Constructing accountability in inter-organisational collaboration: the implications of a narrow performance-based focus.
OBJECTIVE
The purpose of this paper is to analyse how accounts of collaboration practice were made and used to construct accountability in the empirical context of coordination associations, a Swedish form of collaboration between four authorities in health and social care. They feature pooled budgets, joint leadership and joint reporting systems, intended to facilitate both collaboration and (shared) accountability.


METHODS
Empirical data were collected in field observations in local, regional and national settings. In addition, the study is based on analysis of local association documents such as evaluations and annual reports, and analysis of national agency reports.


RESULTS
Accountability is constructed hierarchically with a narrow focus on performance, and horizontal (shared) accountability as well as outcomes are de-emphasised. Through this narrow construction of accountability the coordination associations are re-created as hierarchical and accountability is delegated rather than shared.


CONCLUSIONS
Features such as pooled budgets, joint leadership and joint reporting systems can support collaboration but do not necessarily translate into shared accountability if accountability is interpreted and constructed hierarchically.


CONCLUSIONS
When practice conforms to what is counted and accounted for, using the hierarchical and narrow construction of accountability, the result may be that the associations become an additional authority. That would increase rather than decrease fragmentation in the field.


CONCLUSIONS
This research derives from first-hand observations of actor-to-actor episodes complemented with the analysis of documents and reports. It provides critical analysis of the construction and evaluation of accounts and accountability related to practice and performance in collaboration. The main contribution is the finding that despite the conditions intended to facilitate inter-organisational collaboration and horizontal accountability, the hierarchical accountability persisted.
Johanna
J
Andersson
Ewa
E
Wikström
D002017:Budgets / Q000458:organization & administration*; D003299:Cooperative Behavior; D006268:Health Facilities / Q000191:economics; D006801:Humans; D007400:Interprofessional Relations; D012941:Social Responsibility; D013548:Sweden
Accountability; Collaboration; Health and social care; Inter-organisational; Performance measurement; Pooled budget