Devolution, Accruals Accounting and Asset Management in NHS Wales

Abstract

This paper describes how a strategy for health services has been developed for NHS Wales and examines the role of accruals accounting in asset management and development. It uses archival investigation as well as interviews and a questionnaire. The role of accruals accounting in the operation of the service, particularly as it relates to the capital asset base of the Trusts and how these are managed, is discussed in the context that Trusts are autonomous units that develop services, and hence their capital asset base, through their own internal planning structure. It is found that, on devolution, there was a lack of consistent information about the stock of capital assets and that capital charges, based on accruals accounting, were not penetrating asset management within individual Trusts. Although strategies were being developed centrally, their implementation at a Trust level can be impeded as a consequence of accruals accounting.