"Making up" user voice: accounting for experiences of the vulnerable

Over the past two decades, policy and regulation in social and healthcare settings, as well as across public service delivery more broadly, have placed increasing emphasis on “user voice” and “user experience” in the commissioning and evaluation of services. Yet the formats and methods through which such accounts of user feedback should be produced often remain indeterminate. This paper examines the organizational processes involved in eliciting, assembling, and representing “user voice” within a large social care organization. Drawing on an ethnographic study, we investigate how the organization responds to diverse user feedback requests from external bodies, such as commissioners and regulators, as well as to internal demands for useable and appropriate accounts. Building on Hacking's concept of dynamic nominalism and his later engagement with Goffman, we analyse how user voice is “made up” through processes of tracing, framing, and connecting in the interstices between locally situated lived experiences of service users and top-down professional and regulatory discourses of care and service quality. Our analysis demonstrates the multiplicity, ambiguity and situational malleability of user voice, revealing how it both expands and escapes classification. Together, these dynamics highlight the lateral, transversal movements that occur in the interplay between top-down abstract classifications and bottom-up practices and situated concerns of the classified. The paper concludes by reflecting on both the organizational appeal and the potential dangers of demands for user voice.