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Public and private sector auditors and accruals quality in English NHS hospital Trusts

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  • Ballantine, Joan
  • Forker, John
  • Greenwood, Margaret

Abstract

To promote auditor independence and audit quality in English NHS Trusts the Audit Commission regulates auditor rotation, fees and the appointment of its own and private sector auditors. NHS sanctioned departures from GAAP, some of which allow the financial breakeven target to be achieved, have been criticised by the Audit Commission as detrimental to financial discipline. In this paper, we investigate the association between abnormal accruals and the achievement of financial breakeven in NHS hospital Trusts over the period 1998–2005. We also investigate the association between abnormal accruals, audit fees and the Trusts audited by public and private sector auditors. We find evidence that abnormal accruals are used to achieve financial breakeven and they differ across different types of auditor. We also identify a negative relationship between abnormal accruals and NHS Trust star ratings. These findings raise questions about the ‘quality’ of NHS audit where compliance with NHS-specific regulations overrides the wider GAAP-based requirement for financial statements to show a true and fair view and they warrant reconsideration of the nature of audit in NHS Trusts.

Suggested Citation

  • Ballantine, Joan & Forker, John & Greenwood, Margaret, 2008. "Public and private sector auditors and accruals quality in English NHS hospital Trusts," The British Accounting Review, Elsevier, vol. 40(1), pages 28-47.
    • Handle: RePEc:eee:bracre:v:40:y:2008:i:1:p:28-47
    DOI: 10.1016/j.bar.2007.09.002
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    References listed on IDEAS

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    1. Mark A. Clatworthy & Howard J. Mellett & Michael J. Peel, 2002. "The Market for External Audit Services in the Public Sector: An Empirical Analysis of NHS Trusts," Journal of Business Finance & Accounting, Wiley Blackwell, vol. 29(9‐10), pages 1399-1439.
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    Cited by:

    1. Maria Jose Arcas & Caridad Martí, 2016. "Financial Performance Adjustment in English Local Governments," Australian Accounting Review, CPA Australia, vol. 26(2), pages 141-152, June.
    2. Begkos, Christos & Antonopoulou, Katerina & Ronzani, Matteo, 2024. "To datafication and beyond: Digital transformation and accounting technologies in the healthcare sector," The British Accounting Review, Elsevier, vol. 56(4).
    3. Zubir Azhar & Ervina Alfan & Krishnen Kishan & Nurul Husna Assanah, 2022. "Accrual Accounting at Different Levels of the Public Sector: A Systematic Literature Review," Australian Accounting Review, CPA Australia, vol. 32(1), pages 36-62, March.

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