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New knowledge and new constraints: the case of NHS Direct

New knowledge and new constraints: the case of NHS Direct

Smith, Chris, Valsecchi, Raffaella, Mueller, Frank, Elston, Mary Ann and Gabe, Jonathan (2006) New knowledge and new constraints: the case of NHS Direct. In: The First International Conference on Organizational Learning, Knowledge and Capabilities (OLKC 1), 20-22 Mar 2006, University of Warwick, UK. (Unpublished)

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Abstract

Call centres have mushroomed as a new dominant paradigm for service delivery. This paper presents data from fieldwork into tele-nursing within the UK health service, NHS Direct, as ‘nursing down the phone’ can be seen as a new expression of this wider development. We argue that nursing as a category of work has not been transformed through the advent of telenursing, unlike the situation in commercial call centres. Rather tele-nursing has appeared and developed as one further specialism within the nursing medical repertoire. Furthermore, the organisation of NHS Direct, as a nurse-led and dominated service, may have permitted nurses to expand their knowledge and professional power. But we are not suggesting either an upskilling or knowledge worker thesis as two developments put pressure on nurse’s work. The first is the call centre pressures operating within NHS Direct, despite its’ non-commercial and information/referral character as a health advisory service and the presence of a discourse of transformation with management. The second is the operation of a Clinical Assessment System (CAS) that nurses are obliged to use when responding to caller/patient enquiries. Our conclusions point towards the interplay between occupational autonomy and organisational control within a new service that has not yet finalised its design for the job of a tele-nurse.

Item Type: Conference or Conference Paper (Paper)
Additional Information: Presented at The First International Conference on Organizational Learning, Knowledge and Capabilities (OLKC 1). 20-22 March 2006, University of Warwick, UK.
Uncontrolled Keywords: NHS Direct, call centres, tele-nursing, health advisory service
Subjects: R Medicine > RT Nursing
Pre-2014 Departments: School of Business
Related URLs:
Last Modified: 14 Oct 2016 09:09
URI: http://gala.gre.ac.uk/id/eprint/3569

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