Transcript CHAT to help shape thinking

Who are you talking to?
‘The public’ in regulatory discourse.
Dr Marie Bryce
Regulation and ‘the public’
Relationship between health profession regulation,
regulators and ‘the public’ has emerged as a key theme
during several CAMERA research studies.
Aim is to explore further the idea of ‘the public’
This paper presents some emerging findings from ongoing work
Existing literature
Preliminary literature
searches identified little
information on ‘the public’
in healthcare regulatory
discourse
However, revealed highly
relevant material from the
sciences
Key paper:
Braun & Schultz (2010)
‘a certain amount of
engineering involved’:
Constructing the public in
participatory governance
arrangements. Public Understanding
of Science, 19: 403.
Existing literature
• Braun & Schultz’s categorisations of ‘publics’:
speaking position
settings
designated
function
the general public
anonymous
Opinion polls,
surveys
Knowledge about
attitudes and views
the pure public
Concrete individuals
Conferences
Educating citizens
the affected public
Concrete
individuals,
authentic experts
Consultative panels
Educating the
expert; eliciting first
hand experiences
the partisan public
Interest groups,
political
organisations
Stakeholder
consultations
Knowledge about
the landscape of
arguments
‘a certain amount of engineering involved’: Constructing the public in participatory governance arrangements. Public
Understanding of Science, 19: 403.
Method and sample
Method


Thematic coding in
Nvivo9
Used Braun and
Schultz’s framework
alongside own prior
knowledge
Sampling


Materials from
regulators’ websites
and other relevant
sources
2010-2013
Types of text
Description
Examples
Documents aimed
directly at the public
Public as object
How to make a
complaint;
Documents with ‘the
public’ as a key theme
Public as subject
Evidence to HOC HSC
Documents which
were examinations of
the regulators’
performance or
purpose
Public as driver
‘About us’; ‘Our role’
Documents about PPI
Public as participant
PPI in Undergrad Med
Ed
Coding
Participatory models
Complaint-making
Consultation
FTP Panel
GMC membership
• Coding both for
types of public
and for models of
participation
in/engagement
with regulation.
Revalidation
Appraisal
Governance
Patient feedback
Publicity
Publics
the affected public
the general public
the partisan public
the professional(ized) public
the public as overseer or driver
the pure public
Uncategorized or generic public
Emerging findings:
Patients and the public
Most frequently coded
public is ‘the affected
public’
In this case = patients
However, many
references to ‘patients
and the public’
“We will maintain
open and effective
regulatory
relationships with
patients and the
public…” NMC, 2013.
Patients and the public: as driver
Significant number of
references to ‘patient
safety’ and ‘protecting the
public’
In line with regulatory
functions
In communications,
becomes a mantra
“…it is a question of the
protection of the public and
patient…” GMC, 2013
“We exist to safeguard the health
and wellbeing of the public.”
NMC, 2013.
“We will only do so if the
allegation suggests that the nurse
or midwife’s actions or behaviour
puts patients or the public at risk.”
NMC, undated.
Missing constituencies:
the partisan public and PPI
Partisan public =
organised, collective
voice of affected public
PPI

Patient groups

Active but absent from
regulatory discourse
Little content about
active involvement
Some documents
referring to PPI in
other settings but little
on PPI in regulation
itself
In conclusion…
Communicating with and
about ‘the public’ clearly
important.
Likely to become
increasingly
important: regulators may
need to communicate
directly more frequently
and in different ways
Emerging findings
suggest that there is
scope to think carefully
and more critically about
audience and purpose.
Research amongst
patients and the public
useful.
Thank you for listening 
Dr Marie Bryce
[email protected]