Financial performance reporting by NHS Trusts in England
This research examines financial reporting by National Health Service (NHS) Trusts in England. The particular aspects examined are financial reporting, financial performance and reporting of financial performance. National Health Service Trusts in England were examined over the period from 1991/92, the launch year of the NHS internal market, to 1997/98. The objectives of the research are to conduct an empirical examination of financial reporting and financial performance of NHS Trusts in England. The research methodology involved: collecting data; piloting a study on Northern & Yorkshire NHS Trusts: examining financial reporting; identifying research questions; and testing hypotheses in order to make generalisations from the pilot study to the whole of England. The discussion of financial reporting seeks to identify financial reporting styles of NHS Trusts. The research found that most Trusts prefer publishing an annual report with financial highlights (Repfh) and separate audited annual accounts (Sepac), rather than an annual report including full audited annual accounts (Repac). Regarding the financial performance of Trusts, it is found that they have faced difficulties in achieving their three financial duties, especially the 6% financial target and break-even requirement. The majority of Trusts disclosed detailed financial information, such as that relating to the 6% and break-even targets in Sepac, but not in Repfh. While Repfh documents usually fail to reveal detailed financial information, Sepac documents are often not available in practice. Moreover, the Summarised Account of NHS Trusts and the associated Comptroller and Auditor General's Report failed to provide comprehensive and consistent financial information, especially on the three financial targets. Furthermore, incomplete information in many documents and the obscuring of Trust performance by adjustments have increased difficulties for users attempting to understand the real financial performance of NHS Trusts. These practices hinder accounting research on NHS financial performance.