Developing Financial Accountability in British Acute Hospitals

This paper explains the process of defining, measuring and costing health service outputs (Health Resource Groups – HRGs). It identifies why the introduction of HRGs became necessary and how they were rolled out and became mandatory. The steps followed to achieve national uniformity are explained. Evidence is provided on the extent to which HRGs have been adopted and on the wider roles they may fulfil, such as benchmarking. The possible implications for resource allocation and the power of clinicians are discussed. Finally, attention is turned to the possible consequences of costed HRGs, as a means of achieving detailed financial accountability at operational level and to alternative means of control.