In recent years there has been an increasing emphasis in the UK National Health Service (NHS) on the provision of management information. This has been mainly manifested through…
Abstract
In recent years there has been an increasing emphasis in the UK National Health Service (NHS) on the provision of management information. This has been mainly manifested through the Körner initiatives, but other developments such as management budgeting and performance indicators also have a major implication for the provision of information. In its simplest form, the management information provided could be classified twofold, namely information on service provision and information on the use of resources.
Malcolm Prowle and Don Harradine
This research concerns the issue of financial governance within the UK NHS and aims to assess the effectiveness of existing financial governance arrangements in the main providers…
Abstract
Purpose
This research concerns the issue of financial governance within the UK NHS and aims to assess the effectiveness of existing financial governance arrangements in the main providers of health services in the UK. Also considered is the importance of good financial governance in a time of financial austerity.
Design/methodology/approach
The primary research for this project was based on the use of a questionnaire to all finance directors in NHSTs in England supported by semi-structured interviews with: finance directors, non-executive directors, executive directors and senior finance staff.
Findings
Among the main findings of the study were: certain financial management systems were not prioritised in line with what is seen as good practice; existing financial management systems were not always seen as adequate for the achievement of good financial governance; there was sometimes a lack of understanding of financial issues by non-executive directors; and the complexity of the NHS funding process often resulted in opaqueness of the financial risks.
Research limitations/implications
The research is limited by the relatively small coverage of NHS trusts but this has been compensated for by a series of in-depth interviews with key stakeholders in the governance process.
Practical implications
Weaknesses in financial governance could result in further scandals which result in loss of life and poor patient care.
Originality/value
There are many papers on the issue of governance in the public sector in general and the NHS in particular. However, there is little published on the issue of financial governance in the NHS. Also of great value is the emphasis on strengthening financial governance in an era of austerity
Details
Keywords
It is not possible to make a totally objective analysis of any health care system without assuming various values. These values, in turn, assume that the delivery of health care…
Abstract
It is not possible to make a totally objective analysis of any health care system without assuming various values. These values, in turn, assume that the delivery of health care should conform to various criteria. The Institute of Health Services Management (IHSM) set up a study which attempts to establish a framework of criteria against which alternative systems of funding can be tested. The conclusions of the study are based on a series of working papers which examined the available evidence. In addition the study contains a brief discussion of the management and organisation of the National Health Service.