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Autonomy and improved performance: lessons from an NHS policy reform

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Listed:
  • Paul Anand
  • Mark Exworthy
  • Francesca Frosini
  • Lorelei Jones

Abstract

Autonomy is currently seen by policy-makers in many countries as a possible mechanism for enhancing public sector performance. The authors examine a service reform (the National Health Service in England) in which more autonomy was given to better performing hospitals. Drawing on data from interviews with senior managers, the research suggests that despite being enmeshed in a politicized culture of regulations and guidance, autonomy is increasingly perceived positively and appears to depend on the extent to which organizations have the incentives and the capacity to respond to increased autonomy. The article presents findings that will be of value to policy-makers in many countries.

Suggested Citation

  • Paul Anand & Mark Exworthy & Francesca Frosini & Lorelei Jones, 2012. "Autonomy and improved performance: lessons from an NHS policy reform," Public Money & Management, Taylor & Francis Journals, vol. 32(3), pages 209-216, May.
    • Handle: RePEc:taf:pubmmg:v:32:y:2012:i:3:p:209-216
    DOI: 10.1080/09540962.2012.676279
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    References listed on IDEAS

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    1. Propper, Carol, 1995. "Agency and incentives in the NHS internal market," Social Science & Medicine, Elsevier, vol. 40(12), pages 1683-1690, June.
    2. Giandomenico Majone, 2001. "Two Logics of Delegation," European Union Politics, , vol. 2(1), pages 103-122, February.
    3. Stephen Peckham & Mark Exworthy & Ian Greener & Martin Powell, 2005. "Decentralizing Health Services: More Local Accountability or Just More Central Control?," Public Money & Management, Taylor & Francis Journals, vol. 25(4), pages 221-228.
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