Uncertainty and commitment in commissioning of health services

This article reports on the use of management accounting information in commissioning of health services in England. The effects of environmental pressures and uncertainty on the use of this information in the decision-making process was examined. The relationship was further analysed from the perspective of interorganizational dependence and commitment with reference to particular financial management and budgeting practices. A more integrated approach to health care commissioning could be achieved by better harmonizing fund allocation, performance measurement and management systems and by supporting cultivation of joint multiprofessional groups so that regional hubs of information could be used to formulate consistent, bottom-up and lasting local strategies to secure inter-organizational trust and mutual dependency between local health alliances.