Bloody Paperwork
Algorithmic Governance and Control in UK Integrated Health and Social Care Settings
DOI:
https://doi.org/10.5617/jea.8285Keywords:
algorithmic governance, datafication, alienation, Actor Network Theory, integrated health, social care public servicesAbstract
This article is about paperwork: the work staff in UK integrated health and social care teams did to transform small transactions of everyday care work into big data, which in turn enabled the governance of complex service arrangements. This data-driven approach to governance, algorithmic governance, raises issues of agency and transparency. We address these issues by paying close attention to how care staff articulated their own understandings and apprehensions of the process. The article draws on a study of work roles in UK integrated health and social care teams providing support and follow up for older people and people with mental health problems. Digitised tools were used for the coordination and management of these teams. Staff described how the digitised documentation of care practices produced standardised representations of their work which poorly reflected the complexity of their everyday interactions with colleagues and clients/patients. There was a double-ness to these representations: on the one hand, they were malleable and open to negotiation, on the other they produced tangible consequences hardwired into the system of governance, transforming the work of care into an object outside of itself. In order to bring out the complexities in staff’s accounts about paperwork, the article brings the Marxist analytic of alienation into conversation with Actor Network Theory (ANT) to suggest that overstating the hegemonic power of digital technologies risks itself becoming hegemonic. We advocate a nuanced and situated analysis of what digitised documentary practices consist of and what they do in different circumstances.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Guro Huby, John Harries
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a https://creativecommons.org/licenses/by-nc-nd/4.0/
that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal, for non-commercial purpose, no derivatives are permitted. (Please not that this license has been used since 1.10.2018 and will be used in the future. Articles published between 1.1.2017-and 30.9.2018 are licensed under CC BY license: https://creativecommons.org/licenses/by/3.0/) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).