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Autonomy, accountability, and ambiguity in arm’s-length meta-governance: the case of NHS England

Author

Listed:
  • Jonathan Hammond
  • Ewen Speed
  • Pauline Allen
  • Imelda McDermott
  • Anna Coleman
  • Kath Checkland

Abstract

Meta-governance involves orchestrating the ‘rules of the game’ in public management. Arm’s-length bodies are particularly important vehicles for this. We consider the case of an arm’s-length body (NHS England) created to oversee the English NHS’ day-to-day operation, and remove ‘political interference’. Although mandated by the Department of Health it has increasingly operated as policy-maker, developing policies in tension with existing legislation, while Ministers have faded from public-facing accounts of service operation. This suggests NHS England operates as a meta-governor, insulating government whilst pursuing its own agenda, and raises crucial questions about governmental accountability whilst simultaneously making answers harder to obtain.

Suggested Citation

  • Jonathan Hammond & Ewen Speed & Pauline Allen & Imelda McDermott & Anna Coleman & Kath Checkland, 2019. "Autonomy, accountability, and ambiguity in arm’s-length meta-governance: the case of NHS England," Public Management Review, Taylor & Francis Journals, vol. 21(8), pages 1148-1169, August.
    • Handle: RePEc:taf:rpxmxx:v:21:y:2019:i:8:p:1148-1169
    DOI: 10.1080/14719037.2018.1544660
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