By Stephen Tilley, Roger Watson

Responsibility is a key difficulty for nurses and midwives within the NHS this day. expert accountability--being accountable for your activities and for the results of those actions--is a part of the framework of scientific governance, which goals to supply high quality, inexpensive, evidence-based care.The moment variation of responsibility in Nursing and Midwifery addresses present matters and key issues in responsibility, concentrating on responsibility within the 4 major branches of nursing (adult, baby, studying disabilities and psychological health), in addition to in midwifery, neighborhood nursing, and nursing administration. In an more and more litigious society, the moral and criminal implications of responsibility are starting to be and it's important that nurses comprehend the results for daily perform.

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Watson (1992) suggests that accountability is the very essence of professionalism. Nurses are accountable to the general public for their practice. However, in practice this does not involve giving an account to the public or to patients but rather registration (and possibly regulation) by a professional body – the Nursing and Midwifery Council (NMC). According to Watson (1992) accountability is defined as a feature of professionalism and is understood as ‘answering’ to an external governing body rather than to an employer or to patients.

In their summary of the New Public Management Reforms Ferlie et al. (1996) devote an entire chapter to the issue of accountability. , 1996, p. 197); in effect a shift from public to managerial accountability. Pollitt & Bouckaert (2000) suggest that rather than a simple shift there is a paradoxical tension between a desire to increase political accountability and a desire to increase managerial accountability. However, within the UK and other Westminster-influenced systems, NPM reforms have placed pressure on traditional concepts of public accountability.

63, 70). Therefore the most fundamental distinction between the different discourses of accountability is between an accountability required and an accountability freely given. The first is a technology of domination while the second is about constructing the self. The first raises a series of questions about issues of power and visibility. As a form of disciplinary power structures of accountability have the potential to create new patterns of visibility, make institutional boundaries less opaque and enable the local to become visible to the centre.

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