IFIC Scotland Integrated Care Matters: Webinar Series 6
IFIC Scotland and partners are delighted to launch series 6 of our Integrated Care Matters webinars. The series will kick off with some webinars led by IFICs SIGs then begin to explore how we can work together to promote health and wellbeing, inclusion and participation in communities. This builds on our plenary session at ICIC21 – you can view that session here. Guest panelists from different systems will share insights and challenge us to create age friendly, compassionate, healthy communities that leave no one behind. Each webinar will be accompanied by a topic resource with links to further information. All who register will receive links to the recordings and topic resources.
Join us @IFICInfo #IFICScotland for #IntegratedCareMatters6
Professor John Ellershaw is head of the Palliative Care Unit at the University of Liverpool. He also chairs the International Collaborative for Best Care for the Dying Person, a global network of clinicians and researchers from 22 countries working together to advance the evidence base in end of life care. His main research interests are care for the dying, ethics and medical education.
Download John Ellershaw’s Presentation
Dr Ana Maria Carriazo
Dr Dave Seamark
Dave Seamark has been a GP at Honiton Surgery in East Devon UK since 1990 and has had a parallel research career examining end of life care in the community.
Download Alpana Mair’s Opening Slides
Assistant Professor (Teaching Stream),
Leslie Dan Faculty of Pharmacy
You can follow her on twitter@jendlake
Health Care Institute (BIHAM) of University of Bern, Switzerland
Kristie Weir, PhD, is a postdoctoral researcher at the Primary Health Care Institute (BIHAM) of the University of Bern, Switzerland, and holds a Swiss Government Excellence Scholarship (ESKAS). Her postdoctoral research focuses on deprescribing communication and decision-making in the primary care setting. In addition to this, she is developing and testing typologies to assess how patient- and clinician-related factors influence deprescribing.
She conducted her doctoral research in public health from 2016-2020 at the University of Sydney, Faculty of Medicine and Health, School of Public Health. Her PhD involved a series of qualitative and mixed-methods studies focused on communication, goal elicitation and shared decision-making in the context of polypharmacy. In addition to this, her PhD involved the development and feasibility testing of a communication tool (the Medicines Conversation Guide) for use in medication reviews. She has expertise in qualitative research and has conducted qualitative studies with older patients, their caregivers, pharmacists and general practitioners.
Degree in Medicine (UB, 1986); Doctor of Medicine (UB, 1992); Postgraduate in Information Systems Management and Organization (UPF, 1997). Past-chair of the International Foundation for Integrated Care (IFIC); member of the co-ordinators’ team EIP-AHA B3. Since 2000, he has worked on the definition, evaluation and implementation of new models for the provision of health services, with special emphasis on integrated care models, often using information technology. He has participated in numerous R & D projects funded by the EU around these topics, often as a member of the coordination team. Among the most recent ones, we can mention: HOMECARE, NEXES, INTEGRATE AND SIMPATHY project. Lecturer in undergraduate and postgraduate courses: Degree in Bioengineering (UB), Degree in Medicine (UPF); Master’s in Clinical Research (UB).
Degree in Medicine at Universitat de Barcelona (1993-1999); Specialization as a General Practitioner (2003); Training in Geriatrics (2006). Doctor of Medicine (University of Vic, 2016), thesis entitled “A patient-centred prescription model assessing the appropriateness of chronic drug therapy in older patients with multimorbidity”Nuria works as a Geriatrician at Hospital Universitari de la Santa Creu (since 2009). She is associate professor since 2017 (Faculty of Medicine, Universitat de Girona; Faculty of Medicine, Universitat de Vic); coordinator of the course “Management of advanced chronic condition” (Master in Palliative Care, Institut Català d’Oncologia, Barcelona, since 2018); and, coordinator of the C3RG research group (Chronicity Central Catalonia Research Group). She has participated in around 40 publications in indexed scientific journals, national and international, most of them with a focus on medications and older people. In 2019 she was awarded by a three-year scholarship by the Catalan government to develop a territorial project about medication optimization in older patients.
International Foundation for Integrated Care
Health and Social Care Alliance Scotland
Steven Malone, Principal Architect Architecture Design Scotland
Steve is based within Architecture & Design Scotland’s Place Based Investment team, providing advice and support towards public sector driven investments including Healthcare, Housing & Community and Public Infrastructure Investment. The Team partners with other public bodies to help develop user-led briefing, share learning across organisations, and guide and facilitate collaborative workshops with a focus on place. Steve previously led on ADS work on ‘Town Centre Living: A Caring Place’, which explores how our town centres can be more supportive environments to live in with a particular focus on ageing and the provision of care. The work is currently being developed through a Pathfinder project with Scottish Futures Trust, looking at Housing Led Town Centre Regeneration in Clackmannanshire.
Download Steven Malone’s Presentation
Sarah McLaughlin, Team Leader, Mid and East Antrim Agewell Partnership (MEAAP)
Sarah is the IMPACTAgewell® (Involving Many to Prescribe Care together) Team Leader with Mid and East Antrim Agewell Partnership (MEAAP) and has been with MEAAP where she coordinated the hugely successful Peace IV EU funded cross – community project ‘Peacing Ages Together’ since 2018.
She has a diverse background having originally worked as a journalist for 10 years. She retrained in the health and care system in 2015 and moved into community development led health and social care sector.
Her passion and commitment to older people and those living with long term health conditions has flourished at MEAAP, and through their flagship project IMPACTAgewell®
Download Sarah McLaughlin’s Presentation
Ellen Nixon, IMPACTAgewell Project Officer
Ellen has been an IMPACTAgewell ® Project Officer with Mid & East Antrim Agewell Partnership (MEAAP) since the beginning of the project in 2017. Ellen has a wealth of experience having worked voluntary advice services including Parenting NI, National Debtline, Advice NI and Citizens Advice for the past 20 years.
Ellen has seen IMPACTAgewell® develop over the past 4 years from offering support to patients of 6 GP surgeries to now expanding to support 18 GP surgeries across the area. She works alongside the older person to develop their individual health and wellbeing plans and has been instrumental in developing the project’s links with over 120 local community.
Download Ellen Nixon’s Presentation
Ralph Broad, Director of Inclusive Neighbourhoods Ltd and Founder of the Local Area Coordination Network CIC in England and Wales.
With Eddie Bartnik and other colleagues, Ralph established and developed the Local Area Coordination Network in England and Wales, initially as part of Inclusive Neighbourhoods and now as part of Community Catalysts CIC to support long term development, learning and sustainability of Local Area Coordination in England and Wales. Inclusive Neighbourhoods Ltd is now looking to build an international network of relationships, partnerships and shared learning between Local Area Coordination sites.
He has more than 30 years experience in working in a wide range of statutory and voluntary sector organisations in England, Scotland and Western Australia. Ralph is a fellow at the Centre for Welfare Reform and was previously an Honorary Fellow at University of Edinburgh. He studied at the Tizard Centre, University of Kent at Canterbury, completing his MA in Management in Community Care in 2007.
Watch Ralph Broad’s recording Presentation
Download Ralph Broad’s Presentation
Listen to Ralph Broad’s main recording, ‘Anne’s Story’
Catriona Mason Chairperson of Seniors Together in South Lanarkshire
Seniors Together are a community of older people living in South Lanarkshire who provide a collective voice for issues affecting older peoples lives. They engage with the community to ensure that older people are involved in decision making through workshops, consultations, opportunities for active ageing, and promoting the benefits of good health and wellbeing in later life. Seniors Together try to engage older people to improve society for their needs.
Irene Beautyman, Place & Wellbeing Partnership Lead at the Improvement Service & Public Health Scotland
Bridging public health and local government to support place based approaches that benefit the wellbeing of both people and planet while addressing Scotland’s shameful inequalities. Leading local and national action through the Shaping Places for Wellbeing Programme. Increasing understanding of the shared wellbeing ambitions within the Place and Wellbeing Outcomes, supporting policy and action that both reduces Scotland’s health inequalities, meets net-zero emission targets and post Covid recovery plans. We do not have the luxury of time to deal with one crisis at a time.
Matthew Linning, Strategic Performance Manager, Volunteer Scotland
Matthew is Head of Research and Evaluation at Volunteer Scotland. As part of his research remit Matthew has been involved in understanding the relationship between ‘Volunteering, health and wellbeing’.
Matthew and colleagues are also supporting the development of the ‘Volunteering Action Plan’ for Scotland, which has a key focus is on ‘volunteering, places and spaces’.
Prof Anne Hendry
IFIC Senior Associate,
Director IFIC Scotland
Download Anne Hendry’s Opening Slides
Dr Miquel Mas
Metropolitana Nord Chronic Care Management Team, Institut Català de la Salut and Department of Geriatrics, Hospital Universitari Germans Trias i Pujol in Badalona, Catalonia.
Miquel is a consultant geriatrician and doctor in medicine with expertise on innovating in the provision of community-based care for health crises management in the community to vulnerable older populations. His ongoing projects include the development of integrated care strategies at meso level tailored to people with multiple chronic conditions and advanced illness in the North Barcelona metropolitan area.
Twitter account: @DrMqAgMas
Download Miquel Mas’ Presentation
TEC Prevention Strategy Manager, Delta Wellbeing, Wales
Carla has worked in various roles within the Social Care sector for over 19 years. With over 10 years’ experience in the TEC field she is currently Delta Lead for the implementation of a new model of service across the West Wales region as part of the Transformation Fund awarded to the West Wales Partnership Board.
Download Carla Dix’s Presentation
Consultant in Older Persons Service,
Ana has been a Consultant in Older People’s Services for nearly 15 years based in North Lanarkshire at University Hospital Monklands. She completed undergraduate and early postgraduate training in Ireland and has been working in the West of Scotland for over 20 years. Ana has an interest in person centred care, self management, realistic medicine and innovation in frailty. During her career she has been involved in setting up telemedicine delivered thrombolysis for stroke, hospital at home and is now leading the development of community frailty MDT meetings both in primary care and nursing homes.
Download Ana Talbot’s Presentation
Watch Elizabeth’s story
Deputy General Manager (Community Health & Social Care), NHS Dumfries & Galloway
Stephanie is currently in post as interim Deputy General Manager for Community Health & Social Care. She has worked for NHS for 22 years in various roles in project management, service improvement and general management spanning across both Acute and Community services. Stephanie has led on many projects and change programmes over the years with the biggest challenge now being faced in her career with a role in leading the transformation of our community services.
Home Team Development Lead, Dumfries and Galloway Health & Social Care Partnership
Gail Robertson is currently leading on the development and implementation of Home Teams in the Dumfries and Galloway Health and Social Care Partnership. Born, bred and trained in Dumfries, Gail has undertaken various roles within her career from managing nurses within Acute Rehabilitation and Elderly Care to predominately being involved in Delayed Discharges for most of her career in the role of Patient Flow and Discharge Manager for the Dumfries and Galloway Partnership.
The highlight of her career was in 2018 when she was seconded into the role of Lead Nurse, playing a key role in the planning and coordinating of the transfer of patients, staff and services to the new District General Hospital in Dumfries.
Download Gail Robertson’s Presentation
Health and Social Care Alliance Scotland (the ALLIANCE)
Senior Associate, International Foundation for Integrated Care (IFIC)
Former National Lead for Telecare
Between 2010 and 2018 Ann was the Falls Prevention Lead for Scottish Government’s Active and Independent Living Programme. In 2019, she moved to the University of Strathclyde to lead the Scottish Government’s Technology Enabled Care (TEC) Programme ‘FIRST’ project, which focused on delivering integrated care and support following a fall. In September 2019, Ann went on to join the TEC Programme as Telecare Lead, where she initiated a programme of work to introduce ‘proactive’ telecare. Ann is a Physiotherapist by background and in 2015 received the Chartered Society of Physiotherapy’s Distinguished Service Award for services to falls prevention.
Chair Archbishops’ Commission on Reimagining Care
Anna is author of The Age of Ageing Better? A Manifesto for Our Future and was the founding Chief Executive of the Centre for Ageing Better, an independent charity that brings about lasting changes in society so more people can enjoy later life. With an endowment from the Big Lottery Fund and as part of the What Works Network, Ageing Better is focused on bringing about impact informed by evidence across four priorities: fulfilling work, healthy ageing, safe and accessible housing and connected communities.
She was previously Director of Strategy and Chief Analyst at the Department of Health from 2013-2015. She has also held positions as Director of Policy at The King’s Fund, Lecturer in European Health Policy at the London School of Economics and Political Science, policy analyst at the Department of Health Strategy Unit (2003-04). In 2005-6 she was awarded a Harkness Fellowship in Health Policy by the Commonwealth Fund of New York which she spent at the University of Oregon. She has a PhD in Social Policy from the London School of Economics and Political Science.
She was a member of the Independent Review of Adult Social Care in Scotland and is currently Chair of the Archbishops’ Commission on Reimagining Care
Watch Dr Anna Dixon’s Ageing Well in Later Life presentation
Dr Mei Fang
University of Dundee and Simon Fraser University, Canada
Dr Mei Fang is a Lecturer in the School of Health Sciences, University of Dundee and Adjunct Professor in the Department of Gerontology at Simon Fraser University, Canada. Dr Fang’s primary research contributions has focused on progressing community-based participatory research concepts, theory, and methods for co-designing inclusive and age-friendly environments. For the past decade, she has led and contributed to ageing, health and wellbeing research that surround health and environmental gerontology and ageing and technology. Dr. Fang works as a transdisciplinary research scientist with particular interest in undertaking in conducting community-based participatory research using community-engaged and creative co-creation methods. Her current research focuses on co-creating ecosystems of intergenerational and inclusive places and spaces with and for people working and living in the community
Download Dr Mei Fang’s presentation
Senior Project Manager, Center of Innovation and Technology Transfer at the Medical University of Lodz
Ewa is a graduate of the University of Lodz and the Polish-American MBA program. At the University of Warsaw she participated in the postgraduate program in the field of cognitive training. She combines interdisciplinary education with passion for implementation of the unique projects. She specializes in activities related to the silver economy, entrepreneurship and the development of start-ups.
Ewa gained experience as coordinator of the Polish edition of Silver Starters program dedicated to people 50+ with business idea. She gained experience as a project manager of EIT Health e-Boat, Smart Ageing and Healthy and Active Aging Bootcamps supporting acceleration programs.
Download Ewa Nocun’s presentation
Project Lead, LifeCurve
For the past year and a half, Kathy has worked as the Project Lead for LifeCurve™ Implementation at the Bay of Plenty District Health Board.
Successfully launching the LifeCurve™ app and websites in New Zealand has been a rewarding journey so far, particularly the collaboration between clinicians, website and app developers, university researchers and older people in the community. What she enjoys most about the role is working in partnership with Māori in order to ensure that adaptations to the new version of the LifeCurve™ app and website are in line with a Māori world view.
Kathy trained in the States and have a Bachelor of Science Degree in Physiotherapy with over 20 years’ experience as a clinical physiotherapist in New Zealand and in the US. Although her roles have varied over the years, the majority of her physio career has been focussed on the rehabilitation of older people.
Executive Director Allied Health Scientific and Technical (EDAHST) in the Bay of Plenty District Health Board
Sarah has been the Executive Director Allied Health Scientific and Technical (EDAHST) in the Bay of Plenty District Health Board since March 2019. Prior to moving to Aoteroa New Zealand she held numerous positions within the Scottish Government, latterly as the National Programme Director for the Allied Health Professions (AHPs) Active and Independent Living Programme (AILP). This Government policy and the previous National Delivery Plan were aspirational strategies aimed at transforming healthcare at a national level. They both necessitated enhanced professional development of Allied Health Practitioners and their resultant repositioning as agents of change and leaders of early diagnosis and rehabilitation.
In 2017 in recognition of my contributions to Allied Health and in particular Physiotherapy I became a Fellow of the Chartered Society of Physiotherapy. This Fellowship is the highest award the Society can make to people who have had a significant National impact on the Physiotherapy Profession.
Since taking up post as EDAHST Sarah initiated numerous innovative models of care such as the Community Orthopaedic Triage Services, A Community Integrated Pathway Programme, Child Wellbeing initiatives as well as launching Lifecurve NZ.
All of these initiatives have a focus on equity, patient centeredness and the value proposition of Allied Health across the health network.
Watch Kathy Everitt and Sarah Mitchell’s Life Curve presentation
Strategic Inspector Care Inspectorate
Susan has worked across health and social care for a number of years with particular interests in how adopting a strengths asset-based approach supports people achieve what matters to them. This approach is key to successful, healthy, engaged and positive ageing and has been part of the healthy ageing work she has contributed to – particularly using the ADL LifeCurve model as a way of engaging people in healthy ageing discussions. She sees giving people information and resources about the malleability of ageing can empower them to make different choices personally, in their communities and places of work and therefore experience a more positive ageing journey. She is currently working in the Care Inspectorate, has been a member of the Personal Outcomes Network coordinating group since 2015 and is involved in research into healthy ageing at Strathclyde University.
“Each of us makes a difference, we can decide what that difference will be” (paraphrasing Jane Goodall).
Prof Anne Hendry
IFIC Senior Associate,
Director IFIC Scotland
Download Anne Hendry’s Presentation.
Clinical Fellow in Social Inclusion, School of Medicine, University of Limerick, Coordinator, Deep End Ireland
Dr Patrick O’Donnell is a GP in Limerick city and Clinical Fellow in Social Inclusion at the University of Limerick School of Medicine. He is a member of the Irish College of General Practitioners and supports the coordination of the Deep End Ireland group. He also holds a master’s degree in Global Health from Trinity College Dublin, and he has just completed his PhD on social exclusion and health. His other research interests are inclusion health, homelessness, addiction and the provision of healthcare to people from marginalised groups.
Download Patrick O’ Donnell’s Presentation.
Links Worker Programme Manager,
The Health and Social Care Alliance Scotland
Roseann has been involved with the Links Worker Programme since 2014 and has been integral in its growth from 7 Links Workers to over 50 and growing. She believes a courageous leadership approach is key to the development of her team; encouraging them to use their creativity to achieve goals. Roseann is an advocate for social change, co-production and is passionate about tackling health inequalities and ensuring patient voices are heard.
Senior Community Links Practitioner,
The Health and Social Care Alliance Scotland
Sharon is one of 6 Senior Community Links Practitioners in the Links Worker Programme. She is passionate about ensuring patients are supported to live well in their own local community and acts as an advocate on a daily basis to help patient break down the barriers they face. She. She is also keen to support staff to develop in their role and reach personal professional goals as well as reaching all individuals in their practice population to offer appropriate support.
Dr Kris Ma
Clinical-Community Psychologist and Behavioural Health Fellow, Dept of Family Medicine, University of Washington, Seattle, U.S.
Kris’s research centers around implementation and dissemination of integrated care interventions to improve equitable access and quality of primary care. She has published on facilitators and barriers of integrated primary care for multilingual patients in U.S. Asian immigrant communities, cultural and linguistic adaptations of dementia caregiving services for Chinese older adults, and larger systemic issues related to payment models, workforce development and structural racism that impact health equity. She has worked as a bicultural and trilingual behavioral health provider in interdisciplinary care teams providing whole-person and culturally responsive care in primary care clinics that often treat low-income, racially/ethnically diverse and marginalized populations.
Download Kris Ma’s Presentation
Dr Larissa Verissimo
Professor of Public Health, FMABC University,
Santo Andre, Sao Paulo Brazil
Since obtaining a PhD and MPH in health policy, planning and management, Larissa has worked on designing, planning and developing projects on public health, health inequalities and integrated care in Brazil. She is currently an integrated care consultant at FIPE and Kune, and professor of Public Health at FMABC University. She was previously institutional support coordinator for Sao Paulo State’s Health in Action Program, co-financed by the Inter-American Development Bank, and has acted as an external consultant for the World Bank, Pan American Health Organization, and the Inter-American Development Bank. As a research fellow at The Hopkins Health Disparities Solutions Center, Johns Hopkins University in 2015, she participated at the bi-national agreement Brazil-United States Joint Action Plan for Elimination of Racism and Promoting Equity. In her early career, Larissa was a physiotherapist specialist in Geriatrics and Gerontology.
Download Larissa Verissimo’s Presentation.