Healthcare As A System Of Systems And The Development Of Contingency Plans For Extreme Events

• In Event: The Learning Health System as a Socio-Technical System of Translation

Abstract

The annual winter pressures on healthcare that arise from seasonal flu push both health and social care to their performance limits as those patients with underlying health problems and the elderly require additional care that is beyond the 'normal' set of task demands that the service faces. This paper uses the experiences of the 2018 flu outbreak in the UK to consider the role of expert judgment in framing risk and uncertainty and to challenge the assumptions that healthcare could absorb a larger scale flu pandemic. The paper speaks to several research strands within STS but particularly, the role of expertise in decision making, the management of risk and uncertainty, and the processes around governance and policy making. Within this context, the importance of the management of scale is hjghlighted as a key policy problem. It involves the NHS as both a national, regional and local entity where the management of scale can be seen to have a political dynamic that is often overlooked. The paper is based on a period of ethnographic work within a government body charged with planning for extreme events and also includes the findings of interviews with policy makers and planners who have responsibility for dealing with such events. The paper highlights the need to frame policy making within a system of systems approach and, as a result, seeks to integrate work in STS with that carried out in systems ergonomics.

Authors

• Denis Fischbacher-Smith, University of Glasgow

• Bonnie Atonasova, University of Glasgow

• Moira Catherine Fischbacher-Smith, University of Glasgow