Knowledge and the Discourse of Labour Process Transformation: Nurses and the case of NHS Direct for England

Chris Smith, Raffaella Valsecchi, Frank Mueller, Jonathan Gabe

Research output: Contribution to journalArticlepeer-review


This article draws on fieldwork conducted with nurses in two sites of NHS Direct,
the English tele-nursing service. Theoretically it has two objectives. Firstly to examine
a group of professional workers in order to show how the discourse of work
transformation associated with the call centre paradigm interacts in a non-mass,
non-commercial public sector setting where workers remain attached to their
occupational identity and institutional community which mediate call centre values
and rationalities. In relation to this objective, the article shows how call centre values
inform NHS Direct, but do not produce the same outcomes as in commercial
settings. Secondly, the article establishes that nurses, as knowledgeable actors,
can control, manipulate and create knowledge, without having their autonomy subordinated
to the clinical software they are required to use. The article contributes
to the labour process approach of call centre working, and debates on knowledge
management in the workplace.

Original languageEnglish
Article number4
Pages (from-to)581-599
Number of pages18
JournalWork, Employment and Society
Issue number4
Publication statusPublished - Dec 2008


  • call centres / knowledge / labour process / NHS Direct / tele-nurses

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