Focusing on quality care rather than ‘checking boxes’: How to exit the labyrinth of multiple accountabilities in hybrid healthcare arrangements

Abstract

Accountability relations in modern‐day welfare states have multiplied due to the complex interaction of institutional and sectoral logics. Against this backdrop, this article seeks to unravel complexities which surround accountability relations in hybrid healthcare arrangements. For this purpose, a framework of multi‐faceted identity is suggested in order to theoretically grasp multiple accountabilities of healthcare professionals. Accordingly, healthcare professionals have a cross‐cutting identity (being a professional) that is fortified with nested identities such as the one of partner, citizen and manager. Each identity facet is attached to a specific accountability form such as professional and civic society accountability. By focusing on three settings of healthcare provision—hospital, outpatient and integrated care—the usefulness of a multi‐faceted identity framework will be illustrated. It is concluded that developing a more nuanced understanding of healthcare professionals’ multiple identities and attached accountabilities might be a good starting point for planning healthcare redesign.