gaynor accountants,’ he says. at the strategic health authority, and His application was successful and perspective. a foundation trust. The challenge is he offered me a role working for him. since then he has been working with Favourite food Mexican In 2009, Kate moved to Taunton immense but very rewarding!’ Provider move ‘I learnt a lot from Kevin. He has a colleagues to continue the success of and Somerset NHS Foundation Trust, Kate has some clear advice for Favourite website Google Recognising the need to get some natural coaching style and went out the organisation and move towards where she was a divisional director people considering a career in the provider experience on his CV, Andy of his way to develop people. Looking the achievement of foundation trust Alternative career Martial arts of operations within emergency and NHS. ‘There are lots of opportunities instructor took up his first post at UHC&W in back it was a good thing that I didn’t status. He has particularly focused urgent care. Later, she changed roles in the NHS, there are lots of different 1998. It was the beginning of Andy’s get the PCT post – these things tend on developing relationships and joint to become director of acute service types of finance roles and you can long association with the trust. He to work out for the best.’ working with others in the local health development, where she focused expand your skills beyond the finance started off as a directorate finance Andy says the best advice he has economy, which he sees as crucial on developing robust and effective team if you choose to,’ she says. ‘I’d manager/deputy general manager been given is ‘don’t do a job you for delivering high-quality, financially partnerships with key stakeholders recommend finance is a good basis with responsibility for surgery and don’t enjoy’. ‘Some people do that sustainable services for local people. to develop and implement for a role in general management.’ 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 NHS FINANCE 29 CAREER STORIES

CURRICULUM VITAE Name: Gemma McGeachie Job: senior manager – financial Andy says he still considers himself are as committed to the delivery of Employment history strategy, NHS a finance professional. He says one excellent healthcare as our clinical Qualifications CIPFA and MBA England 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 Sailing the high 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. seas of finance 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 As a senior manager in NHS perfect for me. Fortunately, I had a how they could continue to get the general manager last year. I know that I personally building of a new PFI hospital and England’s financial strategy team, mentor at EY who was supportive benefits of the reviews without going gained from the experience and so needing to make big efficiency 1999 Assistant FD Gemma McGeachie provides and helped me to think about my through intensive assessments did my trust.’ savings. I got through it and was financial input to NHS England’s career and what I wanted to do next.’ every few months.’ 2001 NHS Executive, West Among other highlights, he toured better for the experience. Midlands Regional strategic projects, including the new Gemma was looking for new roles Bitten by the sailing bug, Gemma the country speaking to members in ‘The pressure can be relentless and Office, deputy special models of care work. in EY when her mentor pointed to took a sabbatical from Monitor in how you respond is the true test. NHS projects manager Gemma studied economics at a vacancy at Monitor. ‘He knew I 2008 and took part in the Clipper finance staff need to be resilient as university and had a place on the wanted a change,’ she says, ‘and I round-the-world yacht race. She the financial position is not going to 2002 West Midlands South government economic service thought the interview would give me spent five months sailing from China “Being an get any easier.’ SHA, finance manager 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 2003 Head of finance Coping with pressure accountant. ‘I was on a summer impressed. ‘I worked in financial York, Canada and Ireland. During her in the NHS To help him cope with the pressure, 2004 UHC&W NHST, internship at EY at the same time I services and insurance at EY adventure Gemma had time to think Andy tries his hardest not to work chief finance officer applied for the government economic and Monitor was willing to take a about her career. is different to during his time off. 2008 Deputy chief executive service,’ she says. ‘During the risk despite me not having health As he explains: ‘I sometimes look at officer/chief finance seven weeks I spent at EY, I got Nautical time out being an accountant emails and try to reduce my reading officer involved in a wide variety of projects ‘Life on the boat was basic and I pile in the evenings, but I try really and enjoyed it more than I was spent a lot of time thinking,’ she says. anywhere else. hard not to work at weekends or 2010 Chief executive officer expecting.’ ‘With little electronic communication, We’re not dealing when I’m on holiday. It’s important Faced with two opportunities, you got into a routine of eat, sail and to recharge the batteries and to give Outside interests Gemma sought advice. ‘My lecturers sleep. I learnt so much about team with widgets, it is all yourself time to reflect.’ Andy likes to make the most of his advised me that the public sector dynamics and personal motivations Andy has a wide range of free time. He is passionate about would always be there and that it from living in such close quarters with about people” hobbies that help him to switch off amateur dramatics and recently would be good to get experience my team mates.’ – particularly when he is performing starred as Bill Sykes in Oliver! working elsewhere first and then While on her sabbatical, Gemma in an amateur dramatic production. He keeps fit and in 2011 completed move to the public sector and apply realised she wanted to focus her the branches, attended the US HFMA ‘You cannot think about anything else the London Marathon. He supports what I had learnt,’ she says. career more on health operations, annual conference and was called when you are on the stage’ he says. the Leicester Tigers and England So Gemma returned to EY full-time policy and strategy and less directly to represent the HFMA at the Public Perhaps surprisingly, given what rugby teams. in 2002 and studied the Institute of on traditional finance. As a result, she Accounts Committee, an experience he has achieved so far, Andy doesn’t Chartered Accountants of Scotland completed a postgraduate certificate he says he will not forget. consider himself naturally ambitious. Favourite TV show EastEnders and (ICAS) exams. When she completed in health economics at the University Andy recommends a career in ‘I like a challenge and hate being Mad Men her accountancy training, she didn’t of Aberdeen and a short course on NHS finance. ‘Being an accountant bored.’ he says. ‘This is what drives Favourite film Love Actually have a traditional celebration, instead organisational management in health in the NHS is different to being an me more than ambition.’ signing up to participate in a yacht experience. I left the interview systems at the University of London. accountant anywhere else. We’re not Looking ahead, Andy doesn’t Favourite book The Great Gatsby race around Ireland. wishing I had done more preparation.’ After three years at Monitor, dealing with widgets, it is all about anticipate leaving UHC&W any time Favourite songs Too many to list ‘I wanted to challenge myself and Gemma was successful and Gemma looked for her next people and making a difference to soon. ‘We’ve made lots of progress to do something fun’ she says. ‘I started working at Monitor in 2006. challenge and she embarked on a their lives. Anyone who works in but there is still more to do,’ he says. Favourite food: Everything from fillet couldn’t swim and I’d not been sailing In her role as an assessment year’s secondment to HM Treasury the NHS, whether they’re a clinician ‘We’ve got great staff and ambitious steak to Heinz beans before. We set sail from Plymouth manager, Gemma was involved in as a policy adviser in the health or not, is in a job that makes a plans to integrate services and to Alternative career choice ‘A spy like and I had until we reached Ireland assessing more than 30 foundation team. The culture and dealing with difference,’ he says. work with others so the patients get James Bond’ to learn the ropes. I was hooked trust applications and reviewing ministers directly was different to her the best possible care. immediately.’ transactions in existing foundation previous experience. She gained an Core values ‘I think we’ve got the building blocks Gemma enjoyed her time at EY, trusts. She got satisfaction from the understanding of strategic policy and ‘As well as technical accounting in place to become one of the best but did not see herself staying at the support she was giving. decision-making during the Budget skills,’ he continues, ‘you also need to trusts in the country. It is a genuine firm long term. ‘The accountancy ‘After the assessment process, and in the run-up to an election and share the core values of the NHS. It is privilege to lead such a fantastic firms are a great way to get skills and finance directors would tell me that forged strong relationships with key so much more than just numbers. organisation, especially as it is in the experience in a range of services,’ they really understood the activities contacts across the Department of ‘I’ve had the privilege of working community I live in. I wouldn’t want to she says. ‘While my role was and performance of their trust a Health, Treasury, NICE, the NHS with many great accountants who do anything else’. challenging and rewarding, it wasn’t lot better’ she says. ‘They asked Institute and Cabinet Office. 302 NHS FINANCE CAREER STORIES NHS FINANCE 313 CAREER STORIES

CURRICULUM VITAE Name: Gill McKetterick Job: project manager, In 2011 Gemma left Monitor after market assessments, funding pitches Employment history Mersey Care five and half years to undertake and grant applications as well as Qualifications ICAS NHS Trust 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 Manufacturing 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, meets the Mersey 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 At Mersey Care NHS Trust, Gill worked as an accounts assistant. ‘I have always had a good moral Gemma carried out an organisational on the reconfiguration of services HM Treasury as McKetterick supports the redesign of Gill was supported to study for the compass and wanted to do a role review for Haitian and US-based across north London and beyond. a policy adviser the trust’s finance and procurement CIMA qualification. that would be of benefit to people. My staff, focusing on reducing fraud and services. But a project management She explains: ‘I didn’t complete the parents and friends said joining the corruption risks. Joint venture experience 2011 Partners in Health, role is not something she thinks qualification at the time, and it wasn’t NHS would be a good thing to do.’ Before Gemma returned from her Her experience working at a start-up voluntary work in US she would have looked for earlier in until later, when I was working in the Gill’s career very nearly took a was put to good use as she led on the and Haiti her career. ‘It has been a massive NHS, that I realised the importance different path when, within the first commercial aspects of establishing a 2011 Beacon Health change from my previous roles,’ of professional expertise for patients six months of working in the NHS, pathology service joint venture. she says. ‘But I am relishing the and my colleagues, so I decided it Gill remembers being approached to “I knew that Strategies UK, ‘I had a lot to reflect on from business manager opportunity to make a difference would be a good thing to complete.’ go back to work in manufacturing and the Beacon my experience with the joint and have embraced the prospect of She believes becoming a qualified was tempted by the variety of work venture,’ she says. ‘While some 2012 University College personal development.’ accountant is one of her greatest offered within a smaller organisation. Health elements of our approach worked London Hospitals Undertaking several roles in career achievements. Gill says she ‘The deputy director of finance well, it demonstrated to me that NHS FT, senior the finance department has given always knew she would complete the at the time would not accept my Strategies organisational form is a byproduct of manager Gill a broad range of skills and resignation,’ she says. ‘I suppose defining the outcomes we want and 2013 NHS England, experiences, as well as familiarising they saw more in me and the start-up was high getting the model of care right.’ senior manager – her with constant change. opportunity to develop. Looking back, While at UCLH Gemma found the financial strategy This is useful in her current role, I’m really glad I stayed. It took me a risk, but also that the time to complete a masters degree in as she can relate to colleagues while to realise that my background health policy at Imperial College. affected by the changes at Mersey in manufacturing brought something opportunity wouldn’t In 2013 she moved to NHS Outside interests Care. Having performed many of the different and added value. come along again” England. ‘The director I worked for at Gemma enjoys hill-walking, running roles herself, she knows what it’s like UCLH was moving to NHS England (for charity) and sailing. She also to change. She tries to get the best NHS support network and he asked me to join his team,’ provides financial governance possible solution for everyone. ‘Also the good things about working voluntary work, she started thinking she says. ‘I wasn’t looking for another mentoring to charities and career Encouraged by her grandfather in the NHS are the support you about her next role. ‘When I returned role at the time but I knew we worked mentoring to fellow ICAS members. only to ‘get a good job’, Gill initially receive and the opportunities to from Haiti a friend of a friend asked well together and the team would Favourite film Cinema Paradiso looked at the legal profession. ‘I develop. Over time, my work became me to join an organisation she was be focusing on the type of strategic didn’t have any particular desire to more rewarding, I could see I was starting up,’ she said. ‘At the time, I issues I am really interested in. Favourite book Pride and Prejudice, become an accountant,’ she says. doing a good job and having a had been looking into roles in NHS ‘At the moment, we are Jane Austen ‘I always wanted to be a lawyer – I positive impact. provider organisations. I knew that investigating the potential impacts of Favourite TV show Borgen enjoyed watching LA Law when ‘Working with clinicians and the start-up was high risk, but also the spending review for the NHS by I was younger. CIMA qualification at some stage and understanding clinical services that the opportunity wouldn’t come speculating on a range of possible Top three records Black Sands, ‘The foundation course I studied wishes she had done so initially. helped put into perspective what is along again.’ scenarios that may be announced by Bonobo; All is Full of Love, Bjork; involved law, but I was surprised to ‘Not having a qualification hadn’t important and what working in the Consequently, Gemma became the government.’ 500 Miles, The Proclaimers (Glasgow find that I enjoyed the accountancy affected my career development NHS is all about.’ business manager at Beacon Health Gemma is also a member of the Clipper boat song) aspects of the course and had the directly at that point, but I was Settling into the NHS, Gill worked Strategies UK in 2011. She played a national new models of care team, Favourite food Avocado option to continue to complete a starting to feel my luck would run out,’ across a range of finance roles at key role in establishing and growing looking at different ways of delivering 12-month access to finance course.’ she explains. ‘When I returned to the Walton Centre before moving Google maps its privately managed mental health clinical outcomes and sustainable Favourite website After completing her foundation complete my studies, I had a family, to Mersey Care NHS Trust in 2009 care advisory services. Beacon aims finances. ‘We are working with the course in 1994, Gill took a temporary which created additional pressure as financial accountant. Her focus to improve outcomes for people with first wave of vanguard sites to role through an agency as a finance and meant making sacrifices. changed again in 2014, when she mental health problems by working understand what level of support they assistant at Emerald Airways. It was ‘On the upside, my children have became a project manager to lead as a consultancy service for NHS need and address the barriers they quite an investment for Gill as she been able to see how hard I have the development and transformation partners to translate principles and face for implementing new care needed to buy a car to get to the worked and this has undoubtedly of the finance and procurement theory into models of care. models,’ she says. ‘Finance input is offices. been a good thing for them.’ department as part of a wider Working directly with the chief essential in any service redesign, so Her first permanent role came Gill joined the NHS in 2001, as corporate services review. executive, Gemma gained experience that services are designed in a way the following year, working at T&D an assistant financial accountant at Gill recognised the different skillset of creating a new organisation. She that will meet clinical outcomes and Industries, a manufacturing company the Walton Centre for Neurology & required to be successful in her new supported all aspects of strategy, be affordable.’ that makes steel drums, where she Neurosurgery NHS Trust. role and was keen to develop herself 30322 NHS FINANCE CAREER STORIES NHS FINANCE 333 CAREER STORIES

CURRICULUM VITAE Name: Dinah McLannahan Job: senior business consultant, further. ‘A project management people about a whole range of topics, Employment history NHS Trust qualification was within the desirable so there is something different Qualifications CIMA Development criteria when I applied for the role,’ every day, which is the complete Authority 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 Pulling out all the 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!’ stops for health Neurology & foundation project management Now Gill is not managing a team in Neurosurgery course shortly after changing roles. the finance department, she values Dinah McLannahan is no stranger time as a nurse, it became evident are mainly about money, but also NHST, assistant The course gave her the confidence the strength of relationships and the financial accountant, to working into the small hours to it wasn’t the career for her. The about improving quality and safety of and skills to undertake the role, unofficial support network at the trust. then accounts make finances work. Recently she structure of nurse management was services and getting better outcomes but it was not the first time Gill had supervisor, office worked through the night on a major too hierarchical and if she wanted for patients.’ looked for external support to aid her Broader engagement manager, financial infrastructure project at a trust, and to progress, the jobs would take her Successfully putting forward a development. ‘In my previous role, my accountant she recalls staying up til 3am to away from patients. ‘I felt like every business case on a trust’s behalf ‘While I was studying for CIMA, I conversations would have mainly balance the till for a student job at shift was an eight-hour adrenaline will benefit patients, she says. ‘I am had a coach to support me,’ she says. been with the financial services staff I 2009 Mersey Care a hotel. ‘I had to balance the books rush. You’d take a breath walking the one who puts these cases to the ‘I placed so much pressure on myself managed, but this project means I am NHST, financial on a paper ledger using a computer onto the ward and then let it out Independent Trust Financing Facility. to pass and it was helpful to have the engaging with the entire finance and accountant, project 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 support of another person to ensure I procurement functions. manager sometimes trying to find every last colleagues didn’t seem very happy trust to make the case, so it goes ‘I have similar conversations to penny. I always felt really comfortable and that didn’t attract me to stay in forward and makes a difference to before, about where things are up to, Outside interests with numbers – although I am no nursing,’ she adds. patients. but I now spend a lot of time seeking In her spare time, Gill likes to take mathematician!’ ‘Finance is a support function, “I have lots people’s feedback. I try to capture to the road in her touring caravan. It was that memory, together whether within the TDA or a trust, of meetings their ideas and opinions as well as It’s only small and because all the with an encounter with an NHS and it can be a blocker as well as an their concerns, to make sure we tidying up is done in a few minutes, accountant, that brought her to NHS enabler. That’s an important balance with a variety respond to them.’ that leaves her more time to spend finance. She already had a career to strike. It’s difficult in a risk-averse While enjoying her role, Gill is with her two children. in the NHS as a nurse, a profession culture, but we must not lose sight of of people looking forward to working with she admits to ‘falling into’. ‘I went to innovation as well as safeguarding clinicians more. ‘At the moment, I Favourite film Mamma Mia a really good school, one of the top public money.’ about a spend very little time with clinicians,’ Favourite TV show Strictly Come 10 in the country in terms of results. she says, ‘but I anticipate this will Dancing It seemed everyone knew what they Wide-ranging work whole range of change as the project begins to wanted to do – doctor, lawyer – but Dinah looks after 11 trusts in the engage with stakeholders external to Top three records Copa Cabana, I didn’t. My mum was a nurse at the West Midlands – a mix of acute, topics, so there is finance and procurement. Customer Barry Manilow; Always a Woman to time, so I sort of fell into it.’ community and mental health trusts. engagement will be critical to the Me, Billy Joel; Uptown Funk, Bruno While she was a nurse, the unit ‘I have a tremendously privileged something different success of the project, as it is the Mars accountant would attend the ward role,’ she says. ‘There’s variety in intention to further improve the quality Favourite food Chinese as a patient from time to time. They the work and I am also able to every day” of service provided.’ talked about his role and, having interact with a diverse group of Gill is grateful for her career enjoyed her previous job at the organisations with different styles in the health service. ‘There are hotel, she decided to train as an While NHS finance and her current of doing things. I could be doing a focused my efforts on the right things. lots of opportunities available accountant. role as senior business consultant at financial recovery plan in one trust ‘The coach helped me to press within the NHS. When I worked in A careers teacher was a big the NHS Trust Development Authority or on the business case for a new pause on my day job to allow me to manufacturing, it felt like the only influence, but not in a positive (TDA) are always going to be a step hospital. I also get the whole system think about what I really wanted and incentive to progress was for more sense. She told her to choose a removed from the front line, Dinah view and I feel I’ve learnt a lot.’ what things were preventing me from money; in the NHS, it feels different. practical career rather than anything believes she is having a direct effect She says her biggest challenge achieving success.’ It is about expanding your skills and academic. That hit hard, as it would on patient care. ‘When I was a nurse is developing and maintaining good Gill is putting her formal training adding more value,’ she says. any 16-year-old, she admits, but there were lots of life and death relationships with the organisations. and experience to good use in her ‘Throughout my career, the NHS she was determined to prove the situations, but also lots of occasions ‘You must ensure this is translated current role, where she engages has always been going through a teacher wrong. ‘I knew I wasn’t going when I was able to make someone’s into something tangible so you can with stakeholders on a daily basis. period of change of some kind or for four As at A-level and a degree life a little easier. That stays with make a measurable difference. Leading a change programme was a other. My advice is that there is no from Oxford or Cambridge, but I was you forever. It drives what I do as a Ultimately, boards are accountable, challenge that interested her. need to panic as this offers new capable and bright,’ she says. finance professional, having had this but you can put a lot of development ‘A lot of my time is spent planning opportunities. But even during her three years’ experience,’ she says. support into an organisation and see and monitoring against programmes, ‘You have to want to take the training, she admits she still did not ‘I like to think I help trusts to be the effects that has,’ she says. which involves nagging people for opportunities when they present know what she wanted to do. financially and clinically sustainable. Looking after a variety of progress updates,’ she says. ‘I have themselves and be open to trying While proud of the standards of When I work with a financially organisations has a flip side – it can lots of meetings with a variety of something different.’ care she helped deliver during her challenged trust, the conversations mean life is hectic as she goes from 30342 NHS FINANCE CAREER STORIES NHS FINANCE 353 CAREER STORIES

CURRICULUM VITAE Name: Loretta Outhwaite Job: chief finance officer, Isle of trust to trust, meeting to meeting. ‘You in applying? In the early stages of Employment history Wight Clinical have to be creative with your time pregnancy, she felt she could not take Qualifications Dip HE (RGN) Commissioning management, but logistically it can be the job. But when she was ready to nursing studies; Group 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 Recipe for being 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 an all-rounder 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 From the age of 10, Loretta accountancy books,’ she says. favourite reading material.’ ‘Working outside the NHS taught mental health trust and when I started NHS FT, finance Outhwaite so wanted to be a nurse The hard work paid off. ‘I loved Life on the front line was me the value of not wasting time. you could cut the office atmosphere and business that she spent much of her teenage my job, working with NHS clinicians interesting. She was given a I had to account for every six with a knife. By the time I left, we manager years with St John Ambulance and, helping them to manage their desk in an old sluice cupboard, minutes of chargeable time and was had been shortlisted for two national later, as a Red Cross cadet. ‘My little budgets, build business cases to an abandoned operating theatre, 2010 Dudley and Walsall only allowed 30 minutes of non- awards, delivered surpluses year on brother spent much of his childhood develop their services and find a microbiology lab (‘I can still MH Partnership chargeable time a day. It is a good year, we had a good relationship with pretending to fall off his bike and out ways to make their ever-shrinking remember the smell,’ she says) and, NHST deputy commissioners and had progressed director of finance of trees so that I could put him in the allocations stretch to see ever- her favourite, a children’s outpatient significantly towards foundation trust recovery position or tie him up with increasing numbers of patients.’ clinic. ‘I worked a shift in each clinical status, passing Monitor’s financial 2013 Acting director of slings and splints,’ she laughs. Several promotions meant she department, so I could understand “Working viability assessment.’ finance and But her life didn’t turn out quite as worked in nearly every service area what they did – mopping floors in the outside the She stayed there more than four performance expected. After taking her A-levels, urology operating theatre, providing years, including a spell as acting 2014 NHS Trust Loretta got married and had her first support to A&E staff and reassurance director of finance and performance, son a year later. ‘In those days nurse to patients and relatives.’ NHS taught Development before moving to the TDA in 2014. Authority senior training wasn’t very family friendly The experience and insight gained me the value ‘The NHS is good at offering business consultant and it wasn’t something I could as an operational finance manager development opportunities and I pursue, particularly as my husband remains important. ‘As a chief of not wasting time. have never shied away from taking worked shifts,’ she explains. finance officer in a commissioning those opportunities,’ says Dinah. ‘I Outside interests Nursing’s loss was accountancy’s organisation, it can be a challenge I had to account for haven’t had a clear, defined career To maintain a work-life balance, gain, and now Loretta is chief to make the connection between the plan; I just went with the flow, taking Dinah likes to keep fit with Les Mills finance officer at Isle of Wight work I do and the impact on patient every six minutes of opportunities as and when they body combat classes. The mixed Clinical Commissioning Group. care. It is critical I do make that presented themselves to me. But I am martial arts exercises are ‘really ‘The variety is something I very connection to ensure I understand chargeable time” grateful for the chances I have been therapeutic’, she says. Exercise and much enjoy,’ she says, ‘along with what services people need, what offered and I don’t take them spending time with her family mean the complex, ever changing and the people providing the services for granted.’ she has little down time somewhat unpredictable environment need and that what’s being delivered discipline. Time has to be used well.’ Many colleagues have played Favourite film Short Cuts of the NHS. The aspects I enjoy meets those needs. I therefore spend It was always Dinah’s intention a key part in her career. One is are also the ones that provide the time with service users, clinical to move back to the NHS, so she Jonathan Tringham, who was head of Favourite book Catch 22, Joseph most challenge in the role. I love a colleagues and providers of services jumped at the chance to join South commissioning finance when she was Heller challenge.’ in the organisation, giving her a to keep patient care at the heart of Birmingham Primary Care Trust in at South Birmingham PCT. Favourite TV shows Breaking Bad Working with public and voluntary good understanding of how acute, everything I do and every decision I 2003, looking after 11 Sure Start ‘I came into NHS finance thinking and Great British Bake Off sector colleagues is key to this. ‘We community, mental health and public make.’ programmes as well as a financial it would be a little bit old-fashioned, have a common bond. We all do health services worked. reporting role. but he showed me it absolutely was Top three songs Let It Be, Labrinth; our jobs because we are passionate The time had come to go to a larger Value of secondments She qualified in 2005 and moved not. I could see how talented he was, Ordinary People, John Legend; about providing people in need with organisation and she moved to what Not afraid to work outside her finance into a financial management post in how much detail he knew and how Everybody’s Changing, Keane great services,’ she says. is now Heatherwood and Wexham comfort zone, Loretta’s career the PCT children’s and community he was in command of everything Favourite food Poached egg on Loretta joined the NHS when her Park Hospitals NHS Foundation Trust has featured three very different services team. Two years later she he did.’ toast son was a year old and her mother as a directorate accountant. secondments, the first two in her time moved to Birmingham and Solihull Dinah also mentions Ian Baines spotted a job in a local paper for a ‘I was part of the service team at Heatherwood and Wexham Park. Mental Health NHS FT as a finance (former director of finance) and Gary Favourite website Facebook trainee management accountant post rather than the finance department, After a year there, she was and business manager and was then Graham (chief executive) at the Alternative career choice Doctor at the local district health authority bringing me closer to the front line,’ selected to take part in its annual promoted in that trust. Dudley and Walsall mental health (later an NHS trust). says Loretta. ‘My favourite task was two-day residential management Immediately, another opportunity trust. ‘They taught me so much. Working full-time with a young developing costing, which had just development course. She made a came up. On her first day following Development isn’t always comfortable family while studying for her been introduced. I created my own good impression and was asked promotion, she received a call from a and, though I’ve always pushed accountancy exams was exhausting. cost collection sheets for the top to cover the contract manager’s former boss who was at Dudley and myself, if I don’t want to do something ‘I can remember waving off my diagnosis/procedures and worked maternity leave. Walsall Mental Health Partnership – I think, “yes, it will be scary but I will husband and toddler son every with clinicians to write the “recipe” for ‘I was launched into the world of the deputy director of finance job was get to a better place”. These leaders Sunday to play in the sunshine while an average patient. The BNF [British performance information,’ she says, vacant and would she be interested have helped me do that.’ I was stuck indoors poring over my National Formulary] became my ‘managing external relationships with 30362 NHS FINANCE CAREER STORIES NHS FINANCE 373 CAREER STORIES

CURRICULUM VITAE Name: Yarlini Roberts Job title: chief finance officer, commissioners, setting, negotiating national media attention. It was one Employment history Kingston Clinical and monitoring contracts with multiple of the hardest things I’ve had to deal Qualifications CIMA Commissioning GP fundholders and five health with in my career,’ she recalls. Group 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 ‘It’s not just about 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 numbers’ 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 After passing her A levels, Yarlini see I was making a difference.’ carry out a senior management role. the finance team and she took a post and implementation of an electronic had planned to do a maths degree She also found the diverse nature She recalls one particularly tough 1996 Contracts manager in financial accounting and treasury patient record and picture archiving (secondment) at Warwick University, but had a of her role enjoyable – ‘one minute I time. ‘The finance director was on management. and communication systems. last-minute change of heart. ‘I wasn’t was helping sort out the milk tokens, a month’s development course and Loretta’s new role included her Despite enjoying the role, Loretta 1997 Directorate account’t entirely sure that maths was for me the next I was balancing the ledger’. the other deputy was off because of first foray into commissioning, as decided to further her finance career (emergency, and also whether it was something I A year later, in 1993, she moved to a family bereavement. I was on my it included being finance lead for and became the trust’s head of diagnostic, surgical wanted to do for the next four years,’ the Bethlem and Maudsley Hospital own and thought I wasn’t up to it. But an education consortium. The strategic financial development. 1998 Finance manager she explains. This was disappointing to gain a promotion to senior financial I threw myself into it, and I certainly This included leading on the trust’s (accounting, treasury) news for her parents, who were clear accountant. The trust was just about didn’t get everything right, but nothing foundation trust bid and a private that staying at home and not studying to receive trust status and Yarlini went really wrong either.’ “The aspects I enjoy finance initiative project to replace its 2000 Head of corporate or working was not an option. recalls it as an exciting time When the deputy finance director estate. communications This tough love resulted in Yarlini ‘I loved it,’ she says. ‘There was so returned to work after her maternity are also In 2010, Loretta relocated to (secondment) enrolling on a year’s accountancy much going on and the finance team leave, Yarlini looked for the next step the Channel Islands to work for 2001 NPfIT project foundation course at the local was fantastic. We had to work hard, on the ladder. In 1995 she joined the ones the States of Jersey in its health manager university. ‘My father and uncle were Kingston and District Community and social services department. accountants, but it wasn’t something NHS Trust as chief accountant, that provide Through promotion, she then went 2005 Head of strategic I was really considering as a career. where the challenges were different. the most on to corporate finance director for financial development It’s fair to say that I fell into it’. ‘It was a small trust and there was the treasury, chief minister, income 2006 States of Jersey, After enjoying the course and a question about whether it was challenge in the role. tax and economic development health acting FD/ finding it relatively easy, she decided viable on its own,’ she says. ‘There departments. ‘It was a difficult assistant FD; corpor’te to continue with accountancy and was also a range of skills in the I love a challenge” decision to break my NHS service, FD, deputy lead CSR in 1989 gained a training post finance department, which tested my but I felt strongly I needed wider with McIntyre Hudson, a top 20 management skills’. public sector experience to be an 2010 Isle of Wight PCT, accountancy firm. Yarlini says this consortium focused on workforce effective finance director.’ deputy FD, acting was one of the best decisions she’s Family values planning with provider organisations Loretta’s third secondment was to chief finance officer made. ‘It was a fantastic three-year Starting a family in 1997 changed to identify their clinical workforce Jersey’s comprehensive spending 2013 Isle of Wight CCG, training programme, with different Yarlini’s priorities. ‘I returned to needs, translating them into training review (CSR) team, where she led chief finance officer placements every six months. It gave work four days a week after my first places to purchase from universities the reviews of the courts, home me a good grounding in several child was born, but my career had and managing the contract delivery. affairs, education and health and Outside interests different areas and made me realise to take a back seat,’ she says. ‘My Loretta’s second secondment – as social services. there were aspects of accountancy husband, who’s also an accountant, head of corporate communications – Before the CSR was completed, As well as spending time with her I found interesting.’ Audit, however, and the main breadwinner, had a job came a few years later. On her first she took the difficult decision, for family – she has two sons – Loretta is was not one of them and Yarlini was that involved travelling overseas, so day she received a call telling her family reasons but also because she a keen runner and baker. soon looking for her next role. we were not able to equally share that the prime minister and health missed working within the NHS, to Favourite film Sleepless in Seattle After she passed her ACCA exams, but we also played hard.’ childcare responsibilities.’ secretary would visit the hospital a move back to the UK. Yarlini successfully applied for the Again, it was the range of activities After the birth of her second child, , week later and she would have to She believes secondments are key Favourite book Birdsong post of assistant financial accountant that appealed. ‘Every day was Yarlini decided not to return to Sebastian Faulkes organise the visit. to getting the experience to progress at Croydon Community NHS Trust. different,’ says Yarlini, ‘from large work and focus on her family. ‘I just It was a sink or swim moment, up the career ladder. ‘My advice is to Favourite TV shows Dr Who; Undertaking the audits of a private capital schemes and treasury couldn’t manage it all. I felt as if I and she counts the visit as one of grasp every opportunity given to gain Location, Location, Location; Sherlock hospital had sparked her interest in management to final accounts. I wasn’t being fair to my family or my her most significant work-related additional experience, especially if healthcare and prompted Yarlini’s knew if I was working in the private colleagues,’ she explains. Anything Italian achievements. ‘I decided that if I it is in another operational area or a Favourite food move to the NHS. sector I wouldn’t get exposure to Having a third child led to a three- could cope with that on my first day related organisation or industry. Favourite website Twitter ‘At the time I wasn’t entirely sure I such issues.’ year career break. But it wasn’t long in a job, I could probably cope with Well-rounded experience is was doing the right thing, but I knew Not long after she joined the before she was missing work. ‘I loved anything,’ she says. invaluable. If you’re in a management that I could not stay in audit,’ she trust, Yarlini received a temporary spending time with the children, Other tough days followed. ‘Several position, you should seek to offer says. The move turned out to be a promotion to deputy director of but I needed more. I needed to be months later there was a police people secondment opportunities to good one and the start of Yarlini’s finance to cover a maternity leave. It intellectually challenged’, she says. investigation into suspicious deaths enable them to do this or support career in the NHS. ‘While there were was a steep learning curve, but was A solution presented itself in the (later dropped), which attracted them to find such opportunities.’ 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 NHS FINANCE 393 CAREER STORIES

CURRICULUM VITAE Name: Adam Sewell-Jones Job: director of provider term role working at the Queen been doing the work of a CFO but Employment history sustainability, Elizabeth Hospital NHS Trust (now not necessarily getting the credit Qualifications ACCA Monitor 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 Financial path to 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 a general role 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 Adam Sewell-Jones admits he had Healthcare NHS Trust gave him the what he thought he’d be doing. had been full of Teletubbies and the Wandsworth CCG was particularly accountant no plans to be an accountant while opportunity – looking after its learning ‘We were introducing the 12-hour Wheels on the Bus. But it was great attractive because it is the host of the he was at university studying maths disability and community services. maximum wait in A&E and there to be properly using my brain again.’ South West London Collaborative 1995-1999 Kingston and and statistics. The course had been A year later, the head of the trust’s were real hands-on challenges While the work was enjoyable, the Commissioning, with all six CCGs District Community a natural progression for someone separate management accounts in finding beds so that we could commute proved difficult and at the in the area working together to NHST, chief good with numbers, but he signed up department left and Adam added this meet the new target,’ he says. ‘It end of 2002 she moved to Kingston transform services so that they are accountant with no particular career in mind. role to his responsibilities. was really operational – lots of bed Primary Care Trust, again on a two- sustainable and provide high-quality 2002 Queen Elizabeth ‘Most people on the course were ‘This turned out to be quite management and firefighting – and day-a-week basis. The role initially care for patients. Hospital NHST, headed towards an accountancy significant – it helped me realise that not much time to focus on the focused on providing commissioning Yarlini particularly enjoyed working assistant FD career and lots of them wanted to managing the department was more strategic changes we were keen to finance support for learning on the estates modernisation work for the big firms,’ he says. ‘But interesting to me than being a finance progress.’ disability and mental health, but the consultation across mental health 2002 Kingston PCT, the thought of being an accountant manager,’ he says. The idea was introduction of the new GMS contract trusts in the area – ‘it is really various roles, inc didn’t excite me and I had no cemented when he added a business Work pressures important to create buildings fit for the assistant FD intention of pursuing it. In some manager role for a private patient unit Adam found it harder to switch off 21st century, so that patients are safe 2013 Wandsworth CCG, ways, I felt I was just going down this to his growing responsibilities. when he left work. ‘In management “Things are and make a full and speedy recovery’. head of finance route without any control.’ ‘It made me recognise that when accounts, there are pressure points When Kingston CCG advertised But then a family friend, working as particularly around the outturn where constantly for an interim CFO, Yarlini knew 2015 Kingston CCG, a finance director in the NHS, pointed people would work late and come in she had to apply. She secured the chief finance officer him in the direction of the NHS at the weekend,’ he says. ‘But you’d changing and job in January 2015 and since then national finance training scheme. go home and know that nothing was her appointment has been made ‘All of a sudden I realised that doing going to happen to the accounts until I really do permanent. Outside interests accountancy in something like the the next morning. She is optimistic about the future. As a mother of three teenagers, NHS, where the accountancy wasn’t ‘When you went home on a think that it is a great ‘Things are constantly changing and Yarlini says she has little free time. the end goal, could be exactly what I Friday night as general manager of time to be working in I really do think that it is a great time But she keeps fit by taking her wanted,’ he says. medicine, you’d be worried whether to be working in commissioning. dog for long walks in the Surrey With a massive oversubscription to the agency registrar would turn commissioning” At the moment, we are focusing on countryside and attends a regular the scheme in the year he applied, he up and, if not, what was going to co-commissioning, which will result pilates class. She also likes didn’t secure a place. But the seed happen. The 24/7 nature of the role in much needed changes to patient holidaying in Cornwall and France. was sown and he applied for and got was quite tiring, because I took provided Yarlini with an opportunity to pathways. It is essential so that the Favourite book A Town Called Alice, a trainee management accounting on a lot of the worry of it. When I immerse herself in the intricacies of local health economy is sustainable.’ Nevil Shute job at his local district general eventually moved on, my wife was primary care commissioning. Yarlini is just as clear about her hospital, Basildon and Thurrock quite relieved.’ As her children got older, she took contribution. ‘My role is to evaluate Favourite film The Godfather General Hospitals NHS Trust. While he’d actively looked to step on additional responsibilities and the opportunities, help to manage Best career advice ‘It is good to be It turned out to be a good decision. I moved again I wanted more away from finance, he wasn’t sure increased her hours – a flexibility the risks and make sure that the open and honest, but think before He liked his job and his day-release management in the role,’ he says. he was ready to turn his back on it she believes would not have been necessary governance frameworks you speak – I don’t always remember CIMA training, but what he enjoyed This next step took him back to completely. He was concerned that if possible in the private sector. ‘The are in place,’ she says. ‘It doesn’t to do this’ most was being in contact with Basildon as general manager for he spent too long away, his skills may NHS has treated me well and enabled always make me popular, but I think clinicians and general managers medicine. He admits he was nervous not be viewed as current. ‘I would like to me to develop my career alongside my colleagues respect that I am Alternative career from the outset. ‘My contact with of making the switch as all the other So he moved to University College have my own vineyard, but I’m not bringing up my children,’ she says. always open and honest.’ trainees in the big firms, whom I met general managers at the trust at the London Hospitals NHS Trust as sure that there would be enough By the time of the PCT’s demise She concludes: ‘When you become through studying, made me realise time had a background as senior finance manager for the specialist wine left to sell’ in March 2013, Yarlini was assistant a CFO the accountability suddenly their experience was rather different. nurses. However, his financial hospitals division. He says the scale director of finance. She helped to lead hits you. It’s a huge responsibility, They appeared to be kept away from management skills transferred well and complexity of UCLH – more than the establishment and authorisation but also a huge honour. I would clients at all costs.’ and the role worked out. His financial three times the turnover of Basildon of Kingston CCG. recommend working in NHS finance Having qualified, and recognising track record, supported by the – was a ‘real eye opener’ requiring ‘a It was at this point that Yarlini began to anyone considering a career in that the team at Basildon was pretty nursing background of his deputies, different type of leadership’. to think seriously about whether she accountancy. It’s not just about the stable, he decided he needed to look proved a good combination. It was also his first exposure to wanted to become a chief finance numbers; it’s about doing the best elsewhere to progress his career. A He stayed for two years, but admits a devolved financial structure, with officer (CFO). ‘I realised that I had for the patients.’ finance manager role at Redbridge that the job had veered away from finance managers embedded in 402 NHS FINANCE CAREER STORIES NHS FINANCE 413 CAREER STORIES Name: Justine Stalker-Booth

CURRICULUM VITAE Job: head of financial management specialised vommissioning finance, divisional teams – an arrangement month secondment to the SHA to Employment history NHS England he believes can present challenges help develop a patient experience Qualifications CIMA when finance managers have measure – this would become the national team 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, Full circle with 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 NHS England 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 Justine Stalker-Booth recently began accountant. Here, Justine had I received constructive feedback he applied ‘to see what happens’. involved establishing a programme 2000 Basildon and a new role as head of financial her first experience of costing by on my skills and behaviours, which After being offered the post, he management office and delivering a Thurrock General management for specialised supporting the medical staffing team were assessed against the company found himself ‘on a real learning turnaround plan. Hospitals NHST, commissioning finance in the NHS to cost the trust’s entire medical values. It was the first time I had curve’ supporting the organisation While initially viewed as a three-to general manager, England national team, which brings workforce. She moved back to been involved in this type of exercise through its early days as a first wave six-month role, further CQC concerns medicine and elderly her back to where she started. ‘It’s Colchester in 1990 and became and I realised the value of it for me foundation trust. Three years later, arose and it was a year before Adam 30 years since I joined the NHS and a directorate accountant leading personally.’ 2002 UCLH NHST, outgoing finance director Trevor returned to his job as finance director. finance manager in my new role it feels I have gone a team of four staff to support the It was while working at Capio Smith suggested he apply to be his However, with the appointment of full circle and returned to London to financial management of three Healthcare she realised how replacement. Adam was persuaded, a new chief executive and a focus 2004 Basildon and continue working in an organisation clinical directorates and a support dedicated and hardworking people but was surprised when he was on demonstrating sustainability, Thurrock University that I feel very proud of,’ she says. service. were, in the NHS and private sector. offered the job. Adam was asked to become deputy Hospitals NHS FT, Justine knew she wanted to work in Staying at the Colchester-based She says that it gave her confidence chief executive with responsibility for deputy finance finance. After completing her A levels, acute trust, her next role was in in the skills she had developed and running an ongoing transformation director which included studying accounting, costing. Justine improved the that we can sometimes be too self- “I didn’t programme. As part of this, he led 2007 Director of finance she went to see a careers adviser to way costing was done when she critical. Ultimately she missed the on performance management and and performance get ideas about what was next. NHS and planned her return. want to sit informatics and coordinated the trust ‘My sixth form work experience response to being put in special 2012 Deputy chief included lots of filing in St Mary’s Reaping the rewards in an office, measures under the Keogh review. executive Hospital eye department. I didn’t Justine admits her career has work on tax In August 2015, he moved to 2015 Monitor, director of necessarily want to work in not always been planned but her Monitor as director of provider provider sustainability healthcare finance despite my initial job changes felt right at the time. sustainability, as part of the connection to the NHS. But as my Working hard pays off, she believes, returns and never regulator’s plan to provide greater family have a history of working in and puts you in a good position when Outside interests see the light of day. levels of support to providers to the NHS, I guess it was inevitable.’ opportunities arise. address current service and financial Describing himself as a ‘keen She lived in Colchester at the time Changes in the structure of Doing something challenges. but ageing footballer’, Adam plays in and didn’t know where she wanted the NHS have led to several job He is convinced that, as an a Sunday league team and supports to work. The careers adviser gave changes. ‘Reorganisations in the that matters has accountant, there is ‘no better job Southend United. He plays the her a list of London-based vacancies. NHS can be tough though because than in the NHS’. ‘Right from the euphonium in and conducts brass She says: ‘I applied for jobs at the big the day-to-day focus changes, new been great” outset I knew I didn’t want to sit in an bands and sings both in choirs and accountancy firms, but the interview organisations office, work on someone’s tax return as a soloist. at Westminster Hospital was first.’ are established and people are and never see the light of day,’ he Favourite film Dead Poets Society Her application to Westminster worried about where their future may He remembers it as an exciting says. ‘The ability to do something that Hospital was successful and Justine be,’ she says. time. ‘There were still only a handful matters has been great.’ Favourite TV shows Gogglebox, moved to London. ‘I stayed in implemented a new system. This role Justine’s current role as head of foundation trusts and of FT finance He thinks the opportunity for finance Car Share and Match of the Day nurses’ accommodation and lived was to have a significant influence on of financial management in NHS directors and you really felt part of managers to help improve frontline Top three records Say Something in St Stephen’s Nurses’ Home,’ she Justine’s career in the years to come. England’s specialised commissioning something that was breaking new services will only increase in the Pentatonix; Carnaval, Wynton recalls. ‘I don’t think it exists now, In 2000, she decided to experience finance team came about as a result ground – piloting payment by results, coming years. ‘It is tough financially Marsalis; Etherwood, Etherwood but it would have been on the site of life outside the NHS and joined Capio of one such restructure. As she for example,’ he says. now and, if finance does its job well Chelsea and Westminster Hospital.’ Healthcare. She found her skills were explains: ‘I knew the finance director He adapted to the board role and supports people to do things Favourite website Twitter Justine really appreciates the start directly transferable to the new role and the role suited what I was quickly – helped in part by his general more efficiently, you will genuinely be Alternative career choice Doctor she had and the support she had in as a regional accountant working looking for next. I wanted to use my management experience – and having an impact on patients.’ her training role, which enabled her with two private hospitals. knowledge of NHS payment systems heeded advice about appointing the Drawing on his own career path, he to take day release to complete her ‘At the time, there was more focus and have the opportunity to work with right deputy, enabling him to focus on encourages finance managers to take ACCA qualification. on management skills in the private clinical staff to influence how the tariff strategy and scrutiny. any opportunities to broaden their She worked at Westminster sector,’ she says. ‘As a result I develops.’ In 2009, as part of a ‘stretch experience, through either Hospital for three years as a trainee received formal training, learnt more Moving roles hasn’t always been assignment’ for a strategic health secondments or service manager management accountant and and became a more accomplished as easy, however, and Justine recalls authority aspiring chief executives roles. ‘Time in operational roles can progressed in 1988 to St George’s manager. The training was really an early experience. ‘I moved to St programme, he organised a three- be absolutely invaluable,’ he says. Hospital London as a management focused on patient experience and George’s Hospital and after a couple 422 NHS FINANCE CAREER STORIES NHS FINANCE 433 CAREER STORIES

CURRICULUM VITAE Name: Paul Stocks Job: deputy director group finance of weeks, the finance director asked anxious to start off with, but if people Employment history – financial control, whether I was enjoying myself. They ask me nicely I don’t seem to be able Qualifications ACCA Department of said that whilst I was technically very to say no.’ It turned out that Justine’s Health 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 Firm focus on 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 joined-up finance 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 Paul Stocks is not entirely clear how after coming to the realisation that experienced working in local Healthcare NHST, variances – I was monitoring a £1bn and that wouldn’t be patronising. directorate accountant, his first job came about. He had been the chief finance officer and chief government and the NHS, he budget in East Anglia and the extra ‘The audience were really good and costing accountant planning to go to university to study executive weren’t going anywhere decided to add central government zeros really make a difference! afterwards the organiser described public policy but, out of the blue, he anytime soon, I started to look to his CV and joined the Benefits ‘Otherwise, I generally work with the room as buzzing while they 2000 Capio Healthcare, received a phone call from Doncaster elsewhere,’ he says. Agency as its head of financial service leads to understand how talked between themselves about the regional accountant Metropolitan Borough Council. In 1995, Paul became deputy planning. money is being spent, what we are NHS payment regime. They felt they 2003 Uttlesford PCT, ‘I don’t know how they heard about director of finance at Scunthorpe and The scale of the numbers involved commissioning and how services are understood how and why the NHS assistant FD me,’ he says. ‘But they asked me Goole Hospitals NHS Trust. Again, increased significantly with the new changing.’ pays for things and that it isn’t kept a whether I was interested in applying he was responsible for the day-to- job – he was responsible for planning She jokes that a lot more time is closely guarded secret.’ 2007 NHS Mid Essex, for a trainee position. They promised day management of the finance and budgeting for the agency’s spent on email communication now. The best advice Justine has been assistant director of to support my accountancy training department. He joined the trust just income of £2.5bn. given for her NHS career is to focus commissioning finance and, as I knew I wanted to work in as it was undergoing a period of But although he was still in the on the next steps. Justine has been 2013 NHS England the public sector, it seemed too good structural change – it was this that public sector, Paul missed health. “I am really able to work in different organisations East Anglia area team, an opportunity to pass by.’ attracted him. ‘There is something special about the and she recognises this has been an head of specialised Paul quickly knew he had made the NHS – it matters to people,’ he says. interested important part of her development. commissioning finance right choice. As part of his training ‘At the agency, I felt too removed ‘Having worked in hospitals, I have at Doncaster MBC, he spent time from the frontline and from the people in the NHS a really good relationship with my 2015 National team, head of in different departments, including we were trying to help. I thought that provider colleagues and feel I am a financial management payroll and internal audit. It gave him perhaps being a civil servant didn’t vanguard better commissioner’ she says. specialised a good grounding and a thorough suit me. But I decided to give ‘I’ve worked with one finance commissioning finance understanding of all aspects of local it another go and applied for a job programme. There director across a number of authority finance. During his time at with NHS Estates.’ organisations who has had a Outside interests Doncaster, he passed his accounting Paul started working at NHS is the opportunity to significant influence, initially by Justine is a keen darts player, and technician and CIPFA exams. Estates – which was an agency of be part of something guiding and encouraging me. I was the ladies singles champion for After eight years – which ‘flew by’ the Department of Health – in 1999, given a chance to learn and I now clubs in Colchester. She enjoys the – Paul decided he should widen his as deputy director of finance. Straight that makes a real always try to give people the best social side and plays darts with her experience and he applied for, and away he felt more at home. chance to develop. You have to play partner a few times a week. When secured, the job of chief accountant difference” a role in any team and can achieve not competing herself, she supports at the neighbouring local authority, Estates frontline so much more than working as an Essex Cricket Club. Selby District Council. ‘The organisation was very frontline individual. I was encouraged to join Paul recalls starting the new post. facing,’ he says. ‘There were two ‘When I first started working, there the HFMA’s national tariff group and Favourite film August Rush ‘The change was mindblowing. key parts to the agency’s work. were no personal computers. I still have met lots of different people Favourite book PbR Guidance; I was responsible for the day-to- The first was the policy aspect of prefer to speak to people and make working together and learning by The World According To Bumble; day management and control of ‘It was an opportunity to reform NHS estate management, working sure I use technology effectively.’ sharing issues and solutions.’ Start The Car, David Lloyd the accounting, payroll, payments, the finance function and to make with the Department of Health. There There is so much happening in the Justine has some advice for those housing benefits and administration sure that we had the right systems in was also a commercial aspect to the NHS Justine is excited about. ‘I am considering a career in the NHS. Favourite TV shows Pointless and functions,’ he says. ‘I went from place,’ he says. role, which involved working with really interested in the NHS vanguard ‘Sometimes it can be hard to break Holby City having no staff to having 24. It was A difficult financial position meant NHS organisations and advising programme. There is the opportunity into the NHS, but I think it is more Top three records Baker Street, a shock at first, but before long I that Paul’s focus was on ensuring the them on how to make the best use to be part of something that makes about skills than the history’ she says. Gerry Rafferty; How Soon Is Now?, realised I was really enjoying myself.’ trust returned to financial balance. He of their estates. a real difference, where clinical ‘When I’m interviewing, I look for The Smiths; Keep The Customer It was at Selby that Paul believes did this by building effective working ‘My role covered the financial considerations of how we work and transferable skills. There are often Satisfied, Simon and Garfunkel he really started to develop his relationships with clinicians and aspects of our policy work and, the financial considerations of how we internal candidates who are very management skills. ‘I focused on heads of departments and working again, managing the day-to-day pay for it are brought together.’ strong, so to break in you need to getting the right people into the with them to identify areas where running of the finance department. Justine is clear about the work accentuate how your skills and right roles and on supporting their efficiency could be improved. He also I was also responsible for human she is most proud of. ‘I was asked experiences are relevant. I’d definitely development,’ he says. instigated a programme of finance resources and information to deliver a session on the national recommend a career in NHS finance. After four years in the post, Paul training for non-finance staff. technology. It was really useful to tariff to 60 GPs during the transition to It’s incredibly rewarding and you get decided to look for his next role. ‘I Five years later Paul was looking broaden my skill set beyond finance. clinical commissioning groups. I was to work with so many great people.’ really enjoyed myself at Selby, but for his next challenge. Having I was happy to be working in health 442 NHS FINANCE CAREER STORIES NHS FINANCE 453 CAREER STORIES

Name: Ray Thomas CURRICULUM VITAE Job: assistant chief finance officer, Countess of again and I realised that I was suited and introducing a learning and Employment history Chester Hospital to being a civil servant.’ development culture. CIPFA Qualifications NHS Foundation In 2002, Paul made the move to Paul sees the experience he 1981 Doncaster MBC, various Trust 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 In touch with the 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 technical side 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 Ray Thomas joined the NHS from moved house around the same were challenges: the trust was in involved collating and reporting accountants, so if you are working at 1998 Benefits Agency, head the private sector and has worked at time and I wanted a better balance a turnaround situation at the time performance information from the the department you need to develop of financial planning the same trust for 17 years. between my work and home life.’ The and I had to get involved early on to strategic health authorities. the skills yourself or surround yourself 1999 NHS Estates, deputy FD At university Ray studied challenges of spending time at work, ensure the trust had sufficient cash to ‘While it was still about reporting with people who can write well.’ mathematics and, following his having a new baby and settling into continue operating.’ numbers, it was very different Paul’s current role could be seen 2002 Department of Health, degree, he wasn’t clear on his next the new house prompted Ray to look Changes to the structure saw Ray from working in finance,’ he says. as one of the most challenging in corporate affairs head of steps. ‘I enjoyed myself at university for a different role. take on additional responsibilities. ‘It was a bit scary for the first few healthcare finance. As deputy director finance and business and spent a lot of time socialising’ ‘There was a job advertised at ‘I worked for a deputy director of months. Leadership and stakeholder group finance – financial control, he planning he says. ‘When I graduated I didn’t the Countess of Chester Hospital finance, who later became the management were the skills I used oversees financial management and 2003 Strategy and business want to be an actuary like many of NHS Trust,’ he says. ‘It is my local director,’ he says. ‘She tweaked the reporting across the Department – head of finance my classmates and I faced a shock hospital and where my children were organisation structure to remove that’s more than 400 bodies, revenue that I had to grow up and get a job. born. I knew the care there was the deputy role and I took on “Spending budgets of £110bn and capital 2005 Head of performance The next natural step for a maths excellent and I wanted to build on responsibility for financial systems.’ budgets of £4.8bn. And 2014/15 was reporting and system design graduate seemed to be a career as my good experience on secondment time outside a particularly challenging year. 2007 Deputy director group an accountant.’ previously at the Cardiothoracic Changing roles The job might seem removed finance – financial Ray took a training role at Deloitte Centre.’ Ray became assistant director of the finance from patient care, but some of management and partnering Haskin & Sells in Chester. It was finance for financial services and Paul’s work is directly relevant. He a small regional office of the firm systems (later retitled assistant chief department was recently involved in setting up 2014 Deputy director group and had the training culture of a finance officer) and recruited his financial arrangements to support the finance – financial control big accountancy firm. Shortly after successor into the chief financial and out of your treatment of ebola, working closely joining, the regional office was sold accountant role. Supported in comfort zones really with the Ministry of Defence. Outside interests as part of an organisation-wide the day-to-day activities, he was Paul has also taken part in the Paul spends much of his spare rationalisation. ‘Our office became able to focus on developing and does help with your initiative to reconnect civil servants time as a taxi service for his three Conway & Co,’ he explains. ‘But implementing a new e-procurement in the Department with the frontline daughters, but he likes socialising despite things changing, the new system, which he describes as one of development” of health and social care. He spent and watching football and is a keen organisation still had links with the the highlights of his career. five days working in an accident and supporter of Sheffield Wednesday. large firms and access to training.’ ‘I was helping design a new system emergency department. Ray completed his ICAEW studies with the developer of our financial most. Spending time outside the ‘It was a reminder about what we Favourite book McCarthy’s Bar: A and joined another local firm as ledgers. Other large enterprise finance department and out of your are here for,’ he says. ‘Connecting Journey of Discovery in Ireland, Pete an audit manager. ‘I joined Hacker system developers offered something McCarthy; CAMRA Good Beer Guide comfort zones really does help with with clinicians and managers helps Young in 1992 and worked there for Ray Thomas, right similar but it made sense to develop your development.’ you to see the challenges they face Favourite film Brassed Off; a few years until I moved to KPMG,’ our own integrated solution for our After a couple of years, Paul and how the work we do has an Life of Brian he says. ‘At KPMG, I worked in the financial ledger,’ he says. returned to the finance directorate to impact on them. I’d recommend owner-managed business practice Ray joined the trust as the ‘Our new e-procurement system ; lead the finance business partnering finance staff do something similar Favourite TV show Blackadder before moving into corporate chief financial accountant with was implemented at the trust and

function, as well as financial planning – it really does give you a different Match of the Day transactions.’ responsibility for financial reporting. shared by the developer with other and budgeting across the Department perspective.’ Top three songs That’s Ray’s first experience working in ‘The role was particularly attractive NHS clients. There is no doubt our and its arm’s length bodies. Paul may not have started his Entertainment, The Jam; Trampled the NHS was on a secondment from because of its technical nature. procurement improved and it set a A serious illness in 2013, however, career with a plan, but he knew he Underfoot, Led Zeppelin; Hope KPMG to the Cardiothoracic Centre It suited my experience and my course for continued improvement.’ resulted in Paul taking three didn’t want to take the same route as Street, The Levellers in Liverpool. ‘It was a small and well introduction was spent bringing The trust was successful in its months off work and gave him a his class mates. He grew up in a run centre. I took an operational a number of controls checks and foundation trust application and Something chance to take stock. On his return South Yorkshire mining village, where Alternative career role for six months and it was really reconciliations up to date ready for became one of the first 10 in the football-related or a politician to work, he had a shift of focus a large majority of his school friends interesting. I could see the benefit the preparation of the final accounts.’ country. Ray saw his skills play a key and worked on the Department’s went to work in the pits. Even then, to the community and the intangible Ray describes the transition to the part in the application process. ‘Cash financial management improvement he knew qualifications and ambition benefits of working in the NHS.’ NHS as straightforward. ‘The people was king,’ he says. ‘The long-term programme. It involved looking at would give him choices. ‘You always Ray returned to KPMG but not for working at the trust were brilliant and financial strategy challenged us to the way finance was delivered in the need to be in charge of your own long. He and his wife had just had very supportive. This continues to set out what our future financing Department, re-engineering some destiny,’ he says. ‘Be proactive and their second baby, as he explains. be my experience working across requirements were. At this time, the processes, improving the capability don’t just let things happen to you.’ ‘It was a very busy time for us. We the NHS more widely. But there NHS had not been used to thinking 462 NHS FINANCE CAREER STORIES NHS FINANCE 473 CAREER STORIES

CURRICULUM VITAE Name: Alison Tonge Job: NHS England (North), about cash in this way, as much of benefits to the trust from improved Employment history regional director the focus had been on the bottom procurement but these come at a Qualifications FCA of specialised line. There was a perception of a price. The challenge in my role is to services 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 Letting numbers 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 tell the story 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 Alison Tonge’s life was changed by pieces of work, such as the private ‘It has the same challenges and for the NHS. He says keeping his deteriorated in recent years. ‘The trust Cardiothoracic a book, leading to a career in NHS finance initiative, capital development issues, so you can transfer your professional competence up to plans to play its role in transforming Centre in Liverpool finance, general management and and writing business plans. experience and knowledge from the date is essential. ‘There are a large the local health economy. We healthcare commissioning. ‘I went ‘I was interested in the numbers NHS. However, it is really important number of NHS training courses are projecting a financial deficit. 1998 Countess of to sixth form to do archaeology and telling the story – and still am. to understand the context. Canada available and, more recently, Future- Working with the council, CCG and Chester Hospital languages and I hated it,’ she says. ‘I For me, it’s about using financial is a massive country – you can’t Focused Finance [FFF] has played community trusts, there is a desire for NHS FT, chief was some way into my A-levels, but I information and knowledge to make assume a change that works in one a role. The NHS finance profession stabilisation (sorting out the deficit) financial accountant decided to change tack.’ improvements.’ area will work in another.’ has a good reputation and there and transformation (taking the longer and assistant She bumped into a business Commissioning fitted well with On Alison’s return to the UK, are great opportunities for personal view of service development). My director of finance/ studies teacher, who gave her a these interests and she worked in she went back into commissioning development. FFF builds momentum challenge is helping the trust manage chief finance officer book on Keynesian economics. ‘I several primary care trusts. ‘I was organisations, arriving in her current its short-term financing requirements got hooked on understanding how working in providers on big strategic role – NHS England (North) regional as well as investing in the future.’ Outside interests things work in the economy and then projects and when commissioning director of specialised services Ray sees effective treasury Ray enjoys cycling and achieved one went down the road of business, came along, it felt like it was a good commissioning – early in 2015. “There management and investment in of his childhood ambitions when he economics and law at A-level.’ fit,’ says Alison. There, she leads a team of three the correct projects as the key to bought a Dawes ultra galaxy touring From there, she studied economics operational units, with a budget of are great maintaining quality of services. bike to ride to work. He describes at university, and retains an interest £4bn and 90 contracts. opportunities ‘Carrying on as we are won’t fix the himself as a gadget freak and drives in the subject to this day. Local ‘It’s an opportunity to improve deficit,’ he says. ‘If we under-invest an electric car, which he says is the government offered the best way to quality and equity by improving now, we risk making the situation best gadget he’s ever had. apply her economics degree, she access for patients. At the same for personal worse. We have invested in a decided, and she got a job as a time, we have massive financial development. FFF number of modern wards and new Favourite film Shaun of the Dead trainee accountant at Manchester issues to deal with in specialised departments that really add value Favourite book Daemon by Daniel City Council, studying for the CIPFA commissioning,’ she says. ‘It’s builds momentum for to the patient experience, maintain Suarez qualification. innovative work – which I like – service quality and help control improving the offer to the public and improvement” infection. Investments like these are Favourite TV shows The Walking Heading to health patients by achieving better access an opportunity to generate a return Dead She moved to health in 1987, first and better value for money in a for the patient, rather than simply Top three records The Rake’s Song, with the regional health authority as sophisticated way. Delivering both of increasing the cost base.’ The Decemberists; Scare Away the a financial planner, then to North these motivates me.’ for improvement on the platform Ray also sits on national technical Dark, Passenger; 36D, Beautiful Manchester Health Authority as a Many colleagues have influenced that already exists.’ issues groups to influence the South financial accountant. her. ‘I try to seek out people who I As assistant chief finance officer, direction of the NHS finance With the introduction of the can learn from. Things stick in your Ray’s role involves much of the profession. He is a founding member Favourite food Reasonably spicy purchaser-provider split and NHS ‘Commissioning as we know it mind – phrases or approaches to day-to-day leadership of the finance of the HFMA Foundation Trust curry trusts, she shifted to the provider doesn’t exist anywhere else. The meetings. One colleague told me department and ongoing system Finance Technical Issues Group – a Alternative career Architect sector in 1990. For the next eight nearest thing everywhere you go to go into meetings with trust rather development. For example, his role key forum during the development years, she was deputy director of is to do with strategy, performance than mistrust – the more I look back involves aligning the trust’s system of the foundation trust regime. He is finance at Stockport Healthcare NHS and planning – I’ve always worked in on it, the more I see how right he development to the Department of also a member of the Department Trust, setting up and managing the these areas.’ was. Health’s e-procurement strategies. of Health Bodies’ Accounts Liaison new organisation’s finance function Nevertheless, between 2009 ‘People teach you things and often He says: ‘Changes to national Group, where issues affecting annual and leading on a first-wave private and 2012, Alison served as executive they don’t know they’re doing it. For strategies will have an impact on how accounts are discussed, as well finance initiative scheme. vice-president, strategy and me it’s usually the way they approach we work as a trust. I have to consider the NHS Pension Scheme Advisory A two-year spell in consultancy performance, at Canadian integrated things rather than knowledge – how the implications of a potentially large Board, which considers how the at SECTA/Tribal followed. ‘From care provider Alberta Health they tackle issues with personal systems upgrade to ensure we can pension scheme operates. early in my career, I worked on Services. Despite the nation’s lack resilience and knowledge.’ continue to work with our suppliers. ‘It’s a great way to help the NHS at strategic initiatives and, going into of familiarity with commissioning – Alison says the best piece of career ‘We are a member of the cohort a national level,’ he says. ‘My trust consultancy, I was involved in issues ‘they would not know what you advice she has been given is to work of 22 involved in the Carter review benefits, as the issues we discuss are such as service change. I’d always were talking about’ – she was outside your comfort zone. ‘When I of procurement and efficiency in relevant, and it helps my continual been interested in the bigger picture able to bring a range of skills and worked in consulting in particular, I the NHS. There will be financial professional development.’ and making changes through specific experiences to the job. was amazed by how much you can 482 NHS FINANCE CAREER STORIES NHS FINANCE 493 CAREER STORIES

Name: Richard Wheeler CURRICULUM VITAE Job: director of finance, Employment history East Midlands learn very quickly. I always tell people happened during her time at Ambulance now that if you are going into a job Stockport PCT. ‘I worked with Qualifications CIPFA Service and feeling comfortable it’s probably the doctors on a forerunner to 1990 Stockport Healthcare NHS Trust 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, A path of support 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 and innovation 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.’ Richard Wheeler always wanted a ‘There was a lot of money available his next opportunity. Richard and from that comes a development 2002 Stockport PCT, director professional career that gave him at the time for the right projects was attracted to the NHS by the opportunity.’ Patient focus of finance and estates the opportunity for further study. After and we were involved in many diverse range of organisations and Alison singles out three major Alison has recently been involved in 2005 Deputy CEO completing a degree in mathematics, different activities,’ says Richard. services it provides. He also had a career achievements, one of which projects that will have a direct impact he embarked on a path to become an ‘For example, we managed land and desire to improve business practices is coming back from Canada and on patients’ lives – solid accountancy 2007 NHS North West, exec accountant in the private sector. Now property and supported education and put the NHS onto a better re-establishing herself in the NHS. work on patient pathways and director, health system director of finance at East Midlands services, creating a regional identity financial footing. location of services. She has and development Ambulance Service NHS Trust, he working with the tourist board.’ He became head of finance at helped develop new collaborative 2009 Alberta Health Services has a track record of developing He sees another success during his Leicester, Northamptonshire and “Moving to commissioning structures across (Canada), executive VP, services and supporting innovation. time with the agency as renegotiating Rutland Strategic Health Authority the North of England and taken a strategy and performance Richard started work in 1989 at a change to a VAT methodology that (SHA), where he gained a good lead role nationally in developing Rawlinsons Chartered Accountants, resulted in a £1m repayment. understanding of the NHS and Canada and and supporting collaborative 2012 NHS South East London a small firm in Peterborough. His The agency had a track record developed an overview of what was being able commissioning partnerships. Cluster, finance director clients were mainly small to medium- for embracing technology and its going on in the area. She is also leading the 2012 NHS England (Cheshire sized enterprises, private companies financial system was doing a lot more to apply my development of a strategy and Warrington and Wirral, and their subsidiaries and housing FD ambitions service review programme for the North West Specialised associations. ‘Despite the great He used this role to start the knowledge is an North and with a national group. Services), area director/ training I received, which enabled me transition to becoming a director of Having worked inside and outside director commissioning to pass my ACA exams and become finance. ‘At the time, there were a achievement. People the NHS, in the private sector, in an audit manager, I couldn’t see my lot of mergers and changes to the commissioners and providers, in 2015 NHS England (North), long-term future as an accountant structure in the NHS, which reduced still contact me now finance and general management, as regional director of within a firm,’ he says. the number of job opportunities about work I did” well as in another healthcare system, specialised services In a competitive job market, available to me,’ he says. ‘Also, she has a perspective that is rare. From NHS England (West Richard became finance manager adverts seemed to require 20 years’ ‘Outside the NHS, it’s less about Nov 2015 Midlands), director of at Isle College Further Education NHS finance experience. I knew my the constraints of governance; it’s commissioning operations Corporation. The college had just skills were transferable and arranged ‘It could have gone wrong. I didn’t all on delivery and achievements. transferred from being under local for an existing director of finance to plan anything and thought I would You learn a lot about the importance Outside interests government control and Richard be my mentor.’ do some contract work, but I knew I of delivering to a timescale and Alison enjoys spending time with her spent six years there, eventually Richard’s work at the SHA wanted to join the service again and cost to meet clients’ expectations. family and hiking and yoga. as finance director. ‘We grew the strayed into education, where he start contributing. It has been a hard In contrast to that, in the NHS business to about £6m turnover,’ was involved in medical, nurse slog and I think I’m not quite back to delivery isn’t always the number Favourite film Groundhog Day he says. ‘The college operated in and undergraduate education and the level where I left.’ one thing – there’s also relationship Favourite book A Short History of a small, rural and deprived area, training. ‘We worked with universities, Not that she regrets her time management, politics with a small p Nearly Everything, Bill Bryson so we knew it was important to the university hospital trusts and in Canada. In fact, she sees it as and long-term collaboration.’ local community. Young people who than Richard had seen happening in education confederations [similar Homeland, 24 another of the top achievements in Alison may have moved away from Favourite TV shows had attainment below the national other organisations. to today’s local education training and Would I Lie To You? her career. ‘Moving to Canada and day-to-day NHS finance, but she average when they joined were ‘Budget holders had access to boards] to establish undergraduate being able to apply my knowledge believes it is important for all Top three songs My Aim Is True, leaving with excellent qualifications.’ financial information that was run in programmes,’ says Richard. and be successful is an achievement. managers to keep services to patients Elvis Costello; New York, New York, There were lots of challenges along real time and operational managers ‘Our university partner described People still contact me now about in mind, no matter how far from the Frank Sinatra; Rolling in the Deep, the way, which gave Richard good were able to make updates directly us as leading the country in what work I did there,’ she says. front line of care. ‘You are three steps Adele problem-solving experience. They in the system,’ he explains. ‘This use we were setting up. There had been ‘In the end, my post was back from the service change, but also helped him move to his next of technology gave us the platform little work in joining up finance and Favourite food Thai – and my restructured and I didn’t have a you have to get that reassurance that role as East of England Regional to have confidence in the financial outcomes before.’ husband’s wonderful lasagne role there. That could have been a what you are doing helps – that it’s Development Agency’s head of decisions we were making and the In 2006, Richard moved to East setback, but I am proud of myself for pushing us forward rather than Alternative career Lawyer finance. The agency was a start-up projects we invested in.’ Midlands SHA as deputy director not letting it set me back. I always try dancing around or outside of it. You formed from different government When the organisation of finance. He describes it as to take the positive out of things and have got to ask people, “Is this agencies. Located in a new building, restructured, the finance director transitioning people and bringing have kept my network over there.’ helpful?” Sometimes bright ideas do the revenues grew from £30m to moved on and Richard covered the two former organisations together A third standout career point not reflect what’s needed.’ £105m in five years. role for six months before looking for into new business premises. The 502 NHS FINANCE CAREER STORIES NHS FINANCE 513 CAREER STORIES

CURRICULUM VITAE Name: Robert White Job: health director (value organisation experienced a period changes complicated the production Employment history for money audit), of instability but Richard was able to of the accounts, but they were Qualifications FCA National Audit focus on the opportunity for change. successfully delivered on time. Office 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 The right gear to 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, make a difference 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. A career in management and finance found healthcare roles, initially in mental health, learning disability Regional Development to work across organisations for I’ve worked with really good finance always interested Robert White. in Wimbledon and then central services, regional rehabilitation, Agency, interim FD and bigger economies of scale and we directors and have a good personal head of finance And it quickly became clear that London as financial controller of a general acute, teaching hospitals supported others to do so as well. network to take advice from.’ healthcare was where he was to private hospital offering general and and supporting commissioning and This led to nine out of the 10 PCTs in Richard made the transition to 2005 Leicester, pursue it. However, having grown specialist services. primary care at a health authority the area transferring services to SBS, director of finance and sees the Northamptonshire and up in the Canadian province of It was here he became aware level. For 10 years he was on the as well as a number of trusts.’ mentoring support he had from a Rutland SHA, head of Saskatchewan, it wasn’t initially of the growing opportunities in the board of Midtech Innovations, the Part of Richard’s time at East successful chief executive as key. finance obvious he would spend the vast NHS’s emerging internal market. He intellectual property hub for the NHS Midlands SHA was spent on He has seen an interesting change 2006 East Midlands SHA/ majority of his career in the NHS. took advantage of these in 1992, in the West Midlands, and spent a secondment to United Lincolnshire in his working pattern since 2014, Midlands and East SHA Being the offspring of a finance joining Southmead Health Services similar amount of time on the HFMA’s when he became director of finance Cluster, deputy director director and a matron may have had NHS Trust in Bristol as senior finance national Financial Management and at East Midlands Ambulance Service of finance SHA Cluster an influence on his choice of career, manager. Part of the attraction was Research Committee. He also found NHS Trust. ‘I have responsibility for but Robert declared his healthcare the potential to further his career – time to complete a masters degree in “When I can I finance, procurement, logistics and 2011 secondment to United ambitions at the University in even at this point, he had his sights accounting and finance. estates,’ he says. Lincolnshire Hospitals Saskatoon, one of the province’s two set on a finance director role. ‘I could Robert says he has learnt from get out of the ‘Ambulance service staff are on the NHS Trust, associate major cities. He chose a healthcare some influential leaders. Stephen office, riding road most of the time and it can be a director of finance administration major for the last two Day (former HFMA chairman) and challenge to catch up with people. I 2012 Oxford University years of his bachelor of commerce Steve Webster (former HFMA finance out with prefer to speak to colleagues rather Hospitals NHS Trust, degree. He even set up, and became director of the year) were both in than wade through emails, so when deputy director of finance president of, the business school’s Bristol when he started (and on his ambulance crews I can I get out of the office, including healthcare administration society. interview panel). He later worked with riding out with ambulance crews and 2014 East Midlands His first job saw him become Mark Britnell and Peter Shanahan at and visiting premises visiting our different premises to keep Ambulance Service NHS general manager of a continuing University Hospital Birmingham. And in touch with life at the sharp end. Trust, director of finance care organisation, which involved he also singles out John Adler, his to keep in touch with ‘My office time is spread across the ‘doing everything but the healthcare’. chief executive at Sandwell and West day-to-day financial operations and Outside interests He feels lucky to have had early Birmingham Hospitals NHS Trust. life at the sharp end” catching up with projects with the Outside work, Richard spends experience of working closely Having seen leaders successfully team, maintaining relationships with time with his family. A keen cyclist, with clinical staff, residents and distinguish between the issues auditors and regulators and working he enjoys the Tour de France and relatives and, more widely, with and programmes that require their Hospitals NHS Trust as an associate with my executive colleagues.’ mountain biking with his son. the department of health and trade direct input and those that can be director of finance. ‘It was a great Looking back, Richard says: ‘I have bodies. delegated, Robert has attempted to opportunity to work in a provider seen my level of experience increase Favourite film A fistful Of Dollars ‘Everything’ also included preparing put this into practice himself. organisation,’ he says. ‘I had a good and I have a much greater awareness Favourite book Anything by James the year-end accounts, a task made From Bristol, Robert moved to knowledge of the sector from my time of what to focus on, how to measure Patterson easier after he installed an integrated see a significant career progression Barnet Healthcare NHS Trust as at the SHA and this role gave me an the real impact of things and whether accounting system to replace the opportunity in the NHS,’ he says. deputy finance director for three opportunity to apply my experience they really are a big issue. Favourite TV shows Football on paper-based ‘books’. It was during He admits it took a while to settle years before taking the same role in differently and improve the business ‘There is a lot of excellent support BT Sport and Suits this role he started studying towards into the service, with its unique Solihull Health Authority, moving up activities of a provider.’ and advice for finance staff working in Top three records Closer, Joy his certified management accountant language and, most significantly, to acting finance director. In his next role, at Oxford University the NHS – Future-Focused Finance Division; Under The Iron Sea, Keane; qualification, which he finished in its high degree of central direction Hospitals NHS Trust, Richard was aims to build a platform and develop Diamond Life, Sade the UK – proving his dedication with – something he hadn’t experienced Scaling up named HFMA Deputy Director of the role of the finance team. It’s good flights home for exam preparation in the independent sector. He In 2000, he joined major teaching Fish and chips Finance of the Year 2012, partly in to have this support network across Favourite food weekends! The recent unification of remembers a number of accountants hospital University Hospitals recognition of completing the 2012/13 multiple organisations. Building up the three main accountancy bodies in were making the switch from the Birmingham NHS Trust (UHB) as merger accounts of Oxford Radcliffe contacts is a great way to know who Canada has created a new chartered private sector to the NHS at the time head of financial management and Nuffield Orthopaedic Centre. to talk to and get advice on how to professional accountant designation, and that not all of them could adjust. and planning. He became finance This was the only trust merger approach aspects of our work – there so he is getting used to being ‘R Robert was advised to get as director in 2003, leading on finance, in that year – a complex year with is a terminology, structure and culture White, CPA, CMA’. much experience as possible of all contracting and procurement. technical accounting changes taking to the NHS that can take time to learn With ties to the UK, an opportunity parts of the service. He has taken This was a big shift in organisation place alongside the merger. The when you first join.’ to relocate overseas arose. Robert this to heart, working over the years size. At close to £400m turnover (at 522 NHS FINANCE CAREER STORIES NHS FINANCE 533 CAREER STORIES

CURRICULUM VITAE Name: Kate Whiting Job: Finance director – specialist the time), UHB was one of the biggest pilot for the new PF2 funding scheme Employment history medicine, Central trusts in the country and was in the and was approved to proceed by the Qualifications Chartered Manchester NHS first cohort of teaching hospitals to NHS Trust Development Authority Professional Accountant (Canada) Foundation Trust 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. Manufacturing a 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 career change payment by results, new flexibilities of its financial deficit was his most 1994 Barnet Healthcare and regulatory requirements. But the notable work-related achievement. The finance profession was always I didn’t want to become like that Adelphi was a fantastic experience NHST, deputy trust was also in the throes of working The trust’s £5.7m deficit in 2005/06, director of finance on the cards for Kate Whiting. A myself,’ she says. and I could have stayed there for up a major capital project, financed his first year, was to be its last in career advisory questionnaire at Attracted by the idea of working ever, but I felt I needed a new under the private finance initiative, to his stay at Sandwell and all support 1997 Solihull HA, deputy school identified accountancy as for a smaller company, in 2002 challenge,’ she says. So when build a hospital that would open as loans were repaid. ‘We had some director of finance – the profession for her, based on her Kate joined the Adelphi Group – a Kate received an email from CIMA the new Queen Elizabeth Hospital in external assistance to identify the acting finance director aptitude for mathematics and desire medical communications agency about job opportunities in the NHS, 2010. problem areas and were told we were 2000 University Hospitals to earn a good salary. This led to her whose primary role is to support she thought seriously again about In 2005, staying in the West inefficient everywhere. The upside Birmingham NHS FT, studying accountancy and finance pharmaceutical companies with working in healthcare. Midlands, Robert moved to was that it became everyone’s issue head of financial at university, and six months before market research and bringing new She saw an advert for a divisional the £435m Sandwell and West to resolve,’ he says. management and she graduated she started to think drugs to market. ‘There were only accountant at Salford Royal NHS Birmingham Hospitals NHS Trust as In 2014, the attraction of working planning; director of seriously about what to do next. 600 employees and at the time it Foundation Trust and applied straight in a national capacity drew him finance She researched the prospect of felt like my career moved from one away. She was attracted by working to the NAO, but he could also working for one of the large audit extreme to the other. What really in the public sector and fulfilling her see that the work would sustain a 2005 Sandwell and West firms but decided industry was the attracted me was the opportunity to passion to make a difference. Robert connection to health and social care Birmingham Hospitals way to go. It was at this point she first have a much broader role to expand believes services as well as with NHS finance NHST, director of considered the NHS. ‘I could see the my skills,’ she says. New chance to flourish professionals. finance and real benefits of being an accountant As well as being responsible The culture at Salford enabled being asked He believes the NAO has a major performance in the NHS and being part of an for the traditional aspects of Kate to flourish. ‘The flat structure part to play to support the NHS in management organisation that had an impact on meant that there were always new to lead meeting its challenges through the 2014 National Audit Office, people’s lives, but at the time the opportunities for the finance team. If influence and authority drawn from director, health NHS training scheme professional there was a project going on, people projects outside his its independence. He points to its body of choice was CIPFA. At that were encouraged to put their hands autumn 2014 reports on Public Health Outside interests stage, the risk of limiting my career up and get involved. The divisional area of expertise England’s grant to local authorities A keen cyclist, on and off road, choices to the public sector was too accountants were involved in key created opportunities and the financial sustainability of NHS Robert competes in the occasional big,’ she explains. developments as well as monthly bodies as important early outcomes sprint triathlon. He plays tennis – his Straight after graduating, Kate management accounts’ she says. to learn new skills in his new role. ‘It is a privilege to double-handed back hand is a work began to work for ICL, which was A highlight for Kate was leading work for this organisation and I fully in progress. ‘It’s an age thing’ he later acquired by Fujitsu Services. the financial work on the creation appreciate the responsibility to uphold says. He supports a local Scouts ICL was a large British computer of Salford’s urgent and emergency its high standards.’ group as treasurer, despite his boys company that manufactured care village. ‘Working with clinicians, director of finance and performance Robert insists that continuous having long since left. hardware, developed software and managers and commissioners to set management, where he was to development is vital for NHS provided professional services to a up the village was a privilege and stay for more than eight years – a accountants. He says he can still Favourite book The Last Crossing, wide range of clients. As a graduate seeing it up and running was a real result of being part of a ‘well-led remember key moments, such as Guy Vanderhaege trainee, she spent six months in thrill,’ she says. stable senior management team being urged to realise his potential, Favourite TV programme a variety of finance roles. As Kate In 2011, the FT took over with a shared objective to modernise along with other delegates, at the The Thick of It recalls ‘while the ICL training scheme management accounts, Kate also responsibility for providing community healthcare services in the area’. HFMA Fincare campus in 1993 by was a great grounding, the perks led on negotiation of client contracts. services in Salford, which increased His experience of the UHB PFI then NHS Executive finance director Favourite meal Pasta puttanesca were nowhere near those of the NHS ‘It was great experience. We didn’t the size of Kate’s portfolio. It also project was to stand him in good Gordon Greenshields. He also Alternative career choice Brewing scheme. All the studying happened at have a legal team, so I dealt with any coincided with Kate having her stead – Sandwell had already started says being asked to lead projects real ale weekends and I only had time off to contractual issues, including drafting daughter and taking maternity leave. on a journey towards its own new outside his area of expertise created take the exams.’ contracts, negotiating with clients, On her return, there was some hospital, the Midland Metropolitan opportunities to learn new skills. By 2002, ICL’s turnover was £1bn agreeing confidentiality and non- restructuring within the team, which Hospital, replacing two district general Over his career, he has become and it employed more than 20,000 competition clauses. meant that Kate’s old job no longer hospitals. After a strategic business convinced that meeting service and people. Kate began to feel like a ‘It was the first time I’d done existed and she was given a different case assessment in 2006, there were financial challenges is best done very small cog in a big wheel and something other than pure role – senior business accountant, significant revisions and then a pause collaboratively across whole health was getting little job satisfaction. accounting and I loved it!’ she projects and corporate. while the PFI process itself was systems – and this is where financial ‘Our purpose was clear, but there remembers. It was a promotion that Kate did subject to national review. staff have an opportunity to make a was very little passion from the staff. After six years, Kate started to think not want at that time. ‘I felt that I The scheme came out of this as a real difference to patient care. People just saw jobs as jobs and about making a move. ‘Working at would be one step removed from 54 NHS FINANCE CAREER STORIES NHS FINANCE 55 CAREER STORIES

CURRICULUM VITAE Name: Paul Williams Job: research manager, the divisions, and working with them opener. ‘I can’t explain how hard it Employment history HFMA 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 Finding the right 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 chemistry 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 With a degree in chemical people. I thought it really represented the transactional elements of the trust-wide projects, such as the There were positives. Kate engineering, Paul Williams is well the values of the public sector. I was work we were doing,’ says Paul. costing work that fed into the HFMA’s earned the respect of her clinical 2012 Senior business equipped to grasp technical detail delighted to be successful. ‘It was where I got my interest in report on seven-day services. colleagues for trying something accountant both in the scientific field and in his ‘On my first day in finance I didn’t working in the management of a Kate credits Tony Whitfield, the outside her comfort zone and it gave 2013 Senior manager – chosen career, accountancy. But know what a debtor or creditor was. finance team to improve the team former finance director at Salford, for her exposure to the pressures her acute medicine as well as developing his analytical My colleagues were key in supporting itself, focusing on systems and influencing her career and how she colleagues were facing. ‘I thought skills, chemical engineering also my development alongside my processes.’ approaches her work. ‘Tony made we worked hard in finance, and we 2014 Central Manchester gave him an aptitude for redesigning professional studies.’ He spent six years at Havering it clear what he expected from his do, but it is very different in general NHS FT, finance and streamlining processes. He worked predominantly in before moving into health, at Great management,’ she says. ‘Finance has director – specialist That’s not been lost on those adult and children’s services – Ormond Street Hospital NHS its peaks and troughs but generally medicine interviewing him for jobs over the challenging areas with high demand Foundation Trust. He says this was speaking we know that when we go years and it has led him to roles that and tight budgets, so greater risk of another natural step. ‘There are lots “I was sad home we can switch off’. Outside interests have developed these skills. overspending. Havering was seen of transferable skills, although health Kate completed the secondment Being a mother to a nearly four- At school he enjoyed science in funding allocations as a relatively has a lot of specific practices I had to leave and while she was glad she’d done year-old daughter with a full-time job and maths – learning how to solve affluent London borough, so grant to learn,’ says Paul. ‘At the time I Salford, but it, she was keen to move back to doesn’t leave much time for hobbies. problems and understand how things got the role, my colleagues were finance, but not to forget about her Kate keeps fit by chasing round work. He was encouraged to turn his saying it was difficult to make a move I needed operational experience. after her daughter and running when interests into a ‘real world’ job, but into health, so I was grateful for the The role of finance director, she can. She has also just moved he also wanted a vocation with travel opportunity. For a number of years, I to experience what specialist medicine at Central house and is getting more involved in prospects. ‘My parents were in the had worked with pooled budgets and Manchester NHS Foundation Trust village life. diplomatic service and I lived in India partnerships across social, health the rest of the NHS ticked the boxes. ‘I was sad to leave and Barbados, so I was seeking a job and third sectors.’ Salford, but I needed to experience Favourite book We Need to Talk that offered the chance to travel.’ was like and get a what the rest of the NHS was like and About Kevin, Lionel Shriver But, while he relished the practical Joining the HFMA get a different perspective. The role is Favourite film Dirty Dancing aspects of chemical engineering, He subscribed to the HFMA, and its different perspective” finance but based within the division, he admits he ‘did not quite enjoy it publications and events helped get so is a perfect balance for me,’ she Favourite TV shows Strictly Come enough’. He knew he wanted to work him up to speed quickly. ‘It was good says. Her role is in the specialist Dancing; Location, Location, in the public sector, so Paul decided to see patient-level costing being finance team and what our purpose medicine division and she reports in Location; and Masterchef to do a business management course talked about and used, as well as was. He led by example and always to the director of financial strategy but Top three songs Greatest Day, Take (European business management at service line reporting,’ he says. ‘This put patients first. He encouraged us with a dotted line into the division. That; Sit Down, James; Ain’t Nobody, Manchester Business School). is something we’d tried to do in the to deliver financial viability through She has relished the challenge of Rufus and Chaka Khan He then applied to and was local authority in terms of segmental engagement with clinicians to do the working at Central Manchester. ‘The accepted into the local government money was constrained. He quickly reporting and unit cost of service. best for patients and get most value trust is over twice the size of Salford Favourite food Moules-frites and CIPFA-supported graduate gathered skills in assessing and But it did seem to be more widely from our money’ she says. and is an amalgamation of several Alternative career choice ‘I’d love to finance scheme, Finance the Future, practically implementing savings regarded as a good thing in the Spurred on by Tony and keen hospitals. The budget for my division have my own wedding dress shop – and he trained at the London initiatives. NHS.’ to get closer to the action, Kate alone is more than £150m. Getting I’d sell shoes too’ Borough of Havering. ‘It was good experience. The risk Having spent time looking at applied for a general management to understand how things work has ‘It struck a chord with me,’ he says. of overspending meant the focus the impact of schools becoming post with responsibility for Salford’s been a challenge – eight months after ‘They wanted people to help change was on delivering value and almost academies, he had experience of acute medical specialties. ‘I wanted joining, I am getting there’ she says. the agenda across the public sector always within existing resources. I costing for a couple of years before to explore whether I should take Central Manchester too is benefiting and in local government in particular. worked with some excellent service he moved to health. my career in a different direction. I from Kate’s experience. As she They were looking for people who managers who could relate to While at Great Ormond Street, was offered the post on a one-year explains: ‘I now know I am asking the wanted to change services in a financial considerations, even if they Paul worked closely with clinicians secondment basis. It was a risk, but right questions. I can see where the positive way to achieve value for didn’t always adhere to them.’ and general managers. ‘Some of that there was comfort in knowing that if I problems are likely to arise and can money. Having done the business His process redesign skills shone was about recognising that not every didn’t like it I could go back to finance’ suggest ways to overcome them. I’d course, and with my experience through and he was heavily involved service is going to be the same. In she says. recommend spending time in an designing and improving processes, in leading the operational finance addition to ensuring sustainable For Kate working in general operational role, it really does make I went to the assessment centre and team’s implementation of new ways and viable services, the role was management was a real eye- you a better accountant.’ enjoyed the dynamic with the other of working. ‘It included stripping out supporting innovation in treatments 56 NHS FINANCE CAREER STORIES NHS FINANCE 57 CAREER STORIES

CURRICULUM VITAE Name: Janet Wood Job: non-executive director, South and the way hospital services were manager at Havering. ‘He spent a lot Employment history Essex Partnership delivered. I worked with a very good of time producing great outcomes. I Qualifications CIPFA University NHS team and we had a wide range of saw him as a role model. In my early Foundation Trust 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 Finding the right 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 work-life balance 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 Janet Wood is working hard on committee,’ she says. ‘We don’t just English literature, but instead took a more standardised approach to perspective. She helped me see Street Hospital NHS behalf of patients, not currently talk about financial systems and business and accountancy.’ reaching a solution. past finance to why we were doing FT, finance manager as an NHS accountant but as a risk management. We also look at After graduating, she took a job ‘The private sector does things something: the benefits or outcomes and then senior non-executive director and audit clinical systems, how to improve, with Deloitte in Edinburgh, which she differently. In the value for money for the patient, their families and finance manager committee chair. adopt best practice and do things describes as ‘a great three or four work I did at Deloitte, I learned that the taxpayer. She was invaluable in She came into the role at South better for patients.’ years’. She was involved in the audit 2014 Deloitte, manager if there is a barrier to progress, challenging my thinking on how the Essex Partnership NHS Trust in Under Janet’s leadership, the of large companies, insolvency, value – finance operations it is recognised and addressed finance team operated.’ 2005, bringing a wealth of NHS committee looks at compliance with for money and accounts preparation, and support, audit more quickly using an established and private sector experience. The mental health legislation and also working with a variety of clients, advisory framework to assess the what, why Pace yourself trust was bidding for foundation commissions work from its internal including small businesses, pension and how.’ Paul says the best piece of career 2015 HFMA, research status at the time and, while it had auditors, the board and clinicians to funds, district councils and banks. ‘It advice he has received is to keep manager refreshed its non-executive team, it give it assurance. was a good grounding for running a developing yourself and be patient. had not found a non-exec with an ‘It’s about always trying to put finance department,’ she says. ‘When the right job comes along you accountancy background. the patient at the forefront of the “I’ve always have to be ready to take it,’ he says. Outside interests In 2006, the trust became one of conversation. Potentially there are Chartered path ‘You could go and find it for yourself, As well as playing golf when he can, the first mental health and learning She passed her Institute exams chosen to but don’t stress yourself out by Paul and his wife spend their free disability foundation trusts. first time. ‘I decided to become a work in tough swimming against the current.’ weekends and holidays travelling Asked whether it is difficult to be a chartered accountant as I thought He sees one of his greatest around the country in their beloved former NHS accountant whose job is then the world’s your oyster – it’s a areas to achievements as returning to lead Volkswagen camper van. They are to hold her executive colleagues to good qualification and you can go the team where he first trained three also in the process of renovating account, she replies: ‘Having been where you want.’ challenge myself … years earlier. ‘Before I went back, their house. on the other side, I take the She decided to move to London I thought about how I would be Favourite film Enemy of the State supportive route, but when I get and the first job she got was in the so I was progressing” perceived – maybe people there had worried about something, I will give NHS – at Redbridge Health Directly wanted the role themselves or had Favourite book The Shepherd, them a hard time. But they know it’s Managed Unit. She admits this been there a long time. Frederick Forsyth because I’m worried that I’m giving wasn’t by design. He also spent time producing ‘It was a really great opportunity Favourite TV show Scrubs them a hard time.’ For someone coming into the information to be used by finance and although the relationship However, she adds: ‘We have NHS as a qualified accountant teams to support their work, including changed with my colleagues, they Top three songs Title and been incredibly lucky – we’ve never with experience of the private and an analysis of the impact of an acute were instrumental in developing my Registration, Death Cab for Cutie; been in deficit and we’ve met all our voluntary sectors, as well as other trust estate reconfiguration as part of approach to management.’ Multi-Love, Unknown Mortal financial targets.’ parts of the public sector, this was a an integrated business plan. Would he do anything differently? Orchestra; Lampshades on Fire, That’s not to say she does not frustrating experience at first. This attracted him to the HFMA ‘I’d take more time and enjoy things Modest Mouse believe improvements could be too many conversations where the ‘Some of the people I worked for research manager post. Speaking just more,’ he replies. ‘I have been quite Favourite food South Indian made. ‘In the early years, the patient does not come into it, but we were working towards qualification over a week into the job, he says: ‘My determined in terms of working hard buildings were not really fit for try very hard to come back to the and they didn’t, to my mind, career focus now is on softer skills – and trying to get as much experience Favourite website Google purpose. One of the things I have patient. I or another non-executive understand how to keep accounts EQ-type development for myself and as I can.’ He admits this has affected been really proud of is helping director or the finance director will or prepare business cases. The the people around me to support the his work-life balance at times. ‘I am drive through investment on new be saying, “But what about the unit was trying to become a trust technical learning I traditionally follow. exceptionally grateful to my family, buildings.’ patients?”.’ and it was struggling without project I’ve known of the HFMA for years and particularly my wife, who have been This includes a Procure21 scheme Janet started in accountancy when management skills,’ she says. am proud to be working here. very patient and understanding.’ and private finance initiatives, which she was at school. ‘It was probably a But it improved. A finance director ‘I have always chosen to work in But for those considering a job in have delivered a new hospital and bit more like bookkeeping but I found was recruited from KPMG in the first tougher areas to challenge myself. I the NHS, he has a clear message. secure unit. it very easy. At the time I was thinking year she was there. Nevertheless, have always made sure there was a ‘There are many opportunities in Janet was also keen to link quality about hotel management, but I went she decided to move on, becoming development opportunity, learning or the NHS, so many exciting and financial strategies, introducing for accountancy,’ she says. chief accountant at South Essex experience so I was progressing.’ developments. It’s a great place to quality impact assessments before ‘At that time, to go to the Institute Health Authority. His parents, wife and friends have develop yourself and do a good job they were introduced nationally. [of Chartered Accountants of ‘The team was great,’ she recalls. been a big influence on his career. He for those who will benefit. This could ‘We came up with the concept Scotland], you had to have a relevant ‘I had a straight line to the finance particularly recalls an interim finance be someone you know.’ of widening the remit of the audit degree. I wanted to do history and director and the staff were excellent. 582 NHS FINANCE CAREER STORIES 593

CURRICULUM VITAE

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 Next steps for example, he always let them present it themselves. In too many 2005 South Essex If you are interested in a future working in NHS finance, “I don’t want organisations, a director will present a Partnership University please contact Future-Focused Finance for further paper when someone else has done NHS FT, non-executive information at [email protected] 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 Acknowledgements 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 authors of this briefing were: the HFMA spring school a couple of PTA and is currently a director of Steve Brown, Healthcare Finance editor life balance. But if I times, which were great development their secondary school, sitting on the opportunities. finance committee. Richard Edwards, independent consultant had to cover, I’d be ‘In my current role, I go to a lot of Emma Knowles, HFMA head of policy and research NHS Providers events and I did a Favourite film The American happy to do it” course for aspirant chairs two or three President, Moonstruck Seamus Ward, Healthcare Finance associate editor years ago. However, the one thing Favourite book Crime thrillers by Paul Williams, HFMA research manager that showed me was that I don’t want Karin Slaughter, Linda Fairstein and We are grateful to all the individuals who took part in this 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 project, for sparing the time and for being willing to share she took a career break. ‘I broke the work-life balance. But if I had to cover Favourite TV shows CSI, NCIS, their personal experiences. 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 @ Future-Focused Finance and the Healthcare Financial primary care trust finance director, but Janet is in her third term as a All, Abba; Stars from Les Misérables; Management Association, 2015 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.’ About Future-Focused Finance level, those we work with to deliver organisation that promotes best services and the patients and practice and innovation in financial In February 2014, the six heads of communities that use and support management and governance the finance profession in the NHS those services. across the UK health economy came together to form the Finance through its local and national Leadership Council and to initiate Any enquiries should be sent to networks. Future-Focused Finance. [email protected] or [email protected] or posted to the The association also analyses and Future-Focused Finance is about address below. responds to national policy and ‘Making People Count’ by ensuring aims to exert influence in shaping that everyone connected with NHS About the HFMA the wider healthcare agenda. It has finance has access to the relevant The Healthcare Financial a particular interest in promoting skills, methods and opportunities Management Association (HFMA) the highest professional standards to influence decision making in is the professional body for finance in financial management and support of the provision of high- staff in healthcare. For more than 60 governance and is keen to work quality patient services. It offers years, it has provided independent with other organisations to promote a vision for NHS finance to aspire and objective advice to its approaches that really are ‘fit for to over the next five years. That members and the wider healthcare purpose’ and effective. includes everyone who works community. It is a charitable in finance, in every role at every

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