Uncertainty and commitment in commissioning of health services

Abstract

This article reports on the use of management accounting information in commissioning of health services in England. The effects of environmental pressures and uncertainty on the use of this information in the decision-making process was examined. The relationship was further analysed from the perspective of interorganizational dependence and commitment with reference to particular financial management and budgeting practices. A more integrated approach to health care commissioning could be achieved by better harmonizing fund allocation, performance measurement and management systems and by supporting cultivation of joint multiprofessional groups so that regional hubs of information could be used to formulate consistent, bottom-up and lasting local strategies to secure inter-organizational trust and mutual dependency between local health alliances.

Keywords:

• Commissioning
• decision-making
• foundation trusts
• NHS
• PCTs

Notes

^* This research was supported by the BAFA Special Interest Group on Public Services Accounting funded by CIPFA.

**| NHS foundation trusts are not-for-profit, public benefit corporations with accountability to their local communities rather than central government control. They now provide over half of all NHS hospital, mental health and ambulance services.

Additional information

Notes on contributors

Pinar Guven-Uslu

Pinar Guven-Uslu is a senior lecturer at Essex Business School, University of Essex, UK. She was previously a lecturer at Norwich Business School, University of East Anglia, UK.