Introduction: Quality, accessibility and affordability in Dutch healthcare are system-goals in which the secretaries of the ministry of Healthcare, Welfare and Sports are accountable. These system-goals serve a public interest and they have to be accounted for. This only happens if the allied institutes, professionals and citizens take responsibility of their actions. Healthcare delivery becomes more and more organized in networks and alliances, where more focus is on the right care in the right place, namely integrated health service delivery. How accountability of quality of care takes place is a challenge in the system of regular healthcare as well as integrated care. Policy context and objectives: Accountability takes place in various forms and the term in itself is multi interpretable and is best described from two approaches: As subject of the term “governance”: In Dutch public governance, the ethical code consists of four elements that are related. These elements are ‘control or supervision’, ‘accountability’, ‘steering’ and ‘purchase (of healthcare)’. As three main directions of accountability: To whom is accounted for? About what is accounted for? Why is accounted for? Targeted population: Accountability of quality of care is observed on multiple perspectives. National - and local government, between board of directors and their supervisory boards, organizations and their financiers, organizations and their clients, which also have to account for their received care, which benefits to quality of care. Accountability is not only happening within (healthcare) organizations by structuring decision-making in a vertical, hierarchical sense to pursue control, but accountability takes place more and more in complex partnerships with many mutual dependencies and cross-border character. Accountability shifts from inside organizations towards outside organizations. To citizens, professionals and cooperation partners, towards integrated health service delivery. Impact and outcomes: Accountability in relation to ...