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

Hammond, Jonathan and Speed, Ewen and Allen, Pauline and McDermott, Imelda and Coleman, Anna and Checkland, Kath (2018) 'Autonomy, accountability, and ambiguity in arm’s-length meta-governance: the case of NHS England.' Public Management Review. ISSN 1461-667X

Meta-governance ALB NHSE - PMR revised - anonymous.pdf - Accepted Version

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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.

Item Type: Article
Uncontrolled Keywords: Meta-governance, Accountability, Autonomy, Healthcare, NHS
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
H Social Sciences > HM Sociology
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science and Health > Health and Social Care, School of
Depositing User: Elements
Date Deposited: 20 Nov 2018 12:11
Last Modified: 16 May 2020 01:00

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