National ELF service: Ruth Prickett charts the genesis of an innovative shared service centre providing accountancy services for NHS trusts in north-west England.

AuthorPrickett, Ruth
PositionNational Health Service

The future of healthcare is high-tech, fully automated and will be driven by contracts replacing service-level agreements--and not only on the delivery side. This is why the National Health Service's ongoing modernisation programme has encouraged hospitals to offload increasing amounts of business and finance admin work to shared service centres, which are promising to perform key processes more efficiently and cheaply, freeing up local managers and staff to concentrate on strategy and delivery. So far, so similar to many private-sector initiatives. But the NHS has its own particular challenges and it has been no simple matter to weld together the financial administration of otherwise unrelated healthcare bodies, many of whose systems are far from cutting edge.

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These issues constitute business as usual for Graham Gornall FCMA, director of East Lancashire Financial Services (ELFS). His organisation evolved through an initiative started in 2000 by four NHS trust chief executives in east Lancashire when they discussed the future of back-office finance. At the time, he was assistant director of finance at Blackburn Hospital Trust, but he was also studying for an MA in accountancy and finance. His project dissertation focused on evaluating the business case for setting up a shared service centre in the region. This made him the ideal candidate to become project leader when the project board was established in June 2001. Apart from Gornall, the board comprised one chief executive, local FDs and an HR manager.

He was also in the right place at the right time, since other developments between 2000 and 2002 included the emergence of primary care trusts (PCTs), which were never intended to take on back-office finance roles.

"As a project board, we had a view about how the service could develop, but my MA research helped me to bring in some private-sector experience in areas such as the standardisation and automation of systems and processes, customer-focus initiatives and establishing centres of expertise," he says.

The organisations involved from the start were three new PCTs in east Lancashire, two acute hospital trusts in Blackburn and Burnley, a local health authority and Calderstones NHS Trust (a provider of services for people with learning disabilities). The board's first task was to decide which functions should be taken on by a shared service centre (SSC). Some were easily agreed, but others proved more contentious...

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