Liberating the NHS or trapping doctors?: The effects of NHS reform on today and tomorrow

Maruthappu, Mahiben; Sugand, Kapil; Nagendran, Myura; Leaver, Laurence

doi:10.3399/bjgp10x539407

Cited by 2 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The value of utilising such concepts lies in their capacity to highlight the social and institutional challenges to proximity ( Bauman, 1991 , 1990 ) and to moral categories for sensemaking ( Fevre, 2000 ) that form the pre-requisites for maintaining human social relationships that are responsive to the other. The entrenchment of institutional concerns into the daily practices of clinicians and health-care workers can be seen not just in the ED but across many areas of the NHS, where fears over increased rationing, financial and reputational risks and efficiency targets shape the daily lives of clinicians as well as managers ( Maruthappu et al , 2010 ).…”

Section: Discussionmentioning

confidence: 99%

“…In recent years the NHS has experienced fundamental change, not just in relation to the management of risk and rationalisation, but also because of increasing levels of privatisation ( Pollock, 2005 ), most recently endorsed in the 2012 Health and Social Care Bill under the guise of ‘re-commodification' (see Scamber et al , 2014) . The impact of such change on NHS practitioners has been to generate new, distinctively managerial responsibilities that, some commentators suggest, shift the responsibility for the distribution of increasingly scarce resources away from governments and onto clinicians and, in some cases, patients themselves ( Maruthappu et al , 2010 ). The ED is a focal point for political and public concern over NHS provision.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Institutions of care, moral proximity and demoralisation: The case of the emergency department

Hillman

2015

Soc Theory Health

View full text Add to dashboard Cite

This article draws on concepts of morality and demoralisation to understand the problematic nature of relationships between staff and patients in public health services. The article uses data from a case study of a UK hospital Emergency Department to show how staff are tasked with the responsibility of treating and caring for patients, while at the same time their actions are shaped by the institutional concerns of accountability and resource management. The data extracts illustrate how such competing agendas create a tension for staff to manage and suggests that, as a consequence of this tension, staff participate in processes of ‘effacement' that limit the presence of patients and families as a moral demand. The analysis from the Emergency Department case study suggests that demoralisation is an increasingly important lens through which to understand health-care institutions, where contemporary organisational cultures challenge the ethical quality of human interaction.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%