Supporting the finance community to develop robust financial strategy that is locally-owned, deliverable and sustainable.

Our clients operate in an increasingly challenging financial environment, despite recent commitments to additional funding.  The need to demonstrate value for money from the public purse and to meet statutory requirements remains core to the NHS.  We are seeing large scale changes in the regulatory environment, with the establishment of a single Chief Finance Officer across NHS England and NHS Improvement and highly publicised calls for changes to the payment regime. Amid these changes, the finance community, and the NHS as a whole, still have an ongoing need to develop financial strategy. This must underpin and enable the delivery of high-quality healthcare, despite an environment in which healthcare needs are changing, service pressures are increasing, and best practice evolves.

We have successfully supported the development and delivery of financial strategies in a wide range of systems ranging from those seeking devolved funds, as in Greater Manchester, through to the most challenged as in Devon. Having worked across all aspects of the NHS, we have unparalleled insight into the issues and processes facing staff, which require navigation and agreement. Additionally, our approach is sensitive to the statutory, legislative and political environment in which the finance community operates. This means engaging with front line staff and the Board, working collaboratively to ensure that every pound delivers the best value for money.


Our approach is based on working alongside finance leaders and is focussed on “what?” and “how?”.  We know that any strategy needs to be tied to delivering outcomes, providing capacity and legacy capability.  We bring the knowledge, insight and experience of our Partners, who between them have over 100 years of direct NHS experience, mostly in Board level roles including Finance.  We understand that the development and implementation of a successful financial strategy cannot be achieved from within finance alone. Our specialism is that as ‘NHS people’ we understand the drivers for all parts of the system and can help our clients ensure that people at all levels are bought-in to the same vision and plan.   

Our financial strategy work often underpins many of our other service lines as part of our holistic approach as well as being recognised in its own right.


Case study:

Our work in Devon supported multi-organisational agreement over a system-wide plan, against a backdrop of mistrust between organisations and a track record of non-delivery, with consistent overspending against allocated funds.  In a recent independent review, Devon’s financial rating had moved from ‘red’ to ‘green’.  This work was recognised by both the Health Service Journal Partnership Awards and the Management Consultancy Awards, winning Best Consultancy of the Year 2017 and the award for Change Management in the Public Sector, respectively.

‘The work that Carnall Farrar did with us was designed to provide a framework and methodology for service and financial recovery on a whole-system basis. Throughout this time, however, their advice and expertise on how to best present our case and manage the inevitable tension between commissioner and provider viewpoints, including those of the respective regulators when working outside the boundaries of the normal rules of engagement, was of huge benefit in ensuring our system progress was not derailed.”

John Dowell
Chief Finance Officer, Devon CCGs 

You can read more about the work we have undertaken to support financial strategy here.


If you are interested about the work we do in our financial strategy service line, contact Bev, Paul or Toby for more information.


Bev Evans               Paul Brown            Toby Lambert   

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