Values underlying the National Service Framework for coronary heart disease in England : a discourse analysis

Rayner, Mike, Scarborough, Peter and Allender, Steven 2006, Values underlying the National Service Framework for coronary heart disease in England : a discourse analysis, Journal of health services research and policy, vol. 11, no. 2, pp. 67-73, doi: 10.1258/135581906776318956.

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Title Values underlying the National Service Framework for coronary heart disease in England : a discourse analysis
Author(s) Rayner, Mike
Scarborough, Peter
Allender, StevenORCID iD for Allender, Steven
Journal name Journal of health services research and policy
Volume number 11
Issue number 2
Start page 67
End page 73
Publisher Royal Society of Medicine Press
Place of publication London, England
Publication date 2006-04
ISSN 1355-8196
Keyword(s) government programs
coronary disease -- diagnosis
coronary disease -- therapy
Summary OBJECTIVES: The National Service Framework (NSF) for Coronary Heart Disease--published by the English Department of Health in 2000--sets out how those within the health service should seek to prevent and treat coronary heart disease and care for people with the disease. Its prescriptions are partly based on what is known about coronary heart disease and partly on its underlying 'values'. This paper seeks to identify those values.

METHODS:An analysis of the discourses within the text of the NSF based on critical discourse analysis.

RESULTS: Three different discourses can be identified: the managerial, the clinical and the political. The managerial discourse is dominant. Each discourse has its own values. The main 'aspirational' values within the NSF are efficiency, effectiveness, autonomy (choice), universalism and equity. Some aspirational values--particularly equity--appear to be largely rhetorical and lead to few recommendations or prescriptions. Some values that might have been expected to underlie the framework, such as compassion and democracy, are largely absent.

CONCLUSIONS: Discourse analysis provides a more systematic and transparent method of describing the values behind health care policy than the methods that have been used previously.
Language eng
DOI 10.1258/135581906776318956
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2006, Sage Publishers
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