Doctors 'must get finance savvy'

The NHS is expecting a budget freeze or even cut from 2011

Hospital doctors have been told they must learn more about finance if the NHS is going to cope in the recession.

The Audit Commission and Academy of Medical Royal Colleges have issued a guide to help medics become more savvy about how the £100bn budget is spent.

They said by understanding more about money they could help redesign services to make them more efficient.

Unions said doctors were willing to get involved in finances, but were wary of crude cuts to spending.

While health funding is guaranteed until 2011, many predict the budget will be frozen or even cut after then.

NHS trusts have already started looking at ways of making savings, but the two groups behind the guide said that doctors held the key.

We are not asking them to become accountants, we just want them to take more of an interest in finances Andy McKeon, of the Audit Commission

They said this applied to all hospital doctors from junior medics up to the most senior consultants who lead teams.

They added doctors were responsible for large swathes of the budget through prescribing drugs, ordering tests and carrying out treatment.

At the moment, medical students receive no tuition about NHS finances during their five-year degree.

The two groups said this should change and NHS trusts should also provide more on-the-job training to the doctors they employ.

Andy McKeon, managing director of health at the Audit Commission, said: "We are not asking them to become accountants, we just want them to take more of an interest in finances and use it to inform their decision-making.

"I can understand some will fear it is about getting them to spend less, but I think if they engage with the issue and take responsibility for it they will be able to find new ways of working that are more efficient."

Payment

Since Labour came to power, they have reformed the way money flows round the NHS in England.

Hospitals are now paid for every patient they treat, rather than relying on lump sums based on historical activity as they were in the past.

This means that every decision made by a doctor about patient care has a cost implication.

The guide said knowing how this system, called payment by results, worked was essential.

Health minister Lord Darzi, who is himself a practising surgeon, agreed.

"The NHS needs to bring their expert judgement to bear on difficult financial and management decisions that impact on patient care.

"Only then will the NHS realise its full potential."

A British Medical Association spokesman said doctors were willing to get involved in finances.

But he added: "We believe that putting quality first - rather than imposing crude financial limits - is the most effective lever for efficiency in the NHS."