Who Do We Think We Are? Analysing the Content and Form of Identity Work in the English National Health Service

J Health Organ Manag. 2013;27(1):4-23. doi: 10.1108/14777261311311771.


Purpose: The language used by National Health Service (NHS) "commissioning" managers when discussing their roles and responsibilities can be seen as a manifestation of "identity work", defined as a process of identifying. This paper aims to offer a novel approach to analysing "identity work" by triangulation of multiple analytical methods, combining analysis of the content of text with analysis of its form.

Design/methodology/approach: Fairclough's discourse analytic methodology is used as a framework. Following Fairclough, the authors use analytical methods associated with Halliday's systemic functional linguistics.

Findings: While analysis of the content of interviews provides some information about NHS Commissioners' perceptions of their roles and responsibilities, analysis of the form of discourse that they use provides a more detailed and nuanced view. Overall, the authors found that commissioning managers have a higher level of certainty about what commissioning is not rather than what commissioning is; GP managers have a high level of certainty of their identity as a GP rather than as a manager; and both GP managers and non-GP managers oscillate between multiple identities depending on the different situations they are in.

Originality/value: This paper offers a novel approach to triangulation, based not on the usual comparison of multiple data sources, but rather based on the application of multiple analytical methods to a single source of data. This paper also shows the latent uncertainty about the nature of commissioning enterprise in the English NHS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administrative Personnel / psychology*
  • Attitude of Health Personnel*
  • Communication
  • England
  • Humans
  • Interviews as Topic
  • Linguistics
  • Qualitative Research
  • Self Concept
  • Social Identification*
  • State Medicine / organization & administration*