You do less time for murder!

I recently celebrated 40 years working in the NHS – Kim Gay, Associate Director of Finance, Finance Lead, West Yorkshire Association of Acute Trusts

You’ll perhaps be surprised to know how often I’ve heard this comparison between doing time for a heinous crime and a life working in NHS Finance. Of course, those of us who work inside the service know the real story.

I started work in the NHS in the week before Xmas 1979. I came into a world where there was linoleum on the floor rather than carpet, with shelves stacked high with lever arch files full of paper, where the NHS accounting system only covered financial accounting and the budget reports were run off the local university’s management accounting system, where the Director of Nursing brought her dog to work with her and where the team I first worked with, stopped work for 15 minutes at 10.00 and 3.00 for a cup of tea or coffee.

Computer systems were fed data via the completion of handwritten forms of varying numbers and colours and the output was on tabulated paper with carbon copies.  Each month when the boxes of print outs arrived, one of the first tasks was to separate the copies from the carbon paper, a dull and dirty task, livened by a bit of competition between us junior staff as to who could finish their ‘separating duties’ first.

The management accounting team would review their respective budget reports and list in black ink on the bottom of the report, any corrections that were needed, calculating new totals and underlining them using a ruler of course.

Over my 40 years, I have worked for 5 separate employers, each covering the NHS in my city. Only on one occasion did I seek a new job and employer, the rest resulted from a favourite NHS pastime, ‘reorganising the service’.  As I’m sure that colleagues working in CCGs and NHSE/I can attest, this is a pastime that endures to this day.

I have spent most of my time working in hospitals and within the Finance Department. I have worked in small hospitals and big hospitals;  led Financial Management teams and also managed  Information and Planning teams as well as the emerging contracting function on the introduction of the infamous ‘purchaser: provider split’.

I’ve also worked outside of the Finance fold. I’ve been a divisional director for Women’s and Children’s services and worked for the Medical Director as Head of Planning and Performance, as the two acute trusts in our city merged into one.

Over the past five years, I have moved away from a traditional Finance role of leading and managing a team within a single trust and instead have been working as the Finance lead for a couple of collaborative ventures. One was based on the geography of a single city and a partnership between 3 Trusts, 3 CCGs and the City Council.  The other is for an association of acute trusts within the geography that has become the boundary of our Integrated Care System. 

Although these two collaborations have a different footprint and slightly different perspectives, their purpose is essentially the same, seeking to work together to transform services, in order to provide integrated, sustainable and consistent services that deliver high quality and value for our population. Of course, we all know that organisational, sector and legislative boundaries exist, the trick is to make sure that they don’t act as barriers to us ‘doing the right thing’.

Things I have learned on the way:

  • Don’t start a new job the week before Xmas. Camaraderie and demob happiness abound and however kind people are, the newbie is like a child with her face pressed against the window of the sweetie shop.
  • Don’t try and ingratiate yourself by offering to make another cuppa at 11.00, when clearly the only acceptable times are 10.00 and 3.00! Dropping of pins could be heard in the silence that ensued until one kind lady told me that was ‘not how things were done around here’.
  • Don’t freak out the first time you receive 360 degree feedback. The next time you do it will be better; you’ll have become more self-aware in the meantime (I hope!)
  • Learn to love yourself when you find out that your Myers Briggs Type Indicator is ENTJ when most successful DoFs (including your boss) are ISTJ.
  • When in doubt, go and see for yourself what is happening at the front line and listen to the people working there. There are no better experts.
  • Kindness is a much under-rated virtue.

Finally, I have thoroughly enjoyed my 40 years in the NHS. I have worked alongside and been supported by so many talented, committed, hardworking and kind people. As I always said to new members in my team, the only promise I’ll give you is that you’ll never be bored!