This article aims to investigate the application of re-engineering methodology to public sector health care, in order to determine if increasing demands for customer satisfaction resource cuts in this sector can be addressed. Public sector health care faces large scale change owing to increasing Government performance targets, resource cuts and increasing customer/ patient demands. Re-engineering is a large-scale change philosophy and methodology that has been applied with varying degrees of success and failure in the private sector. In public sector health care there is a paucity of in-depth case study research to determine key success factors for reengineering in this sector. There is a need to determine the appropriateness of re-engineering for helping to address the challenges faced in public sector health care. This article presents the results from a case study application of re-engineering in a public sector health care Trust. The area re-engineered was that of telecommunications. The methodology applied and the key success factors determined by the study are discussed in detail.

This paper is an invitation to contemplate the phenomenon of presence. This is inherently important, in the bigger picture and broader conversation concerning presence and more especially the art of presence as spiritual care. Experience centred narratives are ‘texts’ which bring stories of personal experience into being. The self-narrative (autoethnography) and three additional narratives – co-participants who expressed a willingness to tell their story – is the chosen approach to enable the expression of first-person experience in all its richness, complexity and multiplicity. The essence of presence is portrayed with particular focus on the manifestation, mystery, meaning, movement and ministry dimensions and dynamics of the concept. The patterns and meanings of the lived experience of presence, in the four narratives, emerge beyond the narrative realms of writing, extending into the symbolic realms of art, poetry and music as engaged by the co-informants. This essay is the story of presence in the presence of story – a co-creation of the nature and experience of presence, a tapestry woven on and of the fabric of life.

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