Guidance for CFOs working in health and local government

The health and social care sectors are facing the most difficult circumstances in the most challenging of times. Rising demand for high quality services means that the money must stretch further than ever before, and after almost 10 years of austerity the financial challenges are significant.  

The impetus for change is greater now than ever – and integration must be a major component of the solution. The NHS long-term plan re-emphasised the government’s commitment to the integration agenda, stating that there should be ‘ICSs everywhere’ by 2020.  

Many of the identified barriers to integration relate to the mechanics of two disparate systems coming together – particularly in relation to finance and governance. CIPFA and the HFMA have been working in collaboration to try to break down some of these barriers and promote a shared understanding, particularly to help finance professionals develop open and transparent partnerships with colleagues across organisations and sectors. 

With the need to focus on the ‘place-based pound’ and ensure best use of scarce resources, it makes sense that some of these joint appointments relate to the critical role of the chief finance officer (CFO). This is the position responsible for holding the financial reins of the organisation, ensuring resources are used wisely to secure positive results.

The roles of the CFO in the NHS and local government are set out in this report. The publication aims to consider the implications for the increasing number of CFOs working in a dual arrangement, considering the similarities and differences between the roles in each sector.  

The guidance is intended to be useful for:
• those in these posts to assess their development needs
• those considering applying for a joint role
• chief executive officers when appointing to these roles and assessing performance once their CFO is in post
• board members, governors, councillors and executive colleagues to gain a deeper understanding of the role of their CFO and the challenges they face and to understand the impact of any integration plans on the role of the CFO.