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A crisis in social care is apparent across the developed world as ageing populations put unprecedented demand on understaffed social care workforces. A recent popular response to this 'care crisis' within the UK involves the 'innovation' of single‐handed care (SHC). SHC involves a care package with two or more homecare workers being reduced to one worker using advanced equipment and new moving and handling techniques. In this article, we explore how SHC is rendered in 245 documents from 52 local authorities in England. Using Actor Network Theory as an interpretative lens, we suggest documents attempt to satisfy three 'duties of care': to the individual wellbeing of citizens, morally and fiscally to the collective and to innovation. Each appeal to different stakeholder groups necessary for SHC to work, but the combination of duties can pose problems in enabling coherent stories of SHC. Duties can be kept apart in different documents, but at times they must be brought together in certain textual spaces to enact SHC as a coherent enterprise. Here, the potential tensions that emerge are routinely orientated to as (merely) problems of process that can and should be managed in and through a more refined approach to change management. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2007.01064.x Byline: Tim Rapley (1) Keywords: doctor-patient interaction; distributed; shared decision making Abstract: Abstract Conceptualising the doctor-patient relationship has been a central project for both medicine and medical sociology. This paper seeks to show how an understanding of the distributed nature of medical practice can help us research the decision-making process in doctor-patient encounters. I draw on a range of empirical studies of medical interaction, knowledge, technology and work in primary and secondary care. I describe the 'ethno-methods' (Garfinkel 1967) of patient-orientated medical decision making in order to highlight some of the fundamental facets of distributed decision making. Initially, I outline how decision making is an ongoing event that often evolves over multiple encounters. I then show how decision making is never just a solo, cognitive activity but rather distributed over a range of people. Finally, I outline how decision making is initiated, sustained and transformed over a range of encounters with both people and technologies. I argue that recognising the distributed nature of decision making shifts the focus from overly prescriptive visions of decision making to more plausible, albeit, more mundane sets of ideals. Centrally, a focus on distribution offers new opportunities actively to engage with, support and research decision-making-in-action. Author Affiliation: (1)Institute of Health and Society, Newcastle University Article note: Address for correspondence: Tim Rapley, Health Technology and Human Relations Research Programme, Institute of Health and Society, Newcastle University, 21 Claremont Place, Newcastle Upon Tyne NE2 4AA, e-mail: tim.rapley@newcastle.ac.uk

With the most recent developments to the European General Data Protection Regulations (GDPR) introduced in May 2018, the resulting legislation meant a new set of considerations for study approvers and health‐care researchers. Compared with previous legislation in the UK (The Data Protection Act, 1998), it introduced more extensive and directive principles, requiring anybody 'processing' personal data to specifically define how this data will be obtained, stored, used and destroyed. Importantly, it also emphasised the principle of accountability, which meant that data controllers and processors could no longer just state that they planned to adhere to lawful data protection principles, they also had to demonstrate compliance. New questions and concerns around accountability now appear to have increased levels of scrutiny in all areas of information governance (IG), especially with regards to processing confidential patient information. This article explores our experiences of gaining required ethical and regulatory approvals for an ethnographic study in a UK health‐care setting, the implications that the common law duty of confidentiality had for this research, and the ways in which IG challenges were overcome. The purpose of this article was to equip researchers embarking on similar projects to be able to navigate the potentially problematic and complex journey to approval. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2007.1078_5.x Byline: Tim Rapley (1) Author Affiliation: (1)Institute of Health and SocietyNewcastle University

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2007.01059_1.x Byline: Tim Rapley (1) Author Affiliation: (1)Newcastle University