Spatio-temporal elements of articulation work in the achievement of repeat prescribing safety in UK general practice

Suzanne Grant, Jessica Mesman, Bruce Guthrie

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Prescribing is the most common healthcare intervention, and is both beneficial and risky. An important source of risk in UK general practice is the management of ‘repeat prescriptions’, which are typically requested from and issued by nonclinically trained reception staff with only intermittent reauthorisation by a clinical prescriber. This paper ethnographically examines the formal and informal work employed by GPs and receptionists to safely conduct repeat prescribing work in primary care using Strauss’s (1985, 1988, 1993) concept of ‘articulation work’ across eight UK general practices. The analytical lens of articulation work provided an investigative framing to contextually map the informal, invisible resources of resilience and strength employed by practice team members in the achievement of repeat prescribing safety, where risk and vulnerability were continually relocated across space and time. In particular, the paper makes visible the micro-level competencies and collaborative practices that were routinely employed by both GPs and receptionists across different socio-cultural contexts, with informal, cross-hierarchical communication usually considered more effective than the formal structures of communication that existed (e.g. protocols). While GPs held formal prescribing authority, this paper also examines the key role of receptionists in both the initiation and safe coordination of the repeat prescribing routine.
Original languageEnglish
Title of host publicationThe Sociology of Healthcare Safety and Quality
EditorsDavina Allen, Jeffrey Braithwaite, Jane Sandall, Justin Waring
Place of PublicationChichester
Number of pages18
ISBN (Print)9781119276340
Publication statusPublished - 2016

Publication series

SeriesSociology of Health and Illness Monograph Series


  • organisational theory
  • professionalisation
  • Quality of care

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