The view from: Michael Parker FCCA, Chair of King’s College Hospital NHS Foundation Trust
Q. What are the main finance challenges for NHS bodies over the next five years?
A. To obtain a greater understanding of patient level costing and contribution analysis to ensure we avoid deflationary activity. This is part of evidence-based decision-making that should displace political decision-making. There also needs to be a broader understanding of the inter-dependence of markets, the importance of soft skills in engaging people to face great tasks and the power of knowledge.
Q. Can health service delivery avoid cuts?
A. Cuts could be replaced with a reallocation of resources. Innovation can allow us to increase activity, quality and reduce costs. Professionals, suitably supported, could enable us to yield expansion – home and abroad. There must be awareness that variable costs drive activity and that some expenditure is profitable investment.
Q. Are there opportunities?
A. The end of the private patient cap can be a force for major economic expansion. We should springboard off being a National Health Service into green pastures.
Q. Is your role changing?
A. No. Leadership requires that you envisage the reality that is ahead and in the good times build surpluses that are stored ready to invest and utilise in bad times. This is not a popular position. No one wants to build-up the surpluses, but many volunteer to spend it. It is important to develop transactive leaders who can be mentored into transformational leaders. If we create them in sufficient numbers and with influence, they can defend themselves and transform society. If management can deliver the same quality as our clinical leaders, we can shrink quality variance, fully exploit multi-disciplinary team working and enhance the input of research and education: we will be in a serious phase.
Q. Are you optimistic?
A. The NHS attracts many with great minds and many with great hearts. Both qualities are required for the future.
Michael Parker has been chair of King’s College Hospital since 2002 and is also chair of its finance committee, a board member of the Food Standards Agency and a member of ACCA’s Health Panel, its International Assembly and its Corporate Governance and Risk Management Committee.
King’s College Hospital NHS Foundation Trust had a turnover of £518m in 2008/9, a surplus of £15.5m, the best possible financial risk rating and met all national targets.