Mark Millar, FCCA, chief executive, Hinchingbrooke Health Care NHS Trust
Q. You led the turnaround of Hinchingbrooke trust, overcoming its financial deficit. How big a challenge was it to balance the budget?
A. The underlying financial position was never as bad as it appeared. Some mistakes in business decisions were costly and a small district general hospital suffers from diseconomies of scale.
Q. What has been your approach in balancing the budget?
Essentially standard approaches. Understand the reasons behind the inbalance, identify the non recurrent and historic aspects, concentrate on run rate, benchmark financial and operational performance, identify quick wins, invest in lean methodologies and asset utilisation. Work with clinical staff to effect the required changes.
Q. Are you confident that the budgeting challenge has been overcome?
A. We can only be confident in the short-term. The hospital is funded on a tariff system, based on average costs. The inherent diseconomies of scale mean we must always perform in the upper quartile. We need to keep the support, back office and asset costs at a minimum – possibly as part of a larger organisation.
Q. How have the financial disciplines instilled by being an FCCA assisted in improving the trust’s financial management?
A. I believe I was appointed because of my background and analytical and business skills acquired as an FCCA. Equally important is how we use those skills to influence and persuade clinical colleagues to effect change. One of the joys and challenges of working in healthcare is that it is not a simple command and control structure!
Roles: Chief Executive of Hinchingbrooke Health Care NHS Trust since April 2007. Chair of ACCA’s Healthcare Network Panel.
Former roles: Chairman of the Healthcare Financial Management Association. Director of Resources and Planning at Essex Strategic Health Authority. Chief Executive of Southern Norfolk Primary Care Trust. Director of Finance and Deputy Chief Executive of Suffolk Health Authority.
Other: Worked with Department of Health to develop Payment by Results system. Joined the NHS from school and trained within the service.