IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v268y2021ics0277953620307310.html
   My bibliography  Save this article

Challenges of maintaining accountability in networks of health and care organisations: A study of developing Sustainability and Transformation Partnerships in the English National Health Service

Author

Listed:
  • Moran, Valerie
  • Allen, Pauline
  • Sanderson, Marie
  • McDermott, Imelda
  • Osipovic, Dorota

Abstract

The English National Health Service (NHS) constitutes a unique institutional context, which combines elements of hierarchy, markets and networks. This has always raised issues about competing forms of accountability. Recent policy has emphasised a move from quasi market competition towards collaboration in the form of new regional organisational arrangements known as Sustainability and Transformation Partnerships (STPs). We explore accountability relationships in STPs, focusing on the challenges of increasing horizontal accountability given existing vertical accountabilities, most notably to national regulators. We utilize a case study approach concentrated on three Clinical Commissioning Groups (CCGs) in urban and rural settings in England. We conducted in-person interviews with 22 managers from NHS organisations and local authorities and examined local documents to obtain information on governance and accountability structures. The fieldwork was undertaken between November 2017 and July 2018. We analysed results by considering which actors were accountable to what forums and the nature of the obligation (vertical or horizontal). We found that individual organisations still retained vertical accountabilities and were reluctant to be held accountable for the whole STP, given they were responsible for only part of the joint effort. Moreover, organisations did not feel accountable to STPs and instead highlighted vertical accountabilities upwards to their own boards and to national regulators; and downwards to the public. But while local commissioning organisations, CCGs engaged with their members and the public, STPs failed to engage adequately with the public. Nevertheless, there were indications that horizontal accountability was starting to develop. This could become complementary to vertical accountability by facilitating mutual learning and peer review to anticipate and defer regulatory intervention. While vertical accountability is necessary to provide oversight and apply sanctions, it is not sufficient and should be accompanied by horizontal accountability.

Suggested Citation

  • Moran, Valerie & Allen, Pauline & Sanderson, Marie & McDermott, Imelda & Osipovic, Dorota, 2021. "Challenges of maintaining accountability in networks of health and care organisations: A study of developing Sustainability and Transformation Partnerships in the English National Health Service," Social Science & Medicine, Elsevier, vol. 268(C).
    • Handle: RePEc:eee:socmed:v:268:y:2021:i:c:s0277953620307310
    DOI: 10.1016/j.socscimed.2020.113512
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953620307310
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2020.113512?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Stephen P. Osborne, 2006. "The New Public Governance?-super-1," Public Management Review, Taylor & Francis Journals, vol. 8(3), pages 377-387, September.
    2. Thomas Schillemans, 2008. "Accountability in the Shadow of Hierarchy: The Horizontal Accountability of Agencies," Public Organization Review, Springer, vol. 8(2), pages 175-194, June.
    3. Simon Vander Elst & Filip de Rynck, 2013. "Will Mandated Network Steering do the Trick? A Balanced Assessment of the Belgian Network “Crossroads Bank for Enterprises”," International Review of Public Administration, Taylor & Francis Journals, vol. 18(2), pages 47-63, August.
    4. Andrew Hutchings & Pauline Allen & Naomi Fulop & Annette King & Gerasimos Protopsaltis & Charles Normand & Rhiannon Walters, 2003. "The Process and Impact of Trust Mergers in the National Health Service: A Financial Perspective," Public Money & Management, Taylor & Francis Journals, vol. 23(2), pages 103-112, April.
    5. Barnes, Andrew J. & Unruh, Lynn & Chukmaitov, Askar & van Ginneken, Ewout, 2014. "Accountable care organizations in the USA: Types, developments and challenges," Health Policy, Elsevier, vol. 118(1), pages 1-7.
    6. Lewis, Valerie A. & Tierney, Katherine I. & Colla, Carrie H. & Shortell, Stephen M., 2017. "The new frontier of strategic alliances in health care: New partnerships under accountable care organizations," Social Science & Medicine, Elsevier, vol. 190(C), pages 1-10.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sébastien Gand & Elvira Periac, 2015. "Vers des écosystèmes de services gérontologiques ?," Post-Print hal-01164391, HAL.
    2. Finocchiaro Castro, Massimo & Guccio, Calogero & Rizzo, Ilde, 2023. "How "one-size-fits-all" public works contract does it better? An assessment of infrastructure provision in Italy," EconStor Preprints 270729, ZBW - Leibniz Information Centre for Economics.
    3. Chris Skelcher & Jacob Torfing, 2010. "Improving democratic governance through institutional design: Civic participation and democratic ownership in Europe," Regulation & Governance, John Wiley & Sons, vol. 4(1), pages 71-91, March.
    4. ter Bogt, Henk & Tillema, Sandra, 2016. "Accounting for trust and control: Public sector partnerships in the arts," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 37(C), pages 5-23.
    5. Mihajla Gavin & Scott Fitzgerald & Susan McGrath-Champ, 2022. "From marketising to empowering: Evaluating union responses to devolutionary policies in education," The Economic and Labour Relations Review, , vol. 33(1), pages 80-99, March.
    6. Gaynor, Martin & Laudicella, Mauro & Propper, Carol, 2012. "Can governments do it better? Merger mania and hospital outcomes in the English NHS," Journal of Health Economics, Elsevier, vol. 31(3), pages 528-543.
    7. Marija Aleksovska & Thomas Schillemans & Stephan Grimmelikhuijsen, 2019. "Lessons from five decades of experimental and behavioral research on accountability: A systematic literature review," Journal of Behavioral Public Administration, Center for Experimental and Behavioral Public Administration, vol. 2(2).
    8. Laura Carmouze & Alan Sandry, 2020. "Complex Thinking and Computing Organization Facing Contingent Problems," Public Organization Review, Springer, vol. 20(2), pages 401-419, June.
    9. Anita Breuer & Julia Leininger, 2021. "Horizontal Accountability for SDG Implementation: A Comparative Cross-National Analysis of Emerging National Accountability Regimes," Sustainability, MDPI, vol. 13(13), pages 1-23, June.
    10. Silvia Stuchi & Sonia Paulino & Faïz Gallouj, 2022. "Social Innovation in Active Mobility Public Services in the Megacity of Sao Paulo," Sustainability, MDPI, vol. 14(19), pages 1-16, September.
    11. Hyndman, Noel & Liguori, Mariannunziata & Meyer, Renate E. & Polzer, Tobias & Rota, Silvia & Seiwald, Johann, 2014. "The translation and sedimentation of accounting reforms. A comparison of the UK, Austrian and Italian experiences," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 25(4), pages 388-408.
    12. Sébastien Gand & Elvira Periac, 2016. "Gouverner sans les instruments ? La difficile construction des politiques relatives à la perte d'autonomie des personnes âgées," Post-Print hal-01258274, HAL.
    13. Tom Christensen & Anne Fimreite & Per Lægreid, 2014. "Joined-Up Government for Welfare Administration Reform in Norway," Public Organization Review, Springer, vol. 14(4), pages 439-456, December.
    14. Gabriele Palozzi & Irene Schettini & Antonio Chirico, 2020. "Enhancing the Sustainable Goal of Access to Healthcare: Findings from a Literature Review on Telemedicine Employment in Rural Areas," Sustainability, MDPI, vol. 12(8), pages 1-30, April.
    15. Menno Ottens & Jurian Edelenbos, 2018. "Political Leadership as Meta-Governance in Sustainability Transitions: A Case Study Analysis of Meta-Governance in the Case of the Dutch National Agreement on Climate," Sustainability, MDPI, vol. 11(1), pages 1-23, December.
    16. Fabiana Liar Agudo & Barbara Stolte Bezerra & José Alcides Gobbo & Luis Alberto Bertolucci Paes, 2022. "Unfolding research themes for industrial symbiosis and underlying theories," Sustainable Development, John Wiley & Sons, Ltd., vol. 30(6), pages 1682-1702, December.
    17. Eva Sørensen & Jacob Torfing, 2021. "Accountable Government through Collaborative Governance?," Administrative Sciences, MDPI, vol. 11(4), pages 1-20, November.
    18. Brian BARNARD & Ipeleng MABUSELA, 2019. "Leadership of Entrepreneurship at the Macro-Level," Expert Journal of Business and Management, Sprint Investify, vol. 7(2), pages 236-255.
    19. Ada Scupola & Lars Fuglsang & Faiz Gallouj & Anne Vorre Hansen, 2021. "Understandings of Social Innovation within the Danish Public Sector: A Literature Review," Administrative Sciences, MDPI, vol. 11(2), pages 1-18, May.
    20. Lars Fuglsang & Anne Vorre Hansen & Ines Mergel & Maria Taivalsaari Røhnebæk, 2021. "Living Labs for Public Sector Innovation: An Integrative Literature Review," Administrative Sciences, MDPI, vol. 11(2), pages 1-19, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:268:y:2021:i:c:s0277953620307310. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.