ArticleBMJ open2013
Accountable to whom, for what? An exploration of the early development of Clinical Commissioning Groups in the English NHS.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
13 citing papers in PubMed, 48 citations in OpenAlex.
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- The regulation of competition and procurement in the National Health Service 2015-2018: enduring hierarchical control and the limits of juridification.Health economics, policy, and law · 2020Article
- Ethics education and moral decision-making in clinical commissioning: an interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- GP leadership in clinical commissioning groups: a qualitative multi-case study approach across England.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Article
- Whose voices? Patient and public involvement in clinical commissioning.Health expectations : an international journal of public participation in health care and health policy · 2017Article
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- Incorporating shared savings programs into primary care: from theory to practice.BMC health services research · 2015Article
- Making the case for a fracture liaison service: a qualitative study of the experiences of clinicians and service managers.BMC musculoskeletal disorders · 2015Article
- The 'added value' GPs bring to commissioning: a qualitative study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Article
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- Accountability in the UK healthcare system: an overview.Healthcare policy = Politiques de sante · 2014Article
- Improving accountability through alignment: the role of academic health science centres and networks in England.BMC health services research · 2014Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveOne of the key goals of the current reforms in the English National Health Service (NHS) under the Health and Social Care Act, 2012, is to increase the accountability of those responsible for commissioning care for patients (clinical commissioning groups (CCGs)), while at the same time allowing them a greater autonomy. This study was set out to explore CCG's developing accountability relationships.
designWe carried out detailed case studies in eight CCGs, using interviews, observation and documentary analysis to explore their multiple accountabilities. SETTING/
participantsWe interviewed 91 people, including general practitioners, managers and governing body members in developing CCGs, and undertook 439 h of observation in a wide variety of meetings.
resultsCCGs are subject to a managerial, sanction-backed accountability to NHS England (the highest tier in the new organisational hierarchy), alongside a number of other external accountabilities to the public and to some of the other new organisations created by the reforms. In addition, unlike their predecessor commissioning organisations, they are subject to complex internal accountabilities to their members.
conclusionsThe accountability regime to which CCGs are subject to is considerably more complex than that which applied their predecessor organisations. It remains to be seen whether the twin aspirations of increased autonomy and increased accountability can be realised in practice. However, this early study raises some important issues and concerns, including the risk that the different bodies to whom CCGs are accountable will have differing (or conflicting) agendas, and the lack of clarity over the operation of sanction regimes.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.