Over the last decade, research in medical science has focused on knowledge translation and diffusion of best practices to enable improved health outcomes. However, there has been less attention given to the role of policy development in influencing the translation of best practice across different national contexts. This paper argues that the underlying set of public discourses and ideological presuppositions of healthcare policy significantly influence its development with implications for the dissemination of best practices. Our research examines the policy discourses surrounding the treatment of stroke across Canada and UK, and how they are constituted by different underlying meanings of innovative best practice, user participation, and service restructuring. These findings provide an important yet overlooked starting point for understanding the role of policy development in knowledge transfer and the translation of science into health practice.