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Balancing-act: supporting NHS finance leaders to deliver on short- and long-term priorities
Market Report
30th June 2025
The role of the finance leader in the NHS is more challenging than ever, with a growing tension between the need to deliver on demanding long-term and short-term priorities.
During the last six months Newton and HFMA (Healthcare Financial Management Association) have convened over 50 finance leaders from across the NHS who have shared their experiences of addressing this challenge.
The result is this briefing that explores how finance leaders can navigate today’s operational and financial challenges while laying the groundwork for sustainable, system-wide change. It offers practical tools, case studies, and a transformation roadmap to help leaders create headroom, plan across multiple horizons, and lead with optimism.
Here’s what you need to know
Throughout our engagement with finance leaders, we found that three fundamental considerations are key when balancing short- and long-term priorities.
Thinking across multiple change horizons
Understanding local opportunities and being able to think and plan simultaneously across the short-, medium- and long-term.
System and patient value
Acting with true value in mind, delivering better care and outcomes for individuals and thinking with a system mindset financially.
Leading with hope and optimism
Forming a compelling change narrative.
The briefing includes practical support to balance work across three transformation horizons which aim to create headroom both in terms of time and money:
- A framework for planning: supporting finance leaders to develop plans for long-term financial sustainability and improved outcomes, at the same time as operationalising current plans.
- Clarification of the role of finance leaders within multi-year, multi organisational system change.
- Shared experiences and tools: case studies and practical tools and resources that can support finance leaders today.
“The thing which struck me most from this work is the impressive capability, experience, and commitment within the NHS finance leaders’ community. Leaders all seem to possess a sense of hope and optimism for their teams and organisations. There were numerous examples of brave initiatives and completed projects that can be shared and leveraged. The conversations were truly inspiring, and I hope finance leaders find the tools and insights from this research useful.”
Zillah Anderson, Director, Newton