John Graham’s decision to join the UK’s National Health Service (NHS) in 1983 upon graduating from Liverpool John Moores University was based on practicalities. A job as a trainee accountant with the NHS offered career stability and development potential, plus financial assistance to become qualified in management accounting.
Graham had little familiarity with the internal structure of the health service, but over the duration of his career, he has found it highly rewarding to align financial data and budgeting to services provided by healthcare professionals.
A Liverpool native and the eldest of five siblings, Graham, FCMA, CGMA, continued to pursue a career in healthcare finance and is now the CFO at two NHS trusts: Stockport NHS Foundation Trust and Tameside and Glossop Integrated Care NHS Foundation Trust. He attributes his career success to luck, but ultimately, he believes studying with CIMA and becoming a member and then later gaining the CGMA designation were wise choices that fuelled his success in becoming a CFO.
Graham is adept at finding meaning behind the numbers and linking financial data to solve long-standing challenges in the NHS, such as emergency department waiting times or theatre outcomes. This passion for the profession will serve him well as CIMA president and co-chair of the Association of International Certified Professional Accountants for the coming year.
Graham is an example of how finance leaders can align financial data to strategic objectives and goals to become invaluable business partners.
“I’m an accountant, but I don’t just like doing the numbers. I like the interaction with people,” he said. “I like the interaction with colleagues who work in the organisation.”
His year ahead in office can be distilled into four words: trust, opportunity, community, and innovation.
Public trust, ethics, and integrity
Trust is top of mind for Graham. Accountants are still viewed as trustworthy because of their high ethical standards and integrity — he doesn’t want that trust to wane.
Retaining the public’s trust is crucial for the profession’s sustainability.
“It’s about reinforcing [trust],” he said. “We’ve got to be seen as part of the solution.”
What that looks like to Graham is telling a stronger narrative about finance and accounting and demonstrating the value the profession brings. It’s about finance professionals showing their credibility and deep knowledge of the business.
Graham’s biggest piece of advice when working with doctors, nurses and other clinical and nonclinical staff, executives, community-based staff, and other stakeholder groups is to relate the numbers to issues that matter to them.
“It’s about taking all the data and being able to present it in a way that addresses the different needs and different users,” he said. “We could have an area where there have been a lot of complaints or not-so-good clinical outcomes. How do we correlate that from a management accounting point of view? How do we present that? But then, more importantly, what do we do about it?”
Opportunities for the next generation
Graham sees opportunity in highlighting the profession’s use of artificial intelligence (AI), cloud computing, and automation to tech-adept Gen Zs and others who could be intrigued by a career in finance.
He also believes accounting and finance professionals need to change the perception of the profession. Whilst at university, students need more exposure to what management accountants do and how qualifications like the CGMA Professional Qualification open opportunities.
“Go back to when you were in school and thinking about careers. I think accounting still would be seen as a good profession,” Graham said. “But what is that image in people’s heads? What does an accountant look like, and what does an accountant do?”
Not many university students would picture an accountant in the NHS, but Graham is an example of the CGMA designation opening doors to countless career paths. Skills acquired in the programme are transferable across sectors, industries, and job roles — from business to not-for-profit to the public sector. And the CGMA designation is globally recognised.
Leaders like Graham are discussing how to remove resource entry barriers to the profession without detracting from its high standards. It’s a balance.
Offering more than one pathway to earning the CGMA designation gives candidates options and allows them to choose a programme that works for their circumstances and learning style.
“There’s a general challenge about attracting young people into the profession,” he said. “How does the [CGMA designation] sit with young people’s aspirations at the moment?”
Building a stronger CIMA community
Earning the CGMA designation is more than a pathway to a stable job. It’s an entry point to a community of passionate, likeminded professionals. There’s room within the management accounting profession to develop a deep sense of pride, foster community connections, share personal experiences, and volunteer.
The big task for Graham as CIMA president is to convey the importance of professional and membership involvement with CIMA.
“There is no average member. We’re all different, and we want different things,” Graham said in acknowledging that increasing member involvement is a big task.
“We are interested in [members’] views. We want your input and engagement,” he said.
Technology and the profession
New use cases for AI are developing rapidly, creating more chances for management accountants to enhance workflows.
AI and other technologies are not replacing management accountants, but instead are strengthening their positions as advisers — trusted by business and the public. Human interpretations of complex financial situations, with ethical or strategic implications, cannot be replaced by AI.
“The accountancy profession has been at the forefront of leveraging new technologies and innovation,” Graham said. “We see it as a means for us to do our job more efficiently and effectively.”
Because the NHS is so target-driven and requires datasets from a range of financial and nonfinancial sources, advancements in technology have enabled Graham and his team to easily access that data, ensure its accuracy, and create more precise reports for departments within the organisation.
Data allows him to evaluate theatre productivity, service waiting times, and challenges in paediatric audiology, for example.
“[Management accounting and finance is] taking all the data and being able to present it in a way that addresses the different needs and different users,” he said. “[Technology] enables us to understand what we need to do to meet the [targets] and/or where we’re not meeting them,” he added.
Understanding the business
When talking about his four focus points, Graham continually uses real-life examples he’s encountered in the NHS — staff surveys to gauge workplace engagement, how accountants approach the business side of trauma treatment or orthopaedics, or the use of data to expedite treatments to patients on waiting lists. His examples illustrate his understanding of what it means to be a business partner.
“I think it’s about getting to understand the business, knowing the business, being that business partner, and being able to offer suggestions about how we can improve things,” he said. “I like the ability to say, ‘Shall we try this?’”
As finance professionals align their roles with the demands of today’s organisations, Graham advises to never lose sight of what those numbers mean.
“‘You’ve got to be able to interpret that data [and what it] means as well,” he said. “It’s not just about the numbers, it’s the story behind them.”
— Jamie J. Roessner is a senior content writer at the Association of International Certified Professional Accountants. To comment on this article or to suggest an idea for another article, contact Oliver Rowe at Oliver.Rowe@aicpa-cima.com.
