New forms of expertise and their implications for the system of professions in healthcare: the case of the patient safety specialist role in the English NHS

Abstract

Contemporary societal shifts are disrupting established professional divisions of labour in healthcare. Some have argued that professionalism itself is being transformed, with professions characterised less by claims to exclusive jurisdiction and more by connectivity and complementarity. This article puts these arguments to the test in a domain traditionally characterised as one of professional conflict: patient safety. Informed by the sociology of expertise, we consider the case of a new role—the patient safety specialist—constructed by some as a profession in the making. Drawing on three qualitative datasets comprising interview and focus group contributions from 71 participants, we find that patient safety specialists struggled to establish the legitimacy of their expertise in organisational environments that were often hostile. By forging alignments with the interests of clinical professionals, however, some advanced their roles in ways that served mutual interests, in line with recent theses on the changing nature of professionalism and the need for expertise that connects increasingly interdependent jurisdictions. The extent to which this advancement offered a solid and durable foundation for a claim to professional status, however, seemed more questionable.