Change-promoting research for health services A guide for resource managers, research and development commissioners and researchers By Selwyn St Leger and Jo Walsworth-Bell Open University Press 236 pages £22.50

Ihope that this important, accessible and useful book gets the wide readership it deserves; I worry that it won't.

It draws centrally on the thinking and experience of its two authors, Selwyn St Leger and Jo Walsworth-Bell, both with a background in public health medicine. They argue fiercely for a 'new paradigm' - one which will bring managers and researchers closer together around real issues and problems and encourage the application of research to decision-making in the NHS. This will clearly require a shift in perspective by both parties involved - managers and researchers.

The book is, as one would expect from the Open University Press, stylish and well produced.

It has an excellent index, appropriate references, notes and further reading, and is well laid out. Nevertheless, on first picking it up, most people will see it as a substantial work which they will, perhaps with difficulty, attempt to read from cover to cover. This would be a mistake.

The authors have constructed the book with the clear intention that it should be part of a 'toolkit' for 'implementing change - promoting R&D'.

In the final chapter they set out how to go about this task, which they see as being about collaboration between managers and researchers. The first step is for people to read the book, but the second is to 'establish a mechanism for considering collaborative research'.

The book falls into six sections:

background on the changing NHS and the current position of research, the new paradigm which St Leger and Walsworth Bell set out; two sections on commissioning research; and a major section on research as an activity. The final section, the most important to HSJ readers, is on using research.

The authors acknowledge that the first section will be of most value to researchers, particularly those who 'may not be aware of what has been happening in the NHS'. The fifth section on 'doing research' runs for nearly 90 pages. The authors suggest you 'dip into this chapter as you need it. It is about comfort with the language and ideas of research. . .'

The section certainly is a clear and up-to-date exposition of methodologies and tools, but it isn't integral to the argument of the book.

It is the final section, a tightly written 25 pages on 'using research', which should be the first thing that most people read in the book.

I would draw it to the attention of chief executives, clinical governance leads and other clinical staff involved in clinical leadership within trusts and primary care groups.

The central thrust is about the need to transform NHS organisations into learning organisations which instinctively draw on and stimulate research and development. 'The social and practical complexity of incorporating desired innovation into a health service is more easily handled if that service has the culture of a 'learning organisation'; the move towards clinical governance within the NHS will provide leaders to nurture this.'

And vice versa - clinical leaders attempting to establish clinical governance should see this as one component of what they are doing - creating learning organisations in which R&D is seen as necessary and central is very much the culture of clinical governance.

Tim Scott Senior fellow, British Association of Medical Managers.