PublicSector
Get your career in the best of health
Working in NHS finance can be challenging but hugely rewarding. Vivienne Russell finds out why it’s such an interesting job opportunity
Image: iStock
Ask the average man or woman on the street to describe an NHS worker and they will probably talk about a doctor or nurses.
Accountants are unlikely to be top of the agenda, but the NHS’s finance workforce is doing work that is just as vital as its clinical workforce.
By joining the NHS, you will be part of a large cohort of fellow professionals working for one of the most famous and beloved brands in the country.
Worthwhile cause
Jane Payling is director of the NHS’s East of England Finance Academy following a career in various health service finance roles. She says working in the NHS allowed her to build on the financial acumen she had developed studying economics.
“I didn’t want to spend all my life making profit for other people,” Payling says. “For me, a career in NHS finance hit the sweet spot between being able to use my skills, doing something interesting and making a difference.”
As a public sector employer, the NHS also has a lot to offer in terms of good benefits, a generous pension and job security. There’s also great portability, Payling observes. As a truly national service, there are job opportunities everywhere: wherever you live in the country, you are never very far from an NHS hospital or health centre.
Payling describes the enormous variety and interest of NHS finance roles. From transactional activities to analytics and business cases, the service can offer accountants a huge range of interesting challenges.
“If you’re in a hospital you might be the cashier who is physically dealing with patients, or you could be working at NHS England dealing with multi-billion-pound budgets.”
Tom Shearer, CFO at Central and North West London NHS Foundation Trust, was first exposed to the service in an early job working as a ward assistant alongside his mum.
After finishing university and with an interest in business, a career in NHS finance seemed “a perfect match”.
He echoes Payling’s point that the service offers huge challenge and interest, as well as a diverse range of both corporate and clinical colleagues. He adds: “The biggest plus about working in the NHS is the cause that sits behind it, and the fact that we’re doing our own small part in finance of creating equal access to outstanding healthcare for the whole country.”
Matthew (not his real name) is an AAT member who works as a senior management accountant at a trust in the south of England. After early finance roles in the private sector, he was looking for more fulfilment and trained as an ambulance technician and paramedic.
But, following five years in ambulances, he wanted a role that posed fewer physical risks and offered more regular hours. He secured a finance job with the ambulance trust at which he was employed and has been working happily in NHS finance ever since.
“It does feel worthwhile working for the NHS whatever role you do,” he says.
A career in NHS finance hit the sweet spot between being able to use my skills, doing something interesting and making a difference.
Securing future talent
There are around 16,000 finance staff working in the NHS in England and One NHS Finance is the national programme that works to support, develop and bring them together. It works across three strands: Future-Focused Finance, which gives the profession a voice and offers finance professionals a space to collaborate; the Finance Innovation Forum, which offers a place for finance professionals to discuss ideas and solve problems; and the National Finance Academy, which provides structured training and development opportunities, while also promoting equality, diversity and inclusion.
“It's all about finance people working together to recruit and retain people, to support them and make sure that everyone’s job is as easy and efficient as possible,” Payling says. “What we do locally is look at what kind of training needs people have got and fill any gaps. We support people through their qualifications [and] we run apprenticeship schemes.”
Shearer is overseeing a new programme under the One NHS Finance umbrella to further develop a new generation of talent and help the finance profession better reflect the people it serves.
The NHS Finance Insights placement scheme offers a one-year paid placement, with a minimum of two rotations, for people from non-graduate and lower socioeconomic backgrounds. A small pilot in London was successful with four out of five participants taking permanent roles in NHS finance. The scheme is now being rolled out nationally with 38 participants.
“It will be really exciting to see what happens to the 38,” Shearer says. “There is so much enthusiasm for doing the programme, but that needs to be tempered with making sure we’re not over-enthusiastic at the entry level and not able to look after these young people and provide further opportunities for them going forward.”
Image: iStock
Rising to the challenge
Working for the NHS can also bring distinct challenges. Matthew offers the view that the scale of the health service can sometimes be frustrating.
“You can feel like a small cog in a very big wheel, and almost anything involves so many people, so it can slow things down,” he says, contrasting this with his experience in the private sector where smaller teams and lighter governance often allowed him to resolve issues more speedily.
The cost pressures on the service are also increasingly making themselves felt. Shearer acknowledges that the financial climate in the NHS is “tough” but adds this can be motivating as much as offputting. It’s a fast-moving, ever-changing environment, which might not suit everyone – and resilience is needed, particularly for those in more senior roles.
“I do think that the impact [financial pressures have] on our wider departments can be quite motivating,” he says. “I think the pressure on senior leadership in the NHS at the moment is pretty intense, but the programmes of work and the schemes that are going on within different layers of the NHS are still incredibly positive.”
Impact on the frontline
With little patient contact and more at ease with spreadsheets than stethoscopes, finance professionals are not necessarily foremost in the public’s mind when they think of NHS heroes.
Despite this, Matthew says he does regard himself as part of the NHS family.
“It’s fair to say I might feel a little impostor syndrome when I ask a shop if they offer a Blue Light discount,” he says. “But I do step back and think how important finance staff are in the NHS.
“For example, people call 999 for an ambulance. If there were never [any] accounts payable staff then the paramedics would have nothing to use to treat you; if there were no payroll staff then the ambulances would be parked at the ambulance station with no one to drive them to you;
if there was no capital accountant or procurement team the ambulance station would be empty because no ambulances had been bought. So we do have an important role.”
Payling adds: “At the end of the day, the NHS is not set up to give accountants jobs, but accountants are fundamental to making it all work.”
For Shearer, while the founding principles of the NHS might not always be top of mind for accountants sitting behind a computer poring over accounting software, it’s important to reflect on the bigger picture. “I can't think of any other job in finance where the cause would be more worthy,” he says.
Find out more
Visit the NHS finance website to find out more about an accounting career with the health service.
