Mid Ulster based pharmacist and researcher Dr E F Ruth Miller publishes book on future of healthcare services

Build. Transform. Last. by Dr E F Ruth Miller, who is a Moneymore based pharmacist, said the book brings together decades of research, professional experience and practical knowledge to address a challenge facing healthcare systems internationally: how can we design, deliver and evaluate healthcare services so they are more likely to succeed, sustain beneficial outcomes and be capable of scale?

“Throughout my career, I have worked in senior healthcare roles across Northern Ireland, undertaken doctoral research and led several nationally award-winning healthcare projects, including recognition through the RPSGB Pharmaceutical Care Awards (2014) and HSJ Awards (2016 and 2025),” she said.

“I was particularly delighted to receive an endorsement from Professor Rafael Bengoa, former Minister for Health in the Basque Government, who led Northern Ireland's influential Systems, Not Structures review.

“Publishing Build. Transform. Last. represents a significant personal milestone. It is the culmination of more than 30 years of experience and my ambition to make a meaningful contribution to how healthcare services are developed and sustained, both here in Northern Ireland and internationally.”

In the book she 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.

She continued: “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 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).