The research, led by Barbara Whelan and Declan Devane at the University of Galway together with colleagues at the Health Research Board, the Department of Health and McMaster University in Canada, employed a method known as a rapid evidence support system assessment, or RESSA. The approach is designed to give governments a structured diagnostic of their own evidence infrastructure, something remarkably few administrations have ever done systematically. Rather than evaluating a single policy or a single report, a RESSA examines the system as a whole: who asks for evidence, who produces it, and how well the two sides connect. The Irish team triangulated two complementary data streams to build this picture, combining an analysis of published policy documents with in-depth conversations with the people who work inside the system every day.

The documentary component was substantial in its own right. The researchers reviewed fifty policy documents published between 2018 and 2024, a period that encompassed not only routine health policy development but also the extraordinary pressures of the COVID-19 pandemic. Alongside this, they conducted nineteen semi-structured interviews involving twenty stakeholders drawn from across the ecosystem: officials within the Department of Health, staff at national agencies such as the Health Information and Quality Authority, representatives of research bodies including the Economic and Social Research Institute and the Health Research Board, and evidence intermediaries whose job is to translate academic findings into policy-relevant formats. All interviews were anonymised, informed consent was obtained, and the study received ethical approval from the University of Galway Research Ethics Committee.

The headline finding is one of cautious optimism. Across both the documents and the interviews, policymakers and evidence providers alike expressed a genuine commitment to the use of research evidence in health decisions. This is not a trivial observation; in many jurisdictions, evidence-informed policymaking remains an aspiration rather than a shared norm. In Ireland, that commitment is anchored in concrete structures. The country has formal evidence providers, an established practice of health technology assessment, and defined pathways for particular categories of decisions, such as the evaluation of population screening programmes. These mechanisms give evidence a recognised, institutional foothold in the policy process rather than leaving its use to chance or individual preference.

Yet the assessment also revealed significant unevenness. Analytical capacity within the system varies considerably, and much of the day-to-day use of evidence still depends on informal networks, the professional relationships and personal contacts that allow an official to find the right expert quickly. On the supply side, the picture is similarly mixed. Dedicated research, evaluation and analytics units within the Department of Health play a central role in generating and interpreting evidence, but the processes for requesting and commissioning evidence from external sources vary widely from case to case. Quality-assurance standards, meanwhile, are inconsistent, meaning that the rigour applied to one piece of policy evidence may bear little resemblance to the rigour applied to another.

The interface between research and policy emerged as perhaps the most revealing domain of the assessment. Personal relationships proved to be the connective tissue of the Irish system, enabling remarkably rapid evidence use when it mattered most, particularly during the COVID-19 pandemic, when the National Public Health Emergency Team and its advisory structures required swift synthesis of fast-emerging research. That speed, however, came with a hidden cost. Because so much coordination is ad hoc and person-dependent, the system is vulnerable to staff turnover: when a key individual moves on, the informal channels that carried evidence into decisions can quietly collapse. A resilient system, the authors argue, should not depend on who happens to know whom.

To address these vulnerabilities, the study identifies a series of practical opportunities for strengthening Ireland’s evidence-support infrastructure. Among the most prominent is the creation of a central evidence repository, a single, findable, accessible, interoperable and reusable store of policy-relevant research that officials can consult rather than reconstructing the evidence base from scratch for each new question. The authors also recommend more consistent quality standards for evidence products, expanded capacity for modelling and evidence synthesis, improved access to and linkage of health data, and the establishment of dedicated knowledge-broker roles whose explicit function is to bridge the worlds of research and policy. Rapid-response services for urgent evidence needs would formalise the kind of emergency capability that proved so valuable during the pandemic.

The study’s conclusions are carefully framed. Ireland, the authors write, already possesses many of the building blocks of a strong evidence-support system: dedicated evidence units, valued partnerships between government and research organisations, and a clear policy commitment to evidence use. What is missing is integration. These components operate as fragments rather than as a coherent, end-to-end infrastructure, and the recommendations are intended to knit them into something more coordinated, transparent and systematic. The team is equally candid that structural reform alone will not suffice; realising the vision depends on leadership, resourcing, and the political and cultural conditions that ultimately determine how evidence is valued and used within government.

The assessment is notable not only for its findings but for its methodological honesty. The authors acknowledge that the study assessed a system in which its own funder, the Health Research Board, and several of its authors are embedded, with some team members employed by the organisations under examination and some serving as interview participants. To limit the influence of these overlapping interests, the team followed a published protocol that fixed the aims, scope and methods in advance, applied predefined inclusion criteria and a structured extraction framework to the document review, and discussed their position relative to the system in a dedicated reflexivity statement. The funder, they state, had no role in determining the findings or recommendations beyond the contributions of its employees as members of the research team.

For an international audience, the significance of the work extends well beyond Ireland’s borders. Evidence-support systems exist in every government, yet they are rarely mapped, and even more rarely subjected to systematic assessment. The RESSA framework offers other countries a template for holding up a mirror to their own arrangements, asking whether evidence flows to decision-makers through dependable channels or through luck and goodwill. As governments worldwide grapple with pandemics, ageing populations and constrained budgets, the Irish study makes a compelling case that the infrastructure connecting research to policy deserves the same scrutiny as the policies themselves, because the quality of a nation’s decisions can never exceed the quality of the evidence system that informs them.

Subject of Research: Rapid assessment of the evidence-support system for health policymaking in Ireland

Article Title: Strengthening the evidence-support system for health policymaking in Ireland: a rapid evidence support system assessment

Article References: Whelan, B., Tierney, M., Byrne, P., Saif-Ur-Rahman, K. M., Burke, N. N., Maguire, T., Lavis, J. N., Waddell, K., Creely, C., Gill, C., Horgan, M., O’Driscoll, M., O’Leary, F., O’Neill, J., & Devane, D. (2026). Strengthening the evidence-support system for health policymaking in Ireland: a rapid evidence support system assessment. Health Research Policy and Systems. https://doi.org/10.1186/s12961-026-01539-5

Image Credits: AI Generated

DOI: 10.1186/s12961-026-01539-5

Keywords: evidence-informed policymaking, evidence-support system, RESSA, health policy, Ireland, health technology assessment, knowledge brokering, COVID-19, Department of Health, Health Research Board, evidence synthesis, policy evaluation

RESSA was developed by the Global Commission on Evidence to Address Societal Challenges, an international initiative convened to strengthen the use of evidence in decision-making at every level of government. The tool is not designed to evaluate a single policy decision. Instead, it assesses the entire evidence support system of a country or jurisdiction: the institutions, networks, processes and products that together determine whether policymakers have timely access to high-quality research when they need it. As evidence-informed policy-making has gained prominence worldwide, the commission and its partners have argued that such systems deserve the same scrutiny as the policies they inform. Until now, however, systematic process evaluations of system-level assessment methodologies have been scarce, particularly in the complex, politically charged environments where they are most needed.

The Irish assessment provided an ideal test case. It involved an unusually broad coalition of national institutions: the Department of Health, the Health Research Board, Evidence Synthesis Ireland, Cochrane Ireland and the Global Commission on Evidence itself. Researchers led from the University of Galway, including Marie Tierney and Declan Devane, conducted the process evaluation alongside the RESSA itself, asking three linked questions. Was the assessment delivered as intended? Did the stakeholders involved find it acceptable? And what did their experiences reveal about how such assessments should be run in future?

Methodologically, the study was a qualitative process evaluation with quantitative elements, framed by the Medical Research Council’s guidance on evaluating complex interventions. Three participant groups were recruited: key informants from the Department of Health and affiliated organisations, members of the project’s Oversight Group, and the RESSA lead who carried out the assessment. Delivery fidelity was measured in two ways. The research team qualitatively explored the RESSA lead’s preparedness for the task, and quantitatively compared the delivered assessment against the published RESSA protocol, checking whether each specified component had been implemented as written. Qualitative interviews were analysed using a hybrid inductive-deductive thematic approach anchored in pre-specified process evaluation domains, while acceptability findings were interpreted through the Theoretical Framework of Acceptability, a validated model covering constructs such as affective attitude, burden, perceived effectiveness and ethicality. Reporting followed the Consolidated Criteria for Reporting Qualitative Research, and the study received ethics approval from the University of Galway Research Ethics Committee in March 2024, with written informed consent obtained from all participants.

The headline result is striking in its simplicity. The RESSA was delivered with complete fidelity: all eight protocol components were implemented exactly as specified, a score of eight out of eight, or one hundred percent. In the world of complex interventions, where implementation drift is the norm rather than the exception, such perfect adherence to a published protocol is noteworthy. It suggests that the RESSA methodology, despite operating in the messy reality of a national policy environment, is specified clearly enough to be reproduced faithfully by a trained assessor. Equally important, the assessment proved acceptable to stakeholders across all three participant groups, indicating that the process did not feel extractive, opaque or burdensome to those whose system was being examined.

Beneath those headline findings, however, the qualitative analysis surfaced three cross-cutting themes that the researchers argue are essential to understanding how such assessments actually succeed. The first concerns internal advocacy and governance structures. Stakeholders’ engagement with the assessment, its implementation and its potential impact were shaped by whether champions inside the organisations involved could advocate for the process and whether governance arrangements gave it legitimacy and traction. An assessment of an evidence system, in other words, is not a neutral technical exercise dropped into a vacuum; it lands in an institutional landscape where sponsorship, authority and accountability determine whether its findings are absorbed or ignored.

The second theme centred on communication. Clear, sustained communication supported stakeholder understanding of what the RESSA was and why it was being conducted, fostered engagement throughout the process, and influenced the assessment’s potential to drive change. This may sound obvious, but in practice system-level assessments involve many actors with different expectations, vocabularies and levels of familiarity with evidence terminology. Misalignment at any point can erode trust and blunt the assessment’s usefulness. The third theme concerned relational dynamics: the patterns of trust, collaboration and interpersonal connection among stakeholders were described as central to successful implementation. Where relationships were strong, the assessment could surface candid information about how the evidence system worked; where they were fragile, the process risked becoming superficial.

Taken together, these findings carry a message that extends well beyond Ireland. The researchers conclude that the RESSA can be implemented with high delivery fidelity and in a manner acceptable to stakeholders within complex policy environments, which is precisely the context in which such tools must function. But they also conclude that successful implementation depends not only on methodological fidelity. Organisational context, governance structures, communication practices and stakeholder relationships all shape whether an assessment of an evidence support system delivers meaningful insight. For countries considering a RESSA, the practical implication is that preparation should extend beyond training the assessor and assembling documents: it should include mapping internal advocates, establishing clear governance, and investing deliberately in communication and relationship-building from the outset.

The study also fills a methodological gap. Process evaluation is well established for clinical and public health interventions, but it has rarely been applied to system-level assessment methodologies in the policy sphere. By demonstrating that fidelity can be measured against a published protocol, that acceptability can be systematically assessed using an established theoretical framework, and that qualitative themes can be rigorously derived and reported, the Irish team has provided a template that others can adapt. The authors offer practical recommendations to support the adaptation of RESSA-style assessments across diverse policy settings, from ministries of health in high-income countries to evidence units in low- and middle-income contexts where the Global Commission on Evidence has focused much of its attention.

There are, of course, limits to what a single process evaluation can establish. The study examined one assessment in one jurisdiction, with a small number of participant groups, and the findings about relationships and governance are context-dependent by nature. The research team was also transparent about competing interests: several authors are employed by the Health Research Board, which funded the work, and by the Department of Health, although the design, analysis and decision to publish were led independently by the research team. Even so, the study’s core contribution stands. It shows that the invisible infrastructure connecting research to health policy can be examined systematically, and that when it is, the most important variables may be human ones. As governments worldwide commit to evidence-informed decision-making, the Irish experience suggests that the tools to audit that commitment now exist, and that using them well requires as much attention to trust and communication as to protocol and method.

Subject of Research: Process evaluation of the RESSA methodology for assessing evidence support systems in Irish health policy-making

Article Title: Process evaluation of the Rapid Evidence Support System Assessment (RESSA) methodology for health policy-making in Ireland

Article References: Tierney, M., Byrne, P., Whelan, B., Burke, N. N., Creely, C., Gill, C., Horgan, M., Lavis, J. N., Maguire, T., O’Neill, J., Toomey, E., Waddell, K., & Devane, D. (2026). Process evaluation of the Rapid Evidence Support System Assessment (RESSA) methodology for health policy-making in Ireland. Health Research Policy and Systems. https://doi.org/10.1186/s12961-026-01533-x

Image Credits: AI Generated

DOI: 10.1186/s12961-026-01533-x

Keywords: RESSA, evidence-informed policy-making, health policy, Ireland, process evaluation, delivery fidelity, acceptability, knowledge translation, evidence support systems, Global Commission on Evidence, Health Research Board, governance