Autonomy and improved performance: lessons for an NHS policy reform

Anand, Paul; Exworthy, Mark; Frossini, Francesca and Jones, Lorelei (2012). Autonomy and improved performance: lessons for an NHS policy reform. Public Money and Management, 32(3) pp. 209–216.

DOI: https://doi.org/10.1080/09540962.2012.676279

Abstract

Autonomy is currently seen by policy-makers as a possible mechanism for enhancing public sector performance and in this paper we examine a health-service reform (in England) in which more autonomy is given to better performing hospitals. Drawing on data from interviews with senior managers in the NHS, our research suggests that despite being enmeshed in a politicised culture of regulations and guidance, autonomy is increasingly perceived positively and appears to depend on the extent to which organisations have the incentives and the capacity to respond to increased autonomy.

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