Performing accountability in health research: a socio-spatial framework

The article explores how spaces aimed at improving accountability in health systems are socially produced. It addresses the implications of an initiative to promote patient involvement in government-funded research in the context of a large cancer research network in England. We employ a socio-spatial theoretical framework inspired by insights from Henri Lefebvre and Judith Butler to examine how professional researchers, doctors and patients understand and perform accountability in an empirical context. Our data reveals fundamental tensions between formally-required and routinely-enacted dimensions of accountability as these are experienced by patients. Consequently, our analysis argues for a need to augment abstract, professionalised discourse about accountability in health services by acknowledging embodied spaces of representation, in which patients themselves can contribute to making participatory accountability a reality. We suggest that such a shift will provide a more rounded appraisal of patient experiences within health research, and health systems more widely.