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Medium sized Acute and Community NHS Trust in London


The Trust was characterised by an executive team and board in transition, following several changes in senior personnel due to poor performance over recent years. The Finance Team had lost the confidence of the Chief Executive and the Board; and relations with local CCGs were strained. The financial position was unstable and deteriorating (forecasting a deficit, missing monthly targets, cash shortfalls and a poorly conceived, failing savings programme). The management team were under pressure from the Regulator to agree a financial recovery plan which reversed this trend in-year.

Following appointment, the immediate task was to diagnose the major issues, build confidence in the finance team and develop a programme to reverse the financial trend. This led to the development of a financial recovery plan, working with local commissioners and the regulator to ensure support and expectations were met. The finance team were supported with regular ‘open office’ sessions to set expectations and answer any questions and concerns with close working with key individuals to improve the quality of monthly reporting and raise the confidence and morale of the team. I worked closely with the Chief Executive and the Board (with close management of key NEDs) to ensure financial performance, plans and risks were both understood, supported and signed off.

Within six weeks the in-year recovery plan was presented to the Regulator, based on a simple 8-point plan incorporating a realistic, clear financial trajectory upon which the Trust would begin to rebuild confidence in its ability to meet targets. This included a new governance structure, developed collaboratively with executive colleagues to deliver new in-year savings measures with a run rate reduction of over £15m in the second half of the year. The Trust ended the financial year with a small surplus.

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