Health services globally are changing, strategically, structurally and clinically. Research and Development (R&D) plays a key role, because only good research can elucidate and challenge the status quo or future possibilities for effective health care. Researchers and managers have a duty to collaborate with clinicians, to understand and make the most of each others' skills. This necessitates a new paradigm of health service research which is part of a change management culture and change promotion. A clear philosophical and practical distinction is required between R&D and fundamental biomedical science. This book has been written for people who make decisions and bring about change, at all sorts of levels, and in a wide range of disciplines. They include clinicians in many specialities, as well as administrative staff, and general managers of healthcare organizations. It is also for people doing, or wanting to do, research and development in this fascinating area.