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Using a socio‐linguistic meta‐theoretical framework of language creation from below, this paper explores the significance of language for understanding how clinical governance is being translated into practice. Action‐oriented research with, as opposed to on or for, three discrete groups of NHS practitioners, including managers, has generated a realistic meaning for clinical governance. This meaning is the outcome of a case study that, first, specified the principles underpinning sustained evidence‐based practice for the newly emergent concept of clinical governance, before exploring a primary care setting operationalising some of these key principles through its interpretation of how to introduce clinical governance. Material resources and multiprofessional partnership working have created protected/defended time while maintaining care levels. This combination of resource has enabled practitioners in localities to create regular opportunities to share their problems and their creative ideas, learning together to create better practice that heightens the quality of the care process.

The participatory action research project described in this chapter took place with an established campaigning and research organisation in Manchester. The young activists who were part of the work were all living without legal status in the UK, and had all been failed by the asylum system and cast as the ‘abject’ (Tyler, 2013) and unwanted. Building upon decades of protest against racist and ‘othering’ polices in Britain (Copsey, 2016; England, 2019), the project illustrates a powerful example of young people who are very much on the margins, neglected and disbelieved by the state, and vilified by wider society and deliberate distortions of what it means to ‘seek asylum’, coming together to activate and find a voice in public to call for justice and change. Utilising Voloshinov’s (1929/1986) method of ‘language creation from below’ to create a shared understanding of their experiences in the UK’s ‘hostile environment’ (Goodfellow, 2019), the young activists engaged in consciousness-raising together to explore the commonality of their lives as ‘(young) people seeking asylum’. Rejecting the dominant ideological sign of ‘asylum seeker’, they created a play, ‘Faceless’, to depict the reality of their experiences, to present a counterstatement (Voloshinov, 1929/1986), in the public sphere (Fraser, 1990), and to exercise what Castells (2015) refers to as ‘counterpower’.