Policy aspirations and practice in english telecare: a case study of story-lines and invisible work

[摘要] Telecare – the use of technology to facilitate access to health and social care services – has risen in prominence over the last decade in the context of population ageing, a rise in long-term conditions and economic uncertainties. UK policy advocates adoption of telecare at scale, citing the promotion of independence and empowerment as benefits, but local implementation has been variable and the experiences of service users show a nuanced picture. This thesis investigates telecare policy, and its interpretation and implementation. It draws on an argumentative discourse analysis and material-semiotic approach to understand the experiences of telecare at a case study site. Narrative interviews and observations were undertaken, involving service provider and technology industry stakeholders and service users. Findings reveal four ‘story-lines’ of telecare policy but discrepancies between this discourse and local experiences. People are shown to engage with telecare to different extents, with the prevailing technology ‘script’ influencing non- or mis-use of devices. New work roles created by telecare sometimes appear ‘invisible’ or devalued. Furthermore, there is a lack of meaningful involvement of service users in decision-making. This study adds a theoretically-informed voice to the academic field and makes recommendations for future telecare policy, practice and research.

[发布机构] University:University of Birmingham;Department:Health Services Management Centre

[关键词] H Social Sciences;HV Social pathology. Social and public welfare