Reflecting on a Career in NHS Finance – 36 Years in the Making – Duncan Goff, Deputy Director of Finance at Mid Cheshire Hospitals NHS Foundation Trust.
As I approach retirement in just a few months’ time, I’ve naturally found myself reflecting on a career that—much like most good journeys—didn’t exactly start with a map. In fact, after finishing my Geography degree 36 years ago, I wasn’t entirely sure where I was heading at all. Ironically, I’ve spent the rest of my working life ensuring other people did know where things were heading financially… but we’ll get to that.
Finding My Way In
The NHS wasn’t actually the grand plan. A friend happened to be applying for the NHS Management Graduate Scheme and casually mentioned there was a finance version too—along with the subtle hint that I was “good at maths.” With that glowing endorsement, I applied, waited, and hoped.
Interviews took place in December, the scheme wasn’t due to start until the following September—but Stockport Health Authority (SHA) clearly liked to move quickly. They took me on that very January, before the programme even officially began. A promising start… or they were short‑staffed. Possibly both!
The Graduate Scheme Years
The scheme began with an intense 13‑week Graduate Conversion Course where I met some fantastic people and, thankfully, passed. Returning to SHA, I embarked on the “day in the life of” rotations—a brilliant concept that saw me thrown into:
- A&E
- Catering
- Delivery of goods to health centres
- Laundry
- Estates
- Two wards
To this day, I can confirm that nothing gives you a perspective on NHS operations quite like being ankle‑deep in hospital laundry.
I spent a year at SHA working across Technical Accounts, Payroll, and Accounts Receivable. This was my first real foundation in NHS finance—solid experience but also varied enough to keep me interested (and occasionally confused).
Moving to North Manchester
My next stop was North Manchester General Hospital to complete the final two years of the Graduate Scheme. There I worked in Accounts Payable, Technical Accounts, Commissioning, Systems, Internal Audit, and eventually Management Accounts. Internal Audit taught me attention to detail; Commissioning taught me diplomacy; Systems taught me patience.
After qualifying and becoming a CIPFA member, North Manchester offered me a job—which I proudly took. I joined the General Surgery Management Accounts Team before going on to lead the Mental Health Team, an experience that was very rewarding. I learnt a huge amount, not just professionally but personally.
A Detour into the Private Sector
By the late ’90s, I felt I needed something different. So off I went to the private sector—into a large engineering firm as an Accountant. This was the ultimate test of whether my NHS foundations were truly sturdy. They were!
After two years, I realised the work wasn’t inspiring me anymore. Something was missing. (Spoiler: it was the NHS.)
Returning Home – Mid Cheshire Hospitals NHS Trust
By design or fate—probably fate—I found myself back in the NHS in 2000 at Mid Cheshire Hospitals NHS Trust. I’ve been there ever since, moving through roles in Management Accounts, Chief Financial Accountant, and now Deputy Director of Finance.
Along the way, I picked up management of Payroll, Procurement, and the Charity Team. That’s the thing about the NHS: ask one question and suddenly you have three new departments.
It’s now my 26th set of accounts, but being an accountant in the NHS has never just been about the numbers. The work is diverse, surprising, and often has nothing to do with finance at all. And that’s exactly why it’s been so interesting.
The Reality—and the Reward
I won’t pretend it’s always been easy. It’s hard. It’s busy. And right now, finances are tighter than ever. But that challenge is part of the job, and part of what makes it worthwhile.
As I look toward to retirement—more time with my wife, travelling, going to the gym—I do so with genuine fondness for the path I’ve taken. I feel incredibly fortunate to have been part of the Graduate Scheme, which laid such a strong foundation for everything that followed.
And just as importantly, I’m grateful for the people I’ve met along the way: the mentors who pushed me, the colleagues who supported me, and the many teams I’ve had the privilege to work with.
In Closing
I may not have known what I wanted to do 36 years ago, but I certainly do now: I look back with pride, forward with excitement, and appreciate the remarkable, often unexpected journey in between.
Duncan Goff, Deputy Director of Finance at Mid Cheshire Hospitals NHS Foundation Trust.