Using the Care Programme Approach (CPA) as an example, this article examines the difficulties of implementing change within the National Health Service (NHS). A framework is suggested which aims to clarify the nature of change by distinguishing where, when and how decisions are made. It is...

Purpose: The purpose of this paper is to draw on the direct experience of a practitioner undertaking real-time research in his organization to offer insights into the dual role of practical insider and theoretical outsider. The duality helps the researcher to live “in” and think “out”...

As the nurse role becomes more specialised, leaving the healthcare assistant (HCA) to deliver much of the direct care, questions arise about the nature of the HCA-patient relationship. Do HCAs have a distinctive relationship with patients and what form does this take? Addressing these questions,...

The sociology of work has treated the assistant role in a limited way: it has been seen as a ‘cheap’ source of labour or as a convenient ‘dumping ground’ for the delegation of routine tasks as ‘superordinate’ occupations seek to professionalise. This perspective is reflected in...

Debates on emotion at work have long acknowledged an interest in both the management of the workers’ emotions and those of the customer with whom the worker interacts. The weight of interest has, however, more consistently fallen on the former. Hochschild’s conception of the alienating...