The Attitudes of NHS Clinicians and Medical Managers Towards Changes in Accounting Controls

Clinical directors and medical managers expected accounting information would assume high importance for institutional control as a consequence of NHS reforms. However, clinical directors were not comfortable with the symbolism of formal accounting controls. Their individual understanding of accounting information varied, but was modest overall. Medical managers were more inclined to accept and respond to financial controls. However, acceptance and response was frustrated for all users by inaccuracy and lateness of accounting reports. Cost savings were prompted more by established professional attitudes than in response to accounting reports. Non-financial controls remained the dominant mode of operational control.