TY - JOUR
T1 - Discretion drift in primary care commissioning in England
T2 - Towards a conceptualization of hybrid accountability obligations
AU - Gore, Oz
AU - McDermott, Imelda
AU - Checkland, Kath
AU - Allen, Pauline
AU - Moran, Valerie
N1 - Funding Information:
information This report is based on independent research commissioned and funded by the NIHR (National Institute for Health Research) Policy Research Programme via the Policy Research Unit in Commissioning and the Healthcare System. The views expressed in the publication are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health, ?arm's-length? bodies or other government departments.We are grateful to our participants who were very generous in allowing us access to their organizations at a time of considerable turmoil and change.
Publisher Copyright:
© 2018 John Wiley & Sons Ltd
PY - 2020/6/1
Y1 - 2020/6/1
N2 - In the context of welfare delivery, hybrid organizations mix public and ‘new’ market, social, and professional types of mechanisms and rationales. This article contributes to our understanding of accountability within hybrid organizations by highlighting how accountability obligations can become hybrid, simultaneously formal and informal. Instead of seeing accountability as hybrid only in the sense of the coexistence of types of organizational mechanisms and structures (i.e., the prevalence of both state and market types), we examine accountability arrangements governing a hybrid model—primary care commissioning in England—and interrogate the relationships between accountability actors and their accountability forums. We conceptualize ‘hybrid accountability obligations’ as a state whereby the nature of obligation underpinning accountability relationships is both formal-informal and vertical-horizontal concurrently. The article concludes by highlighting the consequences of this kind of hybridity, namely how it extended discretion from welfare delivery to the domain of welfare governance.
AB - In the context of welfare delivery, hybrid organizations mix public and ‘new’ market, social, and professional types of mechanisms and rationales. This article contributes to our understanding of accountability within hybrid organizations by highlighting how accountability obligations can become hybrid, simultaneously formal and informal. Instead of seeing accountability as hybrid only in the sense of the coexistence of types of organizational mechanisms and structures (i.e., the prevalence of both state and market types), we examine accountability arrangements governing a hybrid model—primary care commissioning in England—and interrogate the relationships between accountability actors and their accountability forums. We conceptualize ‘hybrid accountability obligations’ as a state whereby the nature of obligation underpinning accountability relationships is both formal-informal and vertical-horizontal concurrently. The article concludes by highlighting the consequences of this kind of hybridity, namely how it extended discretion from welfare delivery to the domain of welfare governance.
UR - http://www.scopus.com/inward/record.url?scp=85057051206&partnerID=8YFLogxK
U2 - 10.1111/padm.12554
DO - 10.1111/padm.12554
M3 - Article
AN - SCOPUS:85057051206
SN - 0033-3298
VL - 98
SP - 291
EP - 307
JO - Public Administration
JF - Public Administration
IS - 2
ER -