Informed choice or informed voice? A consideration of the impact of proposed NHS service developments on divided communities.

Parish, Rebecca 2023. Informed choice or informed voice? A consideration of the impact of proposed NHS service developments on divided communities. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Summary Scholars suggest that divergence in national policy across the United Kingdom post-devolution contests the use of the word ‘National’ in the National Health Service. However, ‘big D’ devolution is not the sole factor challenging the word ‘National’, as variation occurs at much smaller ‘little d’ devolved geographies. This thesis considers both healthcare policy divergence between administrations in England and Wales post-devolution and explores the dialogue between a health and care system and the people and communities it serves regarding the reconfiguration of specialist hospital services within a single English county. The analysis explores what informs people’s voices and choices and whether this results in differential appetites for service change between two geographical areas. Le Grand’s (2007) four models for good public services: trust, command & control (targets); voice; and choice & competition is the analytical framework used to undertake the secondary analysis and interpretation of qualitative data from three surveys and two citizens’ juries’ reports. The research identifies what influences the choices people make and the informed voices they use to express their preferences regarding IDEAS for change, POLICY to implement change and specific PROPOSALS for change to the location of specialist hospital services. The results are presented using claim, warrant, data chains with illustrative quotations selected from the data. The analysis reveals evidence of differential appetite for change but not as significant as expected. Influencing factors include accessibility of services and preference for the status quo. The impact of misinformation or misunderstanding about current services is an important finding. The data show that labelling one side of the county as more resistant to change than the other would be inaccurate. This research identifies learning for practice, policy and future research with respect to public services communications and working in partnership with people and communities.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Social Sciences (Includes Criminology and Education)
Date of First Compliant Deposit:	1 March 2024
Last Modified:	04 Mar 2024 16:08
URI:	https://orca.cardiff.ac.uk/id/eprint/166749

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