Monday, 30 August 2010

The NHS Direct helpline is dead. Long live NHS 111!

www.bbc.co.uk/news/uk-11120853. A shame - NHSD provided a reason to think about Freidson’s "lay referral system" again, this time in connection with ICTs (Freidson 1988).


No, you’re not.

Freidson made the point that we need to think about the temporal trajectory of sickness. This meant considering seriously what happens before we opt for a consultation with a medical expert. He noted decisions about whether to access professional healthcare are conventionally first made in our immediate kin/community context, looking at both social relationships and cultural themes as factors.

If ICTs, now a “mundane reality” (Nettleton 2005) for many in seeking out health-related information and advice, have impacted that context then the lay referral system and its two components (the extent to which lay culture is congruent with professional health culture and the cohesiveness and extension of the lay referral structure) may have to be amended.

For example, has the effect of more information availability through dominant providers such as NHS Direct aligned lay health culture more closely with the knowledge base underpinning professional health culture (an especially relevant question for those identified by Freidson as not sharing in that culture, namely the 'lower classes')? Secondly, with the option of finding condition-specific social networks online, those identified as relying on a loose and truncated lay referral structure to help make decisions (identified by Freidson as the 'middle classes'), may find such structures extended, if not more cohesive.

Ultimately, how will digital ICTs interact with other factors, such as the Government's aim to encourage more healthcare to take place in home settings, to change the proportion of referrals to professional medics, if at all?

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