Accountable to whom, for what? An exploration of the early development of Clinical Commissioning Groups in the English NHS

Objective: One 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.

Design: We carried out detailed case studies in eight CCGs, using interviews, observation and documentaryanalysis to explore their multiple accountabilities.

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.