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Provides a thematic case-study analysis of the wide-ranging public sector reforms introduced in one of the states most deeply affected by the global financial crisis: the Republic of Ireland. It presents a timely and apposite examination of how a crisis can be used to overcome barriers and facilitate new reform agendas. The study draws upon unique insider access to the centre of Irish government, as well as interviews with over 60 key figures, to examine the implementation of those reforms over the 2011-16 period. The book opens with a contextual analysis of the creation of the Department of Public Expenditure and Reform.

Surgery is a major contributor to the large environmental impact of healthcare, demanding urgent attention. To date there are no data on the attitudes and behaviours of surgeons towards climate change, or perceived barriers towards sustainable practice. We invited surgeons and surgical trainees in the UK and Ireland to participate in an online survey (developed in accordance with the CHERRIES checklist) conducted between June and November 2020 and disseminated via the Royal College of Surgeons of England, Edinburgh and Ireland, the Association of Surgeons in Training and through local communication. We received 130 responses, across 14 surgical specialties. The majority of respondents (122/130; 94%) were concerned about the threat of climate change. Most respondents had instigated more sustainable practices in their personal lives (113/130; 87%) and, to a lesser extent, at work (73/130; 56%). Surgeons were willing to make changes to their clinical practice (107/130; 82%), but the main perceived barrier to improving sustainability was a lack of leadership (92/130; 70%). Surgeons welcomed greater leadership and guidance from national bodies (118/130; 91%) and more monitoring and regulation (113/130; 87%). The surgeons who responded to our survey are concerned about climate change and willing to engage in efforts to transition to more sustainable practice, but would welcome greater support, guidance and leadership.

•Immunisation nurses (IMNs) feel that HPV education for 15–17 year olds is important.•IMNs are highly motivated to design and deliver HPV education for adolescents.•IMNs are experts in HPV education and feel their skills are underutilized.•IMN barriers include time, resources, parental attitudes and teacher training.•Further collaboration between the PHA and the EA is key to IMN’s role development. Human Papilloma Virus (HPV) is responsible for the development of cervical, vaginal, vulvar, penile, oropharyngeal and anal cancers. Throughout the UK, Immunisation nurses (IMNs) deliver school-based HPV vaccinations to students 12–13 years old. Providing HPV education to 15–17 year old students may promote decision-making regarding their sexual health and award opportunity for unvaccinated students to self-consent to the vaccination. This study aims to explore the perceptions of IMNs regarding the value of providing HPV education to 15–17 year old students and to explore whether IMNs feel that the design/delivery of this education should form part of their professional role. Six focus groups were conducted online with IMNs from all five Health and Social Care Trusts in Northern Ireland, UK, between January-June 2021. Data were analysed using the COM-B model to identify factors that might influence IMNs’ behaviour towards designing/delivering this education for 15–17 year old students. IMNs were highly motivated to design and deliver this HPV education. Facilitators promoting this behaviour included their specialist training, their previous sexual health teaching experience and their desire to educate young people. Barriers negatively influencing this behaviour included lack of time/resources, parental influences, lack of school support and lack of teaching/presentation skills training. IMNs feel that they are the most appropriate professionals to design/deliver HPV education for 15–17 year old students. National policy change, based on collaboration between the Public Health Agency and Education Authority, is a key factor in facilitating IMNs to implement this school-based HPV education intervention.

IntroductionAccording to the WHO, healthcare in Europe requires ‘systemic change through innovation’ if it is to respond to the demographic, epidemiological, environmental and technological challenges the region is facing. However, top-down methods of innovation in healthcare, driven by the macro levels of the system, have been struggling to impact the healthcare system at the scale that is required to drive meaningful and sustainable change. It has been widely acknowledged that frontline-led, employee-driven innovation will be the main driver to ensure that innovation in healthcare is human-centred and prioritises the needs of the patients.This study protocol presents a research project designed to evaluate the experiences of frontline innovators supported by the Irish Health Service Executive’s HSE Spark Innovation programme. The purpose of this research is threefold. First, the findings will further strengthen the provision of support for frontline healthcare professionals, ensuring that they can continue to address the challenges they experience in providing care. Second, the research will provide insight into the structures required to support frontline innovation within the public healthcare sector, forming a starting point for other public sector organisations interested in establishing their own support system for frontline innovation. Finally, it will highlight the impact supporting frontline clinicians to innovate has on service users, staff and the wider healthcare organisation.Methods and analysisA qualitative research design, situated in a phenomenological framework, will be adopted for this research. ‘Participants’ in this study will include staff from the Irish public healthcare system who have obtained innovation support (either funding or human centred design support) from HSE Spark. The participants will be invited to share their experiences of the innovation support they received from HSE Spark, as well as their understanding of the impact of this support on their professional development, their service and the wider healthcare organisation. A stratified purposive sampling approach will be used to ensure the sample provides information-rich representations of individuals’ experiences engaging innovation initiatives supported by HSE Spark. One-to-one, semistructured interviews will be conducted with participants. Transcripts from these interviews will be analysed through a thematic approach, using the data analysis software NVivo. Themes will be derived from the data and used to understand the healthcare professionals’ experiences of engaging with innovation projects and with the support provided to them by HSE Spark. These themes will be used to identify the unspoken needs of innovators within healthcare, the support they need to continue innovating in this sector, and the impact supporting frontline innovation has on the service users, staff and the healthcare organisation.We used the Standards for Reporting Qualitative Research (SRQR) reporting guideline to draft this manuscript, and the SRQR reporting checklist when editing.Ethics and disseminationEthics approval for this study has been obtained from HSE Regional Ethics Committee (No. 20251650-RDMLRREC) and Maynooth University Social Sciences Research Committee (Approval Number: SRESC-2025-40031). Dissemination of results will be via journal articles, conference presentations and proceedings. Study findings will be disseminated in peer-reviewed journals and through conference presentations. Lay summaries of the findings will also be prepared for distribution in internal Irish Health Service publications. Other dissemination activities include the preparation of a book of case studies and key findings on the challenges of integrating human-centred design into public services, to be presented to the Irish Department of Public Expenditure and Reform.

PurposeWorkplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and safety and human resources in healthcare organisations. This study aims to examine factors that influence workplace silence among hospital doctors in Ireland.Design/methodology/approachA national, cross-sectional, online survey of hospital doctors in Ireland was conducted in October–November 2019; 1,070 hospital doctors responded. This paper focuses on responses to the question “If you had concerns about your working conditions, would you raise them?”. In total, 227 hospital doctor respondents (25%) stated that they would not raise concerns about their working conditions. Qualitative thematic analysis was carried out on free-text responses to explore why these doctors choose to opt for silence regarding their working conditions.FindingsReputational risk, lack of energy and time, a perceived inability to effect change and cultural norms all discourage doctors from raising concerns about working conditions. Apathy arose as change to working conditions was perceived as highly unlikely. In turn, this had scope to lead to neglect and exit. Voice was seen as risky for some respondents, who feared that complaining could damage their career prospects and workplace relationships.Originality/valueThis study highlights the systemic, cultural and practical issues that pressure hospital doctors in Ireland to opt for silence around working conditions. It adds to the literature on workplace silence and voice within the medical profession and provides a framework for comparative analysis of doctors' silence and voice in other settings.

The sports clubs’ role in promoting health has been acknowledged by policy makers and researchers, but there is little evidence on how sports clubs implement health-related interventions. The present article investigates the Gaelic Athletic Association Healthy Club Project (HCP) implementation process (mechanisms, barriers, leverages) over a 10-year timeframe. A case study design helped to produce and compare a data synthesis for five clubs involved since 2013. A qualitative iterative data collection, including document analysis was conducted through 20 focus groups with Healthy Club Officers, coaches, participants and members. The Consolidated Framework for Implementation Research was used in the deductive analysis process, conducted by the first author. Results have shown the success of the HCP in placing health promotion on the agenda of sports clubs leading to informal policy for health promotion, even if activities and recognition are directed toward and coming from the community. This study also underlines the virtuous cycle of the settings-based approach in enhancing membership and volunteer recognition through health promotion actions, and the importance of social good and corporate social activities for sports clubs. Nevertheless, the HCP still relies on limited human resources, is not recognized by competitive oriented adult playing members. and acknowledged as a resource by some coaches, limiting its rootedness in the core business of sports clubs. Future research should empower the HCP community to focus on organizational changes and develop outcomes for individuals, for the club as a whole as well as for the local community.

The purpose of this review is to examine transformational school leadership, responding to the question: ‘What is the research evidence in the international literature pertaining to the impact of transformational school leadership in primary schools on school staff and school culture?’. This review presents a synthesis of 15 studies performed between 2012 to 2022. The data are presented within a framework constructed from the dimensions and characteristics of transformational school leadership. They show transformational school leadership as a positive leadership style with a close interconnection between positive impact of transformational school leadership for school staff and for an enhanced school culture. An increased motivation in staff and the fostering of more positive school culture were found to be the leading impacts of transformational leadership on school staff and culture in this systematic literature review.

After a quarter of a century of implementation of New Public Management (NPM) reform strategies, this book assesses the major real outcomes of these reforms on states and public sectors, at both the organisational level and a more political level. Unlike most previous accounts of reform, this book looks at how reform has changed the role of the public administration in democratic governance. Featuring case studies on the UK, Germany, France, Norway, Ireland, Switzerland, Scandinavia, Post communist states, Mexico, South Korea, Turkey and the European Commission, and focusing on two issues this book: Examines the significant variations in the \"trajectories\" of administrative reform among West European countries on the basis of empirically rooted research on different national case studies. Assesses the extent to which these \"constitutive\" public policies have affected the institutions of government and the governing processes of our democratic occidental states and ask how have NPM-inspired programs, with their exclusive focus on managerialist objectives and instruments, challenged the political and democratic nature of public administration? Looking at the broader issues relating to the current recompositions of democratic states, this book will be of interest to students and scholars of all matters relating to public administration and governance within political science, management, public law, sociology, contemporary history, and cultural studies.

This study examined the impact of perceived ethical culture of the firm and selected demographic variables on auditors' ethical evaluation of, and intention to engage in, various time pressure-induced dysfunctional behaviours. Four audit cases and questionnaires were distributed to experienced pre-manager level auditors in Ireland and the U. S. The findings revealed that while perceived unethical pressure to engage in dysfunctional behaviours and unethical tone at the top were significant in forming an ethical evaluation, only perceived unethical pressure had an impact on intention to engage in the behaviours. Country was also found to have a significant impact, with U. S. respondents reporting higher ethical evaluations and lower intentions to engage in unethical acts than Irish respondents. Implications of the findings and areas for future research are discussed.

Purpose - Neo-institutional theory suggests that organisations change occurs when institutional contradictions, caused by exogenous and endogenous dynamics, increase over time to the point where change can no longer be resisted. Human praxis will result, but only when sufficiently powerful interests are motivated to act. This paper aims to examine the role that the accreditation of business schools can play in increasing institutional contradictions and hence fostering organisational change towards stakeholder engagement and engagement with social responsibility and sustainability issues. Numerous accreditations are promulgated within the higher education and business school contexts and a number of these relate to, or have aspects that relate to, ethics, social responsibility and sustainability. Design/methodology/approach - The paper first analyses the take up of accreditations across UK business schools and then uses a case study to illustrate and explore stakeholder engagement and changes related to ethics, social responsibility and sustainability linked to accreditation processes. Findings - Accreditations are found to be an increasingly common interest for UK business schools. Further, a number of these accreditations have evolved to incorporate issues related to ethics, social responsibility and sustainability that may cause institutional contradictions and may, therefore, have the potential to foster organisational change. Accreditation alone, however, is not sufficient and the authors find that sufficiently powerful interests need to be motivated to act and enable human praxis to affect change. Research limitations/implications - This paper draws on previous research that considers the role of accreditation in fostering change that has also been carried out in healthcare organisations, public and professional bodies. Its findings stem from an individual case study and as such further research is required to explore whether these findings can be extended and apply more generally in business schools and universities in different contexts. Practical implications - This paper concludes by recommending that the newly established UK & Ireland Chapter of PRME encourages and supports signatory schools to further embed ethics, social responsibility and sustainability into all aspects of university life in the UK. This also provides an opportunity to engage with the accrediting bodies in order to further support the inclusion of stakeholder engagement and issues related to this agenda in their processes. Originality/value - This paper contributes by introducing accreditation as an institutional pressure that may lead indirectly to organisational change and supports this with new evidence from an illustrative case study. Further, it draws on the role of institutional contradictions and human praxis that engender organisational change.