The Bristol Royal infirmary inquiry is one of the most far-reaching and detailed investigations in to the NHS ever undertaken, addressing fundamental issues of clinical safety and accountability, professional culture in the health service, and the rights of patients.
The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability.
A literature review and environmental scan undertaken by the Canadian Association of Occupational Therapists CAOTT) proposed that guiding principles for caseload management should include: evidence-based occupational therapy, cost-effectiveness, accountability, professional leadership and expert judgment, comprehensiveness and flexibility [ 57].
Despite the differences, common themes and strategies can be traced, such as one staff member (usually senior) providing supervision to a student, another staff member or intern for the purposes of quality client care, improved outcomes, efficiency, accountability, professional development, and support for the supervisee [ 7].
"What this is about is not just a will contest, it's about the accountability of professionals," John Morken, the lawyer for the relatives, 20 grand and great-grand half-nieces and half-nephews, said.
Not by itself, but it is part of a broader movement towards increasing social accountability of professionals and porousness of institutions which authors like Ulrich Beck have tried to capture with the notion of reflexive modernisation.
In a study, occupational therapists argued that, in the face of various "accountability dilemmas", professionals had to choose about how to enact their various obligations.
Health administrators, faced with the economic realities of providing quality health care to increasing populations, are demanding measurement and accountability from professionals offering ICU services [ 7].
The motivation for these changes are rooted in an increasing culture of accountability of professionals and a desire to address growing public and media concern about the ethical conduct of research.
Professional accountability rests with professional regulatory bodies – the General Medical Council (GMC) and the relevant specialty medical royal colleges and faculties.
