The informalisation of professional–patient interactions and the consequences for regulation in the United Kingdom

Seeking to illustrate the usefulness of Eliasian approaches for debates on health care professional regulation, this chapter examines how long-term social processes have transformed the character of health care professional-patient interactions in the United Kingdom in recent decades, rendering them more informal and less asymmetric. The chapter goes on to consider three key implications and challenges of such transformations for regulatory design and practice, first exploring how performances of compassion and care have become more central to understandings of ‘quality’ health care practice. Secondly, these less asymmetric and structured interactions are also less stable, posing problems for quality assurance and regulation. Finally, informalisation processes are bound up with moves away from a more blanket profession-based trust towards a more critical, interaction-won trust. The chapter concludes by considering the implications of new trust dynamics for regulating quality care amid the processes of informalisation, and how heightened demands for reflexivity may open new possibilities for cultivating (professional) virtue through a dialogue between social research and health care practice.