Management Accountant at an NHS trust

Coursework brief:

You have recently been appointed as a trainee Management Accountant at an NHS trust. The trust is made up of 4 hospitals within the region. You have a meeting with a senior manager of the trust who explains about the trust, and its hospitals. From the meeting you have learned that four hospital belong to the trust and each hospital has a number of departments such as cardiology, paediatrics, maternity, and an accident and emergency department. You also gather that each department has its own specialist doctors and nursing staff and provide a range of services to the patients on the wards, in rooms, as well as outpatients. These departments have the capability to provide different surgical operations and to treat patients with various health issues.

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The senior manager you met, has explained that the direct costs of the trust include the cost of materials used in the treatment of patients and doctors and nurses pay and the indirect costs include the costs relating to reception, cleaning etc. He has also stated that the NHS receives funding from the government and that the ability to optimise performance with the limited resources received is essential. He is interested in understanding how the management accounting techniques you have studied at university could help manage performance better.

Research both the NHS context and the Balanced Score Card approach and write a report to the senior management of the NHS trust explaining how the Balanced Score Card approach can be used to measure and control performance. Your report should

a. Discuss the Balanced Score card and how it may be used for performance management within organisations. (35Marks)


b. Discuss how the Balanced Score card approach can be applied within the NHS trust to measure and control performance. Here, under each of the four perspectives your explanation should include at least 2 examples of objectives and measures that relate to the context (the trust) (25 Marks)



c. Critically analyse the strengths and weaknesses of the balanced score card.

(30 Marks)

Marks for professionalism, and presentation (including the cover page, contents page, presentation, language and punctuation, in text citations, reference list) (10 Marks)

Total (100 Marks)

The word count is 2,000 words +/- 10%. This is to be strictly adhered to and marks will be deducted accordingly if you go under or over the stated limit.

Your report must

· Be written in the format of a business report addressed to the senior manager of the NHS trust, and be complete with a cover page, contents page, numbering, subheadings, and full set of references (including books, journal articles and other sources).

· Show clear evidence of research demonstrated through in citation of text books, journals and other resources, and a full list of references presented in Harvard style.

· Show clear evidence of application of knowledge to the context of the hospital. That is, as far as possible you must relate your explanations to the context of a hospital and give examples from the context of a hospital (i.e. the example you may give relating to types of costs, types of overheads, activities, cost pools, cost drivers, variances etc. must be from the context of a hospital).


Marking criteria









Introducing the Balanced score card

Mentioning the 4 perspectives

Explaining the 4 perspectives

Explaining how the BSC is used to evaluate performance









Explanation of each of the four perspectives in the context of the NHS trust

Example of objectives and measures relating to the trust under each perspective








Detailed discussion of the strengths of the BSC supported by citations of books and articles

Detailed discussion of the weaknesses of the BSC approach supported by citations of books and articles







Structure of the report, use of language and punctuation, labelling of any diagrams, correct referencing practice, inclusion of cover page, contents page, and appendices and references etc.




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