Integrated Care Policy Discourse: Austerity and the shaping of the ‘waste watching’ health professional

Seminar abstract

Discussion relating to the boundary between health and social care has existed since the inception of the NHS, with successive government’s claiming the desire to ‘integrate’ care.

This presentation will draw on data collected from a case study community based integrated care service (CBIC), to explore the relationship between the macro level political environment governing health and social care integration in England and micro level managerial and organisational practice, shaped and enacted within this context.

Data collection took place between May 2017 and April 2019, using textual analysis, qualitative interviews and participant and non-participant observation.

Previous research (Hughes 2017) has argued that integrated care policy works as a discourse to manage tensions between competing policy aims to allow the continuation of austerity and fragmented health and social care services. Moving beyond its linguistic realisation within government policy texts, I demonstrate how this discourse is put to work through implementation by actively shaping the materiality, managerial practices, and subjectivity of actors operating within the health and social care arena to mobilise economic austerity.

Drawing on theoretical insights from Fairclough’s Dialectical Relational Approach and Foucauldian governmentality, I show how the material reality of resource pressure in the CBIC had a socially structuring effect on the way in which managerial and organisational practices shaped the subject positions of both health professionals and patients as ‘waste watchers’, when attempting to enact integrated care. This had a dislodging effect on concerns for improvements in patient care and resulted in work intensification, and disempowerment for staff and patients.

How to join this seminar

This seminar is free to attend with no need to book in advance.

We welcome you to join us online on Wednesday 18 May 2022 at 12pm.

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Speaker bio

Hannah is a Research Officer at the Care Policy and Evaluation Centre (CPEC) at the London School of Economics and Political Science (LSE).

She recently completed a PhD in Health and Organisational Research, working across the School of Health and Social Care and Essex Business School, within the University of Essex.

Before beginning her PhD, she worked as a Policy and Programme Officer for an employment and skills charity, and as a Research Project Manager within the Health Management Group at Alliance Manchester Business School (AMBS).

During her time at AMBS, she worked on an NIHR funded project investigating board leadership changes 5 years on from the Francis Inquiry.