The Brighton Citizens Health Services Survey was an academic activism project to identify and understand citizens' perceptions of and responses to healthcare commissioning practices. Significant legislated changes to the National Health System (NHS) across England have increased marketisation in healthcare provision, yet little research has explored the psychological dimensions of this shifting context and its community impact. Taking a community psychological perspective to social policy, we aimed to understand lay citizens' lived experience of changes in healthcare commissioning and provision. Thematic analysis of 379 free‐text responses yielded two thematic clusters. Cluster 1 describes the lived experience of citizens considering reforms to the NHS, depicting grief, mortality and fear in uncertainty. Cluster 2 explores where these affective responses may derive from by detailing conceptualisations of the NHS in the lived experience, describing how the NHS was experienced as a complex and embodied phenomenological object. Findings suggest people relate affectively to local commissioning practices, feeling a sense of loss when facing the degradation of ‘their’ NHS. We argue that an affective relational perspective centres important questions of silencing, voice‐giving, meaningful engagement and ways of knowing that in turn impact the landscape of community health.

中文翻译：

---

家庭中的死亡：英格兰东南部居民改变医疗保健委托做法的经历

布莱顿公民健康服务调查是一个学术活动项目，旨在识别和理解公民对医疗保健委托实践的看法和响应。英格兰对国家卫生系统（NHS）进行的重大立法变更已提高了医疗保健服务的市场化程度，但很少有研究探索这种变化环境及其社区影响的心理方面。从社区心理角度考虑社会政策，我们旨在了解外行市民在医疗保健委托和提供方面变化的现实经验。对379个自由文本回复的主题分析产生了两个主题群。第1类描述了考虑改革NHS的公民的生活经历，描述了不确定中的悲痛，死亡和恐惧。聚类2探索了这些情感反应的来源，方法是在生活经历中详述NHS的概念，描述NHS如何作为一个复杂而具体化的现象学对象而经历。研究结果表明，人们与当地的调试实践有着情感上的联系，在面对“他们的” NHS退化时感到失落。我们认为，情感关系观点将重点放在沉默，给予声音，有意义的参与以及了解反过来影响社区健康格局的重要问题上。面对“他们的” NHS的退化时，会感到失落。我们认为，情感关系观点将重点放在沉默，给予声音，有意义的参与以及了解反过来影响社区健康格局的重要问题上。面对“他们的” NHS的退化时，会感到失落。我们认为，情感关系观点将重点放在沉默，给予声音，有意义的参与以及了解反过来又会影响社区健康格局的重要问题上。