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Accountability
Accountability and governance and governance
in social care: the impact
of personalisation
111
Enrico Bracci
Department of Economics and Management,
University of Ferrara, Ferrara, Italy

Abstract
Purpose – The aim of the paper is to illustrate the changing structure of accountability under
a new public governance agenda introduced in England to deliver social care through personal
budgets.
Design/methodology/approach – The paper draws on accountability and public governance
literature, in particular, the accountability framework proposed by Hupe and Hill. The evidence was
gathered from exploratory case studies conducted in two English County Councils.
Findings – The introduction of personal budgets has modified the roles of the different actors involved
in the co-production of social services. The case studies evidence changes in the accountability
and governance process, particularly with respect to the personal budget regime that has devolved
responsibility and accountability to the customer. Specifically, the customer’s role has shifted
and expanded in the accountability chain and thus developed into a partnership.
Originality/value – This study is one of the first to analyse the relationship between the
personalisation agenda in English social services and the relevant accountability mechanisms
involved. Moreover, the paper refines the theoretical framework proposed by Hupe and Hill according
to the different role the public now plays.
Keywords Governance, Accountability, Personal budgets, Social care, Customer/partner accountability
Paper type Research paper

Introduction
Public governance and accountability are two relevant and interrelated concepts in the
public service context that now constitute a holistic research approach (Broadbent and
Guthrie, 2008; Osborne, 2010). The new public governance (NPG) paradigm suggests
that several different actors are involved in the co-production of public services
(Osborne, 2006). Accountability in NPG systems becomes more intricate, complex and
dynamic (Osborne, 2010). Koliba et al. (2011) suggest focusing on the extent to which
governance structures impact on accountability regimes where these emerge from the
on-going operations of the governance network (Osborne, 2010).

The author wishes to thank the two guest editors and the anonymous referees for their
continuous support and useful comments on the previous versions of the paper. Earlier versions
of the paper were presented during the XVI IRSPM Conference held in Rome in 2012, and during
a seminar held at the Queens’ School of Management in Belfast in 2013, and benefited from Qualitative Research in Accounting &
Management
comments by Pam Stapleton, Noel Hyndman, Mariannunziata Liguori, Giuseppe Grossi. Vol. 11 No. 2, 2014
A special thanks to Sue Llewellyn for her invaluable support during the initial phases of pp. 111-128
q Emerald Group Publishing Limited
developing the research. The research was partially funded by the “Iniziative di 1176-6093
Internazionalizzazione di Ateneo – Start-up 2009” of the University of Ferrara. DOI 10.1108/QRAM-04-2014-0033
QRAM The present paper addresses this issue by considering the changing nature of
11,2 accountability under NPG systems, specifically, the changes brought about through
the introduction in 2006 of personal budgets (PBs) in social care in England.
The traditional approach to social care rested on services delivered by local
authorities (LAs) in a public administration paradigm (Osborne, 2006) whereby people
were allocated by care management processes to the services of LAs. The introduction
112 of PB was intended to encourage LAs to adopt more flexible and creative ways of
providing social care (Wilberforce et al., 2011).
Through the PB scheme, the boundaries of public sector intervention become blurred.
Indeed, the public may simultaneously assume the role of citizens, consumers and
partners (Thomas, 2013) in the design, delivery and evaluation of public services. The role
of LAs changes from producing and buying services to steering and governing customer
choices not only in terms of their care but also with regard to the range of public and
private actors who provide this care. Hence, due to the freedom of choice given to
customers, the network of public, private and not-for-profit organisations
eligible to provide services widens. The participation of these multiple actors in the
co-production of social care influences the governance of the system and the lines
of accountability and responsibility (Mayo and Moore, 2002; Hupe and Hill, 2007;
Bovaird, 2007). Some scholars are concerned that personalisation may dilute public
accountability (Bovaird, 2007), calling for more research to understand the relationship
between public accountability and governance (Broadbent and Guthrie, 2008; Osborne,
2010; Koliba et al., 2011; Hodges, 2012).
This study aims to ascertain the impact on the accountability of customers, care
managers and LAs in the NPG of social care provision resulting from the introduction
of PBs. Drawing on accountability and public governance literature, the paper
addresses the following two interrelated research questions:
RQ1. How does the responsibility and accountability of customers, care managers
and LAs change under the PB system?
RQ2. How are customers, care managers and LAs held accountable under the PB
system?
The remainder of the paper is structured as follows. The second section presents the
literature and theoretical framework. The third describes the methodology used while
the fourth section gives the contextual background to social care in England. The fifth
and sixth sections outline and discuss the main findings from the two case studies.
A discussion and a concluding section follows.

Public service governance and public accountability: theoretical

development
The NPG concept in the delivery of public services has become an umbrella term, albeit
a relevant one (Almquist et al., 2013). Public governance concerns the decision-making
structure in terms of who has what power to decide on what issues (Kaler, 2002). NPG
emerged as a response to the increasingly complex nature of public services as an
alternative to New Public Management (NPM). Under NPG, the focus becomes the
organization in its environment, with particular emphasis on negotiating the values
and the co-production of public services (Osborne, 2006).
 Osborne (2010, p. 11) stresses that in the NPG setting, the accountability question Accountability
becomes highly relevant. Indeed, the interactions between the different actors involved and governance
in public service co-production and accountability systems are directly related
(Osborne, 2010, p. 422; Bovaird, 2007). Stoker (2004) argues that the complexity of
governance structures “makes accountability multiple and intertwined”. Moreover,
several studies indicate that the ongoing structural changes in public service delivery
are bringing about a shift in the way accountability is manifested and conceptualised 113
(Mulgan and Uhr, 2001; Dubnick, 2005; Erkkilä, 2007).
Accountability is based on three fundamental dimensions (Romzek et al., 2012, p. 443):
(1) to whom the organisation or individual is answerable;
(2) expectations of the accountable organisation/individual’s performance; and
(3) the technology through which the organisation or the individual is held
accountable and the related consequences.

The latter dimension needs to be assessed and formalized for organisational actors
operating in complex governance settings (Romzek et al., 2012). Several authors (Koliba et al.,
2011; Erkkilä, 2007) suggest focusing on the extent to which a governance structure affects
accountability regimes through the on-going operations of the governance system.

The theoretical framework

To analyse the relation between public governance and accountability, we adopt the
framework proposed by Hupe and Hill (2007) and study the relation between modes of
public governance implementation in public services and the accountability system. We use
this framework to interpret and give meaning to the empirical evidence. Public governance
entails an institutional design as well as a management dimension that occurs at
the implementation phase (Hill and Hupe, 2002). We propose three modes of
policy/governance implementation, namely, enforcement, performance and co-production
according to Hill and Hupe (2002), who argue that modes of implementation, as well as the
related accountability systems, can coexist at various levels of governance.
Hupe and Hill (2007) use Meijer and Bovens’ (2005) analysis of forms of public
accountability classified into five types: political, legal, administrative, organisational
and professional (Bovens, 2006). Hupe and Hill reconfigure the latter types of public
accountability, assuming the principles on which accountability was founded
(e.g. authoritative and legitimate, jurisdiction, expertise or citizenship) and the nature
of the relationship between the accountee and the accountors (e.g. vertical, horizontal or
mixed) to build a typology in relation to policy/governance implementation modes
(Hupe and Hill, 2007, pp. 288-289). The set of coherent parameters defines three types of
public accountability, namely:
(1) public administrative accountability (also with a managerial variant);
(2) professional accountability; and
(3) participatory accountability.

These forms of public accountability can be found to different degrees in governance

systems according to their modes of implementing public policy or interventions
(Hupe and Hill, 2007). The main characteristics of the accountability modes are
summarised in Table I.
QRAM
Type of accountability
11,2 Public administrative
Public administrative accountability Professional Participatory
Parameters accountability (managerial variant) accountability accountability

Modes of Enforcement Performance Co-production Co-production

114 governance
implementation
Characteristic of Compliance with Compliance with targets Compliance Compliance
accountability at rules with with shared
scale of internalized targets
individuals professional
standards
Characteristic of Conformity to Conformity to contract Conformity to Conformity to
accountability at standard operating shared goals shared goals
scale of procedures and standard
organisation setting
Issue Were inputs Did promised outputs Have shared Have shared
respected? occur? outcomes been outcomes
achieved? been
achieved?
Character of Rule-bound Contractual Trust Trust
relationships
accountors-
accountees
Citizen role in Pre-supposed Exit (when feasible). Voice Voice
accountability compliance. Access to Otherwise provision of potential for
complaint and appeal evidence on contract cooperation
procedures compliance
Fitting labels for Task oriented Indicator oriented Impact oriented Impact
accountability oriented
Table I. regime
A typology of public
accountability regimes Source: Adapted from Hupe and Hill (2007, p. 294)

Public administrative accountability relates to compliance with and conformity to rules

and standards. It tends to be hierarchical/vertical in form and applies to situations where
there is a public governance enforcement mode. The focus of public administrative
accountability is conformity to standard procedures, compliance with rules. It is linked
to political and legal accountability, having in common a vertical orientation with
authoritative and legitimated jurisdiction.
Hupe and Hill (2007) also consider a possible variant of public administrative
accountability, namely, public administration accountability with a managerial variant.
The focus of public administration accountability in its managerial variant is
conformity to contracts, compliance with targets and the overall outputs achieved.
Professional accountability is relevant in the case of technically uncertain problems
where public bureaucrats become expert groups specialised in delivering complex tasks
(Romzek and Dubnick, 1987). In such contexts, work arrangements confer a high degree
of autonomy to individuals or agencies, deferring to expertise, on-going consultations
and an emphasis on performance that supports best practices (Romzek and Dubnick,
1987; Romzek and Johnston, 2005).
 Finally, participatory accountability refers to the role of citizens/customers/voters Accountability
as account receivers (Hupe and Hill, 2007) of street-level bureaucrats (Lipsky, 1980). and governance
This is coherent with the concept of participatory citizenship, which is considered an
alternative citizenship model embedded in representative democracy (Hupe and Hill,
2007; Taylor, 2003). Thomas (2013) argues that in today’s public service environment,
the public can have multifaceted roles as citizens, customers and partners.
Participatory accountability is based on horizontal account-giving between public 115
servants and customers/citizens.

Methodology
In methodological terms, this paper can be considered as an exploratory case study
attempting to understand, rather than predict, the emergent phenomenon and issues
(Scapens, 1990). The theoretical framework is used as a skeleton to focus on the specific
issues of interest and is thereafter fleshed out by the relevant aspects of the case
(Laughlin, 1995). The paper investigates how accountability has evolved and is exerted
under the PB system.
To address the research questions, case studies of two English County Councils
(Council O, and Council N) were conducted to analyse the changes in accountability
under the PB system. The empirical analysis was carried out between January 2010
and May 2010.
Council O was prominent as an early adopter of PB in adult social care, 46.6 per cent
of eligible social care customers were already under the PB scheme in the year
2008-2009. In contrast, Council N started later in promoting and providing PB to its
customers. The percentage of eligible social care customers receiving PB was about
18.4 per cent.
Site A is situated in Council O, which is a metropolitan authority with a population
of approx. 220,000, of which some 180,000 are in dense suburban/industrial areas and
40,000 in very rural areas. The annual budget is around £566 million, with average
per capita spending in adult social care of £430. The council has pockets of deprivation
alongside areas of significant affluence. Adult and community services receive around
5,000 new referrals per year with approximately 4,000 open cases at any one time, and
3,000 new assessments carried out each year.
Site B is situated in Council N, which has a resident population of approx 600,000.
It is largely rural with some areas of low population density and a high proportion of
elderly persons. The Council manages a budget of around £871 million, with per capita
spending in adult social care of £380.
The study was conducted through semi-structured interviews. An open-ended
approach was adopted in the interviews (Yin, 2003, p. 89) with a fluid rather than rigid
structure. The interview schedule followed the line of enquiry while also allowing for
other “conversational” questions to emerge (Rubin and Rubin, 1995) and opening
discussion around the two research questions. This strategic approach of interviewing
is aimed at adapting the interview to the expertise and experiences of each interviewee,
according to previous studies in the field (Kraus, 2012) and methodology literature
(Irvine and Gaffikin, 2006).
The social care service unit managers in charge of the PB system in each council
were interviewed. Both social service managers were in charge of the social care unit
before and after the introduction of the new PB policy program. Eight care managers
QRAM who dealt with customer assessments, planning, monitoring and evaluations of PBs
11,2 were also interviewed as well as one administrative manager.
The interviews overall lasted an hour and took place in the conference rooms and
offices where participants carried out their daily work. All interviews were audio taped.
In addition to this empirical material, personal contact was established with three
employees at different levels of the organisation. In view of the exploratory nature of the
116 research, questions included information on the situation before and after the
implementation of the PB system in social care, on the way PBs were introduced and
their effect on the governance of social services and on the accountability mechanisms.
Once the data was reviewed, the interview transcripts and notes were coded
manually to identify both common issues and any particularly noteworthy or unique
instances (Ahrens and Dent, 1998). The coding categories selected were the following:
general information on PBs, governance issues in terms of changes in the role of
professionals and other actors, accountability issues with specific reference to the
typology of the conceptual framework. The above categories were derived from the
theoretical interest of the paper and were broad enough to allow flexibility to adapt
them to the different empirical material.

Personalisation and PB: background

Personalisation of public service provision in England is part of a broad political process
known as the “modernising government” manifesto of 2004 (Gardner, 2011).
Personalisation is a social care approach that is described by the Department of
Health (2006, p. 165) as “Giving people greater choice and control over the services they
use, we also need to ensure that everyone in society has a voice that is heard”.
Personalisation implies services that are tailored to the needs of the individual rather
than organized in a one-size-fits-all approach.
A PB can cover more than social care including access to work, healthcare and
leisure activities. PBs can also combine a budget in cash with services in kind. One of
the explicit government goals is greater flexibility in setting priorities with regard to
the use of budgets on an individual level; customers can choose to use the services
provided directly by the LA or use a mixture of direct services and purchase other
support and equipment. Table II summarizes the main characteristics of a PB.
The care management process of the PB system differs in several ways to the
traditional social care delivery system. Personalisation starts from the very beginning.
Customers are required to complete a needs assessment questionnaire (NAQ),

Key features An allocation of resources that may be held by the service user in cash
form or by a care manager or by a third party, e.g. service provider
The allocation is based on self-assessment needs
Degree of accountability Expenditure must be agreed with LA in advance through a support plan
and restrictions on use Receipts are usually required
Few restrictions, limited to issues of legal use of the budget, risk/safety
and consistency with agreed user outcomes/priorities
Accountability for outcomes
Use of funds Personal assistants, purchase of social care, access to work, leisure and
Table II. other within the support plan
PBs: features and
main issues Source: Adapted from Wilberforce et al. (2011, p. 599)
(or a resource allocation system – RAS – as it is called in some LAs). This contrasts Accountability
highly with the previous system where the customer was assessed by a professional, and governance
who subsequently designed the customer’s care plan.
The PB assessment process involves changes in the public governance structure and
is intended to change how power and responsibility are distributed among different
actors (Kaler, 2002; Needham and Carr, 2009). Indeed, PB is an explicit process to share or
delegate responsibility between the LA, professionals and customers (Needham and 117
Carr, 2009). The above described PB context shares some of elements of the NPG
paradigm. Osborne (2010) stresses that under NPG, the nature of state is plural
(LAs, customers and the market place are involved in shaping and delivering services),
the focus is the public organisation and its environment (LAs steering and shaping the
market place), within an open/closed system (the numbers of actors can vary,
within stated rules). In particular, under a PB, the public plays a multifaceted role.
According to Thomas (2013), in the co-production of public services, individuals can
simultaneously act as citizens, customers and partners.

The changing responsibility and accountability system under PBs

Responsibility is considered an integral part of accountability (Dubnick, 2005, p. 6;
Bovens, 1998), and even an “a priori” to accountability (Hoskin, 1996; Llewellyn, 1998).
As a consequence, in the attempt to answer our RQ1, in this section we discuss the
governance system of social care delivery in England in terms of how responsibility
and accountability of customers, care managers and LAs change under the PB system.
Table III summarizes the main findings that emerged from the interviews in terms of
responsibility distribution under PB.
Before the introduction of the PB system, customers had very limited or no power
and responsibility for the choice of services. They could either accept the services that
the care manager deemed suitable for their needs or not. Under the PB system,
customers become active actors in the process, involved during the assessment phase
and in the co-production of the personalised set of services.

Actor Before PB Under PB

Customers Limited or absent responsibility for Co-responsible for the choice of services and
the choice of services outcomes to be achieved (support plan)
Not relevant or accountable for the Customers also as partners in co-producing the
use of money (if direct payment) support plan
Accountable for the use of money and outcomes
achieved
Care Responsible for the types of Co-responsible for the choice of services and
managers services provided to customers outcomes to be achieved (support plan)
Accountable for achieving financial Accountable for the use of money and outcomes
targets and performance measures achieved as well as performance measures (star
(star system) system)
Local Responsible for the provision of Responsible for the creation of the market place
authority services and financial targets (commissioning) and achievement of PB Table III.
Accountable for performance performance and financial targets Responsibility and
assessments and indicators Accountable for performance assessments and accountability changes
indicators through PB
QRAM The initial self-assessment is intended to give customers some level of power, control
11,2 and responsibility over their needs, as a care manager stresses in comparing PB with
traditional social care delivery:
If you look at the personal budget from a care manager’s perspective, when we used to go and
do need assessments, it was us (e.g. the care manager) with the control and the power. Under
PB, the power over decisions is shared with customers, as well responsibility over the RAS
118 (Care Manager N).
Consequently, the main change, also highlighted by other interviewees, entails the
devolution of decisional power and responsibility away from professionals towards
customers (Glasby and Littlechild, 2009).
The customer is responsible for the choices made in terms of how to allocate the
public money and the outcomes to achieve. The customer is not, however, alone in this
process as the care manager has the role of mediating the requests.
The support plan proposed by the customer is evaluated by the care manager
appointed to the case. In approving the support plan, the care manager and customer
share responsibility and much of the risk is transferred to the customer. The following
comment stresses the new roles of both customers and care managers, with the quest
for responsibility at the centre of the discourse:
The care manager role is to look at some of the decisions that the customer makes (. . .) we have
no right to take away the risk and responsibility from the person. I think it’s more shared
responsibility now than the traditional mode of delivery social services (Service Manager O).
Through the support plan, customers together with their care manager identify the
type of support they think will satisfy their needs, reaching a mutual adjustment
(Whitaker, 1980).
In presenting the support plan, the customer takes full responsibility over the way
public money is to be spent and for what purposes.
At the same time, n signing the support plan, the care manager de facto shares part
of the responsibility, trusting the customer’s capability and willingness to achieve the
planned outcome. As stressed in the following comment, trust is implicit in the
co-production process:
I had to deal with customer’s choices even though I did not completely agree with them.
Overall, it is also about trust and not just legal obligation (Care Manager N).
Personalisation, and co-production within, assumes trust as an important regulative
medium (Levine and Fisher, 1984, p. 186). Trust between care managers and customers
is based on co-decision and co-planning of the support plan.
At the LA level, the main change is the responsibility to implement government policy
and to create a market place for social care services through commissioning agents
(Baxter et al., 2011). The LA’s role becomes one of steering rather than just delivering
public services, governing the different actors involved to sustain public policy and
services. This new paradigm of social care delivery under PB is coherent with NPG where
“multiple interdependent actors contribute” to the sustainability of public services and
where the inter-organisational dimension becomes the norm (Osborne, 2010, p. 9).
Under PB, the LA’s role is to shape and steer the market (Boland and Coleman,
2008). The data shows that LAs attempt to create and steer the network of actors
constituting the market place through commissioning. Commissioning means enabling
a market place for PB, letting customers choose from among several providers, and Accountability
ensure the providers are sufficiently flexible to adapt to the personalised requests and governance
(Needham, 2010).

The accountability mode within the PB governance system

In this section, we attempt to answer the RQ2, namely, how are customers, care
managers and LAs held to account under the PB system? We analyse and discuss this 119
question using the three categories suggested by Hupe and Hill (2007): public
administrative accountability (also with a managerial variant), professional
accountability and participatory accountability.
Public-administrative accountability is linked to political and legal accountability where
authoritative and legitimated jurisdictions set policy objectives (Hupe and Hill, 2007).
Public administrative accountability also involves care managers who are held
accountable for policy implementation and achieving the government’s programs and
goals. In this sense, the LA and care managers are responsible for policy requirements
over time, and have to account for these. The interviews did not indicate traditional
public-administrative accountability as particularly relevant or impacting on service
delivery. Moving onto the managerial variant of administrative-accountability,
considered a form of traditional top-down political accountability (Hupe and Hill,
2007), this is based on performance indicators and attempts to measure public services
using an input-output approach.
The adoption and diffusion of PBs in English LAs can also be ascribed to the
introduction of a specific indicator in the comprehensive performance assessments
(CPA)[1]. As highlighted by the following comment, performance indicators play a key
role in the accountability mechanisms of social care:
We have performance indicators for personal budgets as well. There is a new indicator
(NI130) which looks at personalisation (. . .) we are now being monitored on personalisation.
So that’s a very strong driver for the Local Authority to change (Service Manager, N).
Within the LA, public administrative accountability is also exerted in terms of financial
results and performance. In the cases under study, service managers controlled the
performance assessments of care managers. Care managers are held accountable for
both financial and output performance, as exemplified by one care manager:
Even under the PB we have to account for the financials, on how and where money is
allocated, and also how many assessments we have made and how many customers are we
following (Care Manager O).
However, when the care manager’s performance is not in line with that foreseen, this is
discussed from both a professional “what’s come through the door” and managerial
perspective, as indicated in following comment by a care manager:
How many assessments have been made, what the cost is. I’ve sat down with some of the
general managers who say “explain to me why you have all these packages over £5,000,
while your colleague has them mainly under £5,000”. So we have those debates and
sometimes it’s just the nature of what’s come through the door (Care Manager N).
Other interviewees stressed the limitation of performance indicators at the LA level
and the need to go beyond these, and to not limit care to a discussion around budget,
as suggested by the following statement:
QRAM Performance needs to be more than just a budget. Sometimes, I struggle in the attempt to
explain why it is important to allow extra budget for one customer and less for another, even
11,2 though I cannot measure straight away. It is more a professional evaluation, and sometimes
what it is important to me and the customer cannot be measured (Care Manager O).
This comment shows the tension that public administrative accountability with a
managerial variant can create at the level of care managers. Professionals contest the
120 sole use of quantitative performance indicators, arguing for more qualitative
indicators.
Professional accountability is the second mode proposed by Hupe and Hill (2007)
whereby peers practice collective, albeit managerial, forms of self-management and
accountability, assuming control functions to preserve the profession (Day and Klein,
1987). PB, in the first instance, requires formalizing the standard procedures to be
followed. This is evidenced by the following comment made by one interviewee:
In dealing with PBs we had to first discuss and decide what the best procedure and standards
to follow was and how to deal with the customer in the different phases of the process (Care
Manager N).
Professional accountability in our cases studies would seem to involve financial and
output measures as well as outcomes. The following service manager commented on
the accountability shift under PB, with particular attention to the impact on the
“person” and the “partnership”:
The inspection regime is changing to be less process focused. Because [previously] as long as
you were doing your assessments and you did the right number of reviews, it was really
about the quality of them. Now the shift is about demonstrating what difference this has
made to this person, your working partnership, the effective use of resources, and the like
(Service Manager O).
The references to “outcomes” were not isolated examples of how professionals
perceived accountability. Although they considered accounting for numbers
important, the tension towards presenting and accounting for the account was
evident, as the following comment shows:
Our tension is being able to account for the outcome achieved through a PB, it is normal to
adopt anecdotal accounts, like videos or CDs. We tend to discuss and share this
information, problems and successful cases, with or without formal reports or accounts (Care
Manager O).
Anecdotal accounts such as videos are used by customers and professionals to describe
and demonstrate the outcomes achieved according to the support plan. This form of
lateral accountability and informal communication becomes relevant and central in a
professional environment ( Jönsson, 1996; Bracci, 2009).
As discussed in the previous section, care managers are also called on to account for
the overall performance of the service. In particular, budget and financial controls are
set at the care manager level in a boundary role between professional and managerial
responsibilities (Llewellyn, 1998). One service manager explained:
A lot of the front-line staff were really engaged by it [the PB], but very frustrated because
they are dealing with two conflicting pressures and that is bad. One is to keep your budget in
line and the other is to give customers more freedom to spend their money and they’re quite
difficult messages to manage for my front-line managers (Service Manager N).
In addition to such internal tension between financial performance and effective PBs, the Accountability
confusing message also emanates externally from the policy-maker and regulator. This can and governance
create difficulties and tension at the care manager level, as voiced by one care manager:
I think we struggle because we have two different messages coming from central government
and the regulator. How many numbers have you served? And they will also say they are
interested in outcomes (Care Manager O).
121
Almost all interviewees indicated that the tension between counting the number of
customers served and reporting on outcomes is an issue that must be addressed to
structure a coherent form of accountability. Although multiple objectives can coexist,
the risk is that outcomes are sacrificed in the name of public sector efficiency
(Mulgan, 2000) and central government pressure to control expenditure (Hodges, 2012,
p. 45).
Participatory accountability is a form of customer-based evaluation of the work of
professionals (Hupe and Hill, 2007; Lipsky, 1980; Pollitt, 2003). However, under the PB
regime, customers simultaneously have two different accountability roles: as customers
in the strict sense and as partners (Thomas, 2013), entailing different accountability
relationships.
The public as customers continue to evaluate the LA’s service as well as the care
managers in terms of the overall effectiveness of the support services received during
the PB process. The following comment highlights the importance of positive customer
evaluation and feedback, inquiring about the professional support received and the
experience under the PB:
With PB we are evaluated by customers on the way we supported them in making their own
choices (. . .) how our services can support your needs (Care Manager N).
Moreover, the evidence suggests that participatory accountability under PB also
involves the additional role of customers as partners, becoming accountable agents on
their own. As previously noted, under PB the customer co-produces the support plan
and becomes responsible for the use of public money.
The support plan, as described in the previous section, is both the planning document
and the basis for the accountability process, as stressed by the following comment:
In terms of accountability, the support plan needs to show how the customer is going to use
this money to meet his needs, and outcomes (. . .) The customer will then be asked to account
for what was written in the support plan (Service Manager O).
As a planning document, drawing up the support plan involves sharing
responsibility between the care manager and the customer through the needs and
risk assessment.
Thus, the agreement to hold a PB creates a new responsible agent (e.g. the customer
as partner) willing to carry out the assigned tasks and answerable to others (Llewellyn,
1988). Answerability entails accepting a financial audit and the need to account for the
results achieved. To operationalize financial accountability, paper-work is delegated to
customers who periodically report to the care manager, presenting receipts justifying
the use of the money. This can be seen from the following comments:
Customers tell us what they’re going to do with the PB, then we’ll release the money. Then
there is an accountability issue. We do expect that they keep basic records (Care Manager O).
QRAM Another commented:
11,2 (. . .) to make customers accountable is important, it is still public money (Care Manager O).
In addition to the accountability of customers with regard to the way the money is
spent, the outcome is one of the main accountability issues for customers and care
managers. A care manager explained:
122 Accountability is very much about measuring people’s progress towards the personal
outcomes they identified initially in the support plan (Care Manager N).
However, if the care manager has doubts over the customer’s behaviour, he/she can
request more frequent accounts. This demonstrates the role of trust in the
customer/professional relationship, as indicated in the following comments:
Customers account for the outcome achieved during the annual review. Besides, this, if I have
elements of doubt, I can ask for more frequent accounts, until I completely trust the
customer’s capability and autonomy in making responsible decisions (Care Manger N).
Trust is implicit in the relationship between the customer as partner and the care
manager and affects the accountability relation in both directions in the planning/design
phase and the control/accountability phase of the PB. In accountability (Hupe and Hill,
2007) and governance ( Jönsson, 1996) literature, trust is fundamental for the efficient
and effective flow of horizontal relationships and collaboration in co-producing public
services (Osborne, 2010).

Discussion
The PB regime entails a shift from a paternalist form of social care to a form of shared
responsibility between care managers and customers (Wilberforce et al., 2011;
Scourfield, 2007). PB emerges as an alternative concept of co-producing public services
by combining the benefits of collaboration, empowerment and involvement.
Co-production is aimed at shaping service delivery in a more responsive and efficient
way, enabling customers to personalise their own outcomes (Glasby and Littlechild,
2009; Boivard, 2007). In this process, responsible customers share the burden of being
“answerable”, providing accountability for the use of public money as well as
accounting for the outputs and outcomes achieved.
The preliminary evidence of the case studies highlights the need to redefine and
assess the boundaries of public sector accountability in the context of NPG, and
co-production in particular. Public managers need to be aware that in such a context they
interact with members of the public covering different roles: as citizens, as customers
and as partners (Thomas, 2013). In an NPG setting, given its multi-dimensionality, both
power and accountability are exercised by different actors (and also by the public) on
different scales (Osborne, 2006; 2010; Hupe and Hill, 2007). Furthermore, PB involves the
devolution of some responsibility and accountability obligations from public sector
actors to individual customers.
Our findings reveal the emergence of a new actor responsible and accountable under
the PB system: the customer as partner. Indeed, customers now have a twofold role, not
just as accountors of social services but also as accountees now called on to account for
the way public money is spent and the outcomes achieved. This form of two-way
participatory accountability is neglected in literature and should be reassessed.
This paper proposes a refinement of the Hupe and Hill (2007) framework by suggesting Accountability
the formal inclusion of the public as citizens, customers and partners and, accordingly, and governance
as accountees as well as accountors.
In Table IV, the types of accountability proposed by Hupe and Hill (2007) are
reformulated in terms of who is accountable, to whom the account is rendered and the
explicit and implicit standards involved. In their original proposition, Hupe and Hill
(2007, p. 290) suggest focusing particularly on professionals being held accountable by 123
customers/citizens, although not explicitly considering instances of customers
(as co-producing partners) being held accountable nor the possibility of a
multifaceted role of the public.
Our case studies suggest that participatory accountability in PB structurally involves
customers as partners held accountable by professionals through written agreements
and negotiation (i.e. as expressed in the support plan). Customers as partners are added
to the accountability chain and are formally recognised as actors adopting a mix of
formal (care plan/annual review) and informal (talk, shared information) accountability
based on trust, reciprocity and durable relations. Accounting in this context of shared
responsibility sustains the value of narratives to become “communication-efficient”
(Llewellyn, 1998b, p. 306; see also Lindkvist, 1993), providing measures that are
simple to represent and communicate. Shared responsibility for decisions and activities
advocates morality and ethics towards the creation of a public good (Llewellyn, 1998).
The personalisation policy in public services is changing the public governance
system, and, as this paper demonstrates, accountability. In this context, responsibility
and accountability are devolved and also driven by outcome-based indicators and
evaluations (Hodges, 2012). As indicated, the customer accounts for the use of money
and for the outcome, but the question “outcome for whom?” (i.e. the customer or social
services) remains unanswered. Outcome for whom needs to be negotiated and then
demonstrated for the sustainability of public services in fragmented states (Broadbent
and Guthrie, 2008; Osborne, 2010). Moreover, as Purcell and Chow (2011) argue,

Who is To whom is
Accountability type accountable account rendered Explicit standards Implicit standards

Public administrative LA, care Government, Administrative Deference to

accountability manager supervisors, procedures, authority
bosses citizens organisational rules
and standards
Public administrative LA, care Government, Performance Deference to
accountability manager supervisors, measures, authority
(managerial variant) bosses citizens administrative
procedures
Professional Professional, Peers, supervisor, Codes of ethics, Professional
accountability experts experts professional norms, expertise,
standards and competence
performance
Participatory Customers/ Customers/ Written agreements, Trust, reciprocity,
accountability Partners Partners negotiation regimes durable relations Table IV.
Professionals Professionals, Accountability
experts, framework under PB:
supervisors an extension
QRAM particular attention should be paid to the effect of “excessive monitoring” and
11,2 accountability in the promotion of personalisation.
The devolution of responsibility and budgets to customers renders participatory
accountability an important part of public accountability ties. Participatory
accountability is therefore deemed a relevant conceptual framework in NPG to
highlight the changes, difficulties and tensions in terms of public accountability when
124 customers are involved as partners and competing and legitimate interests come into
play (Hodges, 2012).

Conclusions
The main aim of this paper is to examine the relationship between the NPG mode
introduced under the PB scheme and accountability. This study is exploratory in
nature in view of the limited research on PB yet contributes to extant literature and to
the special issue topics in several ways.
It is one of the first attempts to understand the impact of the personalisation policy
in terms of public governance and accountability. In doing so, it draws an interesting
trajectory of devolving responsibility to customers as partners and making them
accountable both in terms of financial resources used and outcomes achieved. The
results support the claim that as public service delivery changes to more complex
forms of public governance, accountability undergoes a dynamic process of evolution
and adaptation (Considine, 2002) through the multifaceted role played by the public
(Thomas, 2013). Furthermore, our evidence demonstrates that public accountability
and NPG are two interrelated concepts representing a relevant research avenue
(Broadbent and Guthrie, 2008; Almquist et al., 2013). In the case of personalised social
services, performance and administrative-based measures are integrated with
professional and participatory modes of accountability.
While this study supports Hupe and Hill’s (2007) framework, it proposes a
theoretical refinement of their model, particularly of the participatory accountability
mode. This is required to account for the broader role of the public and more in detail as
customers and as partners (Thomas, 2013). As the case studies show, customers are
formally added to the accountability chain as partners of the co-production process and
consequently as accountees and accountors. They become responsible agents called on
to give appropriate accounts to the care managers. In particular, the present paper
shows that accountability can be achieved through co-production and customer
participation through mutual adjustment between care managers and individual
customers, developing hybrid forms of accountability (Goetz and Jenkins, 2001). The
latter are correlated to the increase in citizen engagement (Goetz and Jenkins, 2001),
participation in the governance of public services (Ackerman, 2004) and the
co-production of services (Osborne, 2010).
Future research could expand on the issues raised by these case studies in similar
contexts or in other fields and analyse emergent issues within NPG, for example, the
management of critical cases and associated public scrutiny and accountability, but also
focusing on performance measurement. Furthermore, it would be interesting to evaluate
whether the PB scheme, through co-production and the participation of customers as
partners, is able to achieve its intended outcomes, and above all, if it can achieve the
sustainability of public services. At the same time, under the NPG paradigm, further
studies should focus on whether and how public accountability becomes more diffused
and fragmented, raising questions on who is accountable, to whom, for what, and by Accountability
what means. Given this study is limited to only two cases, other studies could extend the and governance
breadth and depth of the analysis or adopt more quantitative approaches.

Note
1. Although the CPA is now disbanded, it was in force at the time of the research. 125

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Corresponding author
Enrico Bracci can be contacted at: enrico.bracci@unife.it

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