I am a Professor of Medical Sociology at the University of Kent’s School of Social Policy, Sociology and Social Research. I am also Director of Studies for BA Social Policy and BA Health and Social Care.
I am interested in the sociology of health, illness and health policy. I’ve published extensively in journals, chapters and books about a range of health-related issues and my books include ‘Health and Illness: the lay perspective’, ‘Going Private: why people use private health care’, ‘The Prevention of Coronary Heart Disease: prospects, politics and policies’ and 'Work Stress: the making of a modern epidemic'. ‘ Modern Medicine: lay perspectives, ‘Health, Medicine and Society. Key Theories, Future Agendas’.
I joined SSPSSR in 2007 and prior to that I was Professor of Medical Sociology and Senior Scientist in the Medical Research Councils’ Health Services Research Collaboration at the University of Bristol (2000-2007). I was Professor and Director of CHSS at the University of Kent from 1994-2000 and convenor of the MA in Health Studies.
I completed my PhD at the University of Kent, my BSc from the University of London and my MSc at the University of Bristol.
University of Kent
Kent CT2 7NF
Also view these in the Kent Academic Repository
The study of trust relations in health care
Trust relations in healthcare has been a major focus of my research over the last 10 years. A programme was initially funded by the HSRC, Medical Research Council (2005-2010: see Calnan M and Rowe R (2008) Trust Matters in Health Care, Open University Press, Berkshire) and since then I have been the principal investigator on two ESRC funded studies. One of these focused on trust relations in mental health care which had implications for theory and health service policy. It showed that trust relations are crucial to the therapeutic encounter in mental health between clinician and patient but that current mental health policy with its emphasis on risk aversion mitigated against development of trust relations (see Brown P and Calnan M (2012) Trusting on the Edge, Managing uncertainty and vulnerability in the midst of serious mental health problems, Policy Press, Bristol)
The second of the studies focused on the social influences on decision-making made by NICE in relation to technological appraisals. This was an innovative study and involved an ethnography of decision-making particularly looking at the management of different types of uncertainty and how trust along with other mechanisms was a way of bridging uncertainty. It particularly illustrated the relations and tensions between NICE and the drug industry and how they were managed. The findings and recommendations from this study are being used by NICE in its current strategic review of technological appraisals. Very recently the focus has shifted to the examination of trust relations in health systems more globally and the current research has involved an exploratory study investigating the nature of trust relations in the healthcare system in India (see Kane S, Calnan M and Radkar A (2015) Trust and trust relations from the providers perspective: the case of the health care system in India, Indian Journal of Medical Ethics, 12,3,158-169.)
I am currently working:
- on an ESRC funded ethnographic study which is exploring the use of trust entitled “Managing uncertainty within NICE technological appraisals: the nature and impact of the 'social features' of decision-making”
( 2011- 2014).
The National Institute for Health and Clinical Excellence is emblematic of the “neutral” and “objective” approach of modern regulatory institutions. Through systematic appraisals of the cost-effectiveness of drugs for the NHS, it aims to overcome the inconsistencies of the previously discretionary decisions of medical professionals. Cost-effectiveness recommendations ensure a more standardised access to medication across the NHS, as well as regulating the imperfections of the market in terms of over-priced medication.
These regulatory roles have important ethical implications for access and resource use, yet the neutrality and objectivity referred to is not straightforward. The volume, contestability and complexity of information which is processed within these appraisals means that a number of decision mechanisms for coping with uncertainty are inevitably invoked. Uncertainty appears to be inherent in this decision making process.
The study is investigating the nature of uncertainties faced within appraisal decisions, the social mechanisms applied in dealing with these, and the impact this has on decision outcomes. This ethnographic study involves: non-participant observation of committee meetings and interviews with committee members, analysts from NICE’s project team, a range of representatives from the various interest groups, and experts involved in the process and documentary outputs from committee processes.
- on international comparative research:
- Studies of Trust and Food Health Systems in Ireland, Australia and New Zealand
- Trust relations in Healthcare Systems in India
- Identifying priorities for social research and the 2013-16 Ebola virus disease (EVD) epidemic in West Africa: This involved a research scoping exercise carried out by an interdisciplinary team in Guinea in January 2017 with the aim of identifying priorities for further research into the impact of the EVD epidemic. It examined the research needs and priorities from the perspective of those who directly experienced the EVD epidemic in Guinea. The aim is to explore these key priorities in future research. For further information see:
- Centre for Health Services Studies (CHSS) Spring 2017 newsletter. and
- The Response to and Impact of the Ebola Epidemic: Towards an Agenda for Interdisciplinary Research (article on International Journal of Health Policy and Management website)
The study of ageing and health care specifically exploring dignity and the provision of health and social care for older people
Older age is one stage of the life course where dignity maybe threatened due to the vulnerability created by increased incapacity, frailty and cognitive decline in combination with a lack of social and economic resources.
Evidence suggests that it is in contact with health and welfare services where dignity is most threatened. Our most recent SDO funded study with the University of Cardiff explored the experiences of older people in acute NHS trusts in relation to dignified care and the organisational, occupational and cultural factors that affect it.
These objectives were examined through an ethnography of four acute hospital trusts in England and Wales, which involved interviews with older people (65+) recently discharged from hospital, their relatives/carers, and trust managers, practitioners and other staff, complemented by evidence from non-participant observation.
The picture which emerged was of a lack of consistency in the provision of dignified care, which appears to be explained by the dominance of priorities of the system and organisation tied together with
the interests of ward staff and clinicians (for full report see Tadd, W., Hillman, A., Calnan, S., Calnan, M. ,Bayer, A. and Read, S. (2011) Dignity in Practice :an exploration of the care of older patients in acute NHS Trusts,
I welcome postgraduate research proposals in the areas of Sociology of Health and Illness and Health Policy. If you are interested in studying at the University of Kent, please email me to discuss further.
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I teach the following modules:
- Sociology of Health and Illness
- Health and Health Policy
- Key Issues in Welfare
- Comparative Social Policy
Elected member of the ISA research committee 15, Sociology of Heath 2014 - .
Currently an academic adviser to a number of international scientific research bodies: including Fundação para a Ciência e a Tecnologia, I.P. (FCT) Portugal, Research Council of Norway, Swiss National Scientific Foundation and Commonwealth Scholarships (London), ESRC Future Leaders panel.
Think Kent lecture exploring the importance and meaning of trust within different clinical, organisational and cultural contexts: Trust Matters: The Case of Health Care