Developing a reputation-based theory of public accountability
: the case of management consultants in the English National Health Service (NHS)

Student thesis: Doctoral ThesisDoctor of Philosophy (PhD)


The aim of this thesis is to expand understanding of public accountability by developing the reputation-based theoretical perspective advanced by Busuioc and Lodge (2016, 2017). It does this by exploring the operation of public accountability through the lens of reputation in the reputation-rich setting of private sector management consultants operating in the public English National Health Service (NHS).

Some argue that we are in a “reputation society” (Masum & Tovey, 2011). Yet, the field of reputation in the public sector is “emerging and immature” (Wæraas & Maor, 2014b, p. 2) and there is a gap in understanding the relationship between public accountability and reputation.

Management consultants are “masters of illusion” (Stewart, 2009) for whom reputation management is critical (Harvey, Morris, & Müller Santos, 2016). They are influential policy actors and partners in the management and delivery of healthcare in the NHS (Kirkpatrick, Lonsdale, & Neogy, 2015; Saint-Martin, 2012). Yet some accuse consultants of being structurally unaccountable (Bortz, 2018; Fincham, 1999; Leys, 1999; McClure, 2017; Wedel, 2014). This is, therefore, an ideal context for exploring the relationship between accountability and reputation.

The research adopts a multi-method qualitative approach comprising 42 interviews and 9 observations to gather insights into accountability practices.

The primary contribution of this research is to develop a reputation-based model of accountability. This model builds on the reputation-based theory of accountability advanced by Busuioc and Lodge (2016, 2017) and the definitions of accountability proposed by Bovens (2007) and Bovens, Goodin, and Schillemans (2014). In doing so, it responds to calls for competing theoretical approaches to accountability (Olsen, 2013) and for theoretical and empirical development and testing of the reputation-based theory of accountability (Aleksovska, 2021; Busuioc & Lodge, 2017).

In addition, it makes an important empirical contribution to the understanding of the accountability of management consultants in healthcare.
Date of Award21 Jun 2022
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorDeborah Wilson (Supervisor) & Andrew J Sturdy (Supervisor)

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