County Derry pharmacist publishes book on sustainable healthcare services
Dr Ruth Miller explores how to design sustainable medical services that survive beyond initial pilot funding in Build. Transform. Last.
An award-winning Moneymore-based pharmacist, born and raised in Magherafelt, explores how to build healthcare services that deliver lasting benefits for patients in her debut book.
Build. Transform. Last. by Dr E F Ruth Miller argues that promising initiatives risk fading away when pilot funding ends because their long-term future has not been considered from the outset.
Drawing on more than 15 years of experience designing, evaluating and sustaining services, the book examines what helps improvements become an established part of patient care.
The book is aimed at healthcare professionals leading or shaping new services, senior health managers responsible for results that have to last and project managers delivering transformation in complex systems.
As a practical philosophy for healthcare service design and delivery, Build. Transform. Last. offers a different starting point built on eight principles.
Author Dr E F Ruth Miller says: “The most important thing when designing and building healthcare services is to involve the people closest to the work first. Then you need to build evaluation into those services from the beginning and create a clear sense of ownership.
“These steps are essential to making improvements last and are all outlined in my book Build. Transform. Last.”
The book helps readers to understand the importance of:
- Seeing the whole pathway, not just their part of it
- Assuming nothing, and testing what they think they know
- Designing with the people closest to the work
- Building evaluation in from the beginning
- Making ownership the driver of adoption
- Treating implementation as the beginning, not the end
- Using evidence to secure the future of what works
- Repeating, scaling and sustaining
Build. Transform. Last. does not replace improvement methodology, change management or project management and helps readers to ask the right questions from early on before choosing the methods and tools they need.
Dr E F Ruth Miller is the founder of EFRM Consulting Ltd and creator of the Build. Transform. Last. philosophy and the Evidence Future Ready Model. A multi award-winning pharmacist, researcher, project manager and healthcare service designer, she has more than 90 peer-reviewed publications, has secured half a million pounds of research funding and has won two HSJ Awards (2016 and 2025).
Praise for Build. Transform. Last.
"This book by Dr Ruth Miller is not only timely in our European settings, but also of global interest. At this moment, it is difficult to find a country that is not seeking to transform its health care system, but many are jumping to what are apparently structural ready-made solutions without stopping to reflect. … The book also reflects on the other key global trend for leaders: the need for more local freedom, more licence to innovate, and collaboration among those at the delivery level, and how to scale up those innovations with patient pathways in mind, not structural reorganisations. … I encourage everyone to read it!"
Professor Rafael Bengoa Former Minister for Health, Basque Government; Northern Ireland review "Systems, not Structures"Build. Transform. Last. A Practical Philosophy for Healthcare Service Design and Delivery is out now.