A Critical Examination of Regulatory Responses to Patient Safety Incidents Relating to Hospital Discharges

Student thesis: Phd


This thesis sets out to determine how healthcare regulation in England might better ensure the safety of patients experiencing hospital discharge. The core problem at the heart of this thesis can be articulated as follows: healthcare regulation within England is suboptimal at safeguarding patients experiencing hospital discharge. The thesis is comprised of a series of published papers, each of which identify and address problematic aspects of the regulatory status quo. I consider in turn: the structure and strategy of healthcare regulation; the liminal spaces within this regulatory structure; and the concept of regulatory accountability. Through analysing the structure of healthcare regulation in England, and the risk-based regulation strategy employed by regulators, I present three weaknesses regarding how regulators identify, conceptualise, and subsequently prioritise risk in the context of regulating hospital discharges. By employing the anthropological concept of liminality as a lens through which to explore and identify these regulatory I bring into focus the liminal space that exists amongst regulatory bodies within the hospital discharge regulatory arena. Following this critical examination of structure, strategy, and space, I then analyse concepts of accountability in the regulatory context. The rationale for doing this is to consider the potential impact of regulatory actions upon registrants – for this impact is key to ensuring patient safety. Throughout this thesis I provide practical recommendations which regulatory bodies could incorporate to improve the safety of patients leaving hospital. Taken together, all of my research findings could inform regulatory approaches to improving patient safety more broadly throughout the NHS.
Date of Award1 Aug 2022
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorSarah Devaney (Supervisor) & Gavin Daker-White (Supervisor)


  • Patient Safety
  • Regulation
  • NHS
  • Hospital Discharge

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