Paper short abstract:

A presentation of preliminary findings from PhD research examining how transformations of the GP system during and post COVID-19, are negotiated by marginalised populations. With a focus on the 'work' of engaging with the healthcare system, and 'responsibilisation' of patients for their healthcare.

Paper long abstract:

In response to the COVID-19 crisis, there’s been a shift in the way healthcare services are accessed in the UK with most non-acute healthcare service delivery made remote. The digitalisation of healthcare services is part of a longer narrative, accelerated by the pandemic. This is against a background of austerity and strong, persistent inequities in health outcomes and healthcare access in the UK. Whilst there are hopes that digital healthcare will remove barriers to accessing healthcare, it’s also possible that this form of service delivery will both create new types of inequities as well as replicate and re-embed existing ones. I will present the preliminary findings from my PhD research examining how transformations of the GP system during and post-crisis, are negotiated by marginalised populations.

I am taking an ethnographic approach involving observation and interviews, conducted across a range of field sites in London. These include a foodbank, an advice centre for refugees and asylum seekers, and a charity offering digital support. The analysis explores the ‘responsibilisation’ of individuals to self-manage their healthcare, the ‘work’ which individuals must do to engage with and navigate the healthcare system, and finally ‘candidacy’ for healthcare and how this is negotiated by patients and providers. I discuss the risk of the ‘uncommoning’ of GP services as individuals turn to private healthcare alternatives. I also consider how patient ‘work’ is constructed by changes to the healthcare system and how this is transformed and negotiated by individuals through strategies developed to increase their capacity for action.