Publications

Barry S, Dalton R. Understanding Change in Complex Health Systems: A review of the literature on change management in health and social care 2007-2017
This review was conducted as a companion piece to People’s Needs Defining Change - Health Services Change Guide (HSE, 2018). It presents an academic appraisal of current literature on change management in health and social care systems. Much of this literature focuses on developments in implementation science but also draws on the social sciences for greater understanding of context and its determining factors - organisational culture, values, attitudes and behaviours, healthcare environments, governance, hierarchical structures, and the distribution of core functions such as leadership, management and decision-making. Complex systems is the dominant lens applied in the literature, which challenges our understanding of the concept of ‘change’.

Burke S, Barry, S, Siersbaek, R, Johnston, B, Ní Fhallúin, M, Thomas, S. (2018) Sláintecare – A ten-year plan to achieve universal healthcare in Ireland
In May 2018, the Pathways team, led by project co-ordinator Dr Sara Burke, has published an academic article on the policy process and content of Sláintecare – the ten-year cross-party political plan for health reform including the delivery of universal healthcare published on 30 May 2017. The Pathways team worked with the Oireachtas Committee on the Future of Healthcare which produced Sláintecare between October 2016 and May 2017.

Pathways Project Team (2018) ‘Sláintecare’ – a Pathway to Universal Healthcare in Ireland
This policy brief from the Pathways Project team summarises the key components of the Sláintecare health reform proposal and describes the circumstances that led to its creation.

Barry, S, Burke, S, Tyrrell, E, Thomas, S. (2017) ‘Is someone going to saw off the plank behind me?’ – Healthcare managers priorities, challenges and expectations for service delivery and transformation during economic crisis
This article provides insights into the priorities, challenges and expectations for Irish healthcare managers. This research, which was carried out as part of our previous research project assessing the impact of the economic crisis on health system, provides valuable lessons for health system change required for the delivery of universal healthcare.

Burke, S, Normand, C, Barry, S, Thomas, S. (2015) From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis.
Members of our team wrote this article, published in Health Policy, charting the shift from the Irish governments stated policy, in 2011, of implementing universal health insurance in Ireland to a new focus on universal healthcare. Details on how exactly universalism will be achieved have yet to emerge.

Thomas, S. (2015). Building Resilience into the Irish health system.
In this presentation from February 2015, Dr Steve Thomas, provided a complete overview of the findings and impact of the Resilience project, which the Pathways project builds on. The presentation provides the background to our current work.

Barry, S, Burke, S, Boyce, M, Eustace-Cook, J, Normand, C and Thomas, S. (2015). Mapping the organisational challenges of implementing universal healthcare/coverage policies for health systems in countries with a GDP per capita greater than $22,000.
Dr Sarah Barry is the lead researcher of this systematic review of the international literature on the organisational challenges, barriers and opportunities of implementing universal healthcare.

Thomas, S, Burke, S, and Barry, S. (2014). The Irish health-care system and austerity: sharing the pain.
This quick read from The Lancet, gives a comprehensive image of the impact on the health service in Ireland of the financial crisis, and by extension the impact on the population.

Burke, S, Thomas, S, Barry, S, Keegan, C. (2014). Indicators of health system coverage and activity in Ireland during the economic crisis 2008–2014 – From ‘more with less’ to ‘less with less’.
This article, from Health Policy, explores in depth the variety of ways the Irish healthcare system responded to increasing cuts from 2008-2014. At first, efficiencies meant that the system performed better and was able to treat more patients, with fewer resources. However, by 2012, once possible efficiencies had been made but resources continued to be cut, the result was a reduction in free and subsidised care, an increased transfer of spending from the State to individuals, and a reduction in health and social care staffing.