Enhancing Democratic Accountability in Health and Social Care

The Role of Reform and Performance Information in Health and Wellbeing Boards

  • Wed 14 Feb 18

    14:00 - 16:00

  • Colchester Campus


  • Event speaker

    Professor Stuart Cooper

  • Event type

    Lectures, talks and seminars
    Essex Accounting Centre

  • Event organiser

    Essex Business School

Essex Accounting Centre is delighted to welcome Professor Stuart Cooper to our weekly research seminar series to present his paper, titled 'Enhancing Democratic Accountability in Health and Social Care: The Role of Reform and Performance Information in Health and Wellbeing Boards'.

Event abstract

The UK government passed the Health and Social Care Act in 2012 and a key element of this legislation was the introduction of Health and Wellbeing Boards (HWBs) in local government. HWBs were argued to have the potential to both improve democratic accountability and give greater autonomy to health and social care leaders to strengthen health outcomes. This paper explores how members of HWBs construct and discharge accountability for better health outcomes to a local population. Our findings provide evidence that there are multiple types of accountability experienced within HWBs. We find that there is a layering of various accountability systems, where democratic accountability can be complemented by other types of accountability. The potential to achieve accountability for health and wellbeing outcomes is especially problematic and complex. As such the move towards a more post-NPM focus upon integration and coordination would appear to have the potential to have an overall positive effect (Christensen and Laegreid, 2015). In particular, the long-term and complex nature of health and wellbeing outcomes is a ‘wicked’ challenge that will not be easily addressed by a single organisation. We also find evidence of some competing accountability relationships whereby HWB members feel a primary responsibility to other bodies (for instance NHS England). A further threat to the potential positive effect of HWBs is the ever changing policy context in which the health and social care services operate. Our study, potentially, has implications for re-considering accountability in new provider models that unite local government, general practice and community organisations in improving health and reducing health inequalities.

Speaker biography

Stuart Cooper is Professor of Accounting and Head of Teaching and Learning for the Department of Accounting and Finance, University of Bristol. He is a joint editor of Advances in Environmental Accounting & Management and is on the Editorial Boards of a number of international journals including: Accounting, Auditing and Accountability Journal; Accounting Forum; and Accounting and Business Research. His research interests include issues related to the effects of organisations on environmental sustainability and social justice. He is particularly interested in accountability mechanisms and how organisations measure, manage and communicate their environmental and social impacts to their stakeholders. His research has been published in international journals such as: Accounting and Business Research; Accounting, Auditing and Accountability Journal; Accounting, Organizations & Society; and Critical Perspectives on Accounting.

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