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Purpose – To identify the key success factors in a change process and to demonstrate how adherence to the phases of large-scale change contributed to the successful reform of the Irish cancer services and is critical to the sustainability of this large-scale change.

Design – In-depth retrospective analytical case study drawing from face- to-face semi-structured interviews with key stakeholders and players.

Findings – The Irish health care reform had been continually thwarted by local politics. The Irish government confronted this trend by bringing in an outside expert to head the cancer services reform project who, with government support, managed both clinician and public resistance and, based on the evidence of international best practice, led the reform. Sustainable change was achieved by attention to how large-scale change works. The leadership of the project is an important element in overcoming the path dependency that is dogged in most health care reforms.

Value – This chapter provides evidence that the four key phases of large system change: understanding the need for change, framing the change, undertaking the change and sustaining the change, coupled with key success factors in relation to timing, financial viability, political will and leadership, public support, well-managed process, and technical infrastructure and capacity are critical to the implementation and sustainability of large-scale change.

The purpose of this paper is to explain the path that the Irish health system has taken towards achieving good clinical governance, exploring the historical influences on its’ development, some of the major initiatives that have been implemented and the obstacles that have been encountered.

The paper draws on the author's experience researching and teaching in health systems and healthcare management.

The paper offers some explanations for why earlier attempts failed to change the system as well as why recent attempts have met with more success. Greater efforts need to be made to progress clinical governance in the primary care services. In addition it is argued that there is a need to institute systems that enable learning form errors, to involve the public and patient groups and to invest in research that enables answers to the how and why questions that are so often neglected in the reform process.

The paper discusses clinical governance in the Irish Health system and identifies some of the challenges yet to be addressed, many of which are common to clinical governance efforts in other jurisdictions.

Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services.

An extensive review of relevant HSE’s publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented.

PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals’ management systems.

The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE’s PM framework, with a particular interest in acute hospitals and emergency services.

This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.

WE are pleased to devote this Special Number of THE LIBRARY WORLD to a discussion of Irish libraries and librarianship. Our contributors are all distinguished members of the profession in Ireland, none more so than Dermot Foley, to whom we are greatly indebted for having convened this issue.

Our Dublin correspondent telegraphed last night:

How people die and experience the road to death is important for all concerned ‐ the patient who is dying, the family carers and loved ones they leave behind, and the health and social care practitioners. However, family carers often make great emotional and financial sacrifices and also assume heavy administrative roles to support the care of their loved one. This paper reports on the social interactions between patient, carers and professionals during end of life (EOL) care. The findings are based on a primary care trust (PCT) funded consultation that examined the quality of EOL care services in one London borough. The project made use of ethnographic methods (open‐ended qualitative interviews and observations) with 50 borough residents of which 32 were patients and 18 were carers. The findings will consider in more detail the social relationships between patients, carers and professionals. It is suggested that while there are some encouraging signs of good practice among EOL agencies and professionals, greater care is needed on the part of frontline professionals in their day‐to‐day interaction with patients and carers to ensure a better quality of EOL care.

Presents 35 abstracts from the 2001 Employment Research Unit Annual conference held at Cardiff Business School in September 2001. Attempts to explore the theme of changing politics of employment relations beyond and within the nation state, against a background of concern in the developed economies at the erosion of relatively advanced conditions of work and social welfare through increasing competition and international agitation for more effective global labour standards. Divides this concept into two areas, addressing the erosion of employment standards through processes of restructuring and examining attempts by governments, trade unions and agencies to re‐create effective systems of regulation. Gives case examples from areas such as India, Wales, London, Ireland, South Africa, Europe and Japan. Covers subjects such as the Disability Discrimination Act, minimum wage, training, contract workers and managing change.

Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐17; Journal of Property Investment & Finance Volumes 8‐17; Property Management Volumes 8‐17; Structural Survey Volumes 8‐17.

Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.