This paper aims to identify whether the components of a loose-coupled system were present
in the asset management systems of the National Health Service (NHS) in Wales and, if so,
whether this had a negative impact. By utilising a qualitative analysis of semi-structured
interviews with senior officials at two NHS Hospital Trusts together with the findings of a
survey of all of the Hospital Trusts in Wales, we conclude that the asset management system
of the NHS in Wales exhibits the features of a loosely coupled system with detrimental
consequences. Where information on capital assets has been required below board level,
lower management relies on local systems, while the information for senior managers and
political leaders relies on the management accounting system and ad hoc enquiries. The
result has been an impairment of the ability of lower management to reconfigure capital
assets which leads to the nation’s health service underperforming.