The International Foundation for Integrated Care is delighted to introduce Webinars Series 3: in collaboration with IFIC Scotland and IFIC Ireland on people-centred integrated care in practice. This series will have a particular focus on active and healthy ageing and preventing and managing frailty. The webinars will be hosted by IFIC Scotland and IFIC Ireland in partnership with the University of the West of Scotland, the Institute of Research and Innovation in Social Services, the Health and Social Care Alliance, and with ADVANTAGE Joint Action on the prevention and management of Frailty, co-funded by the European Union’s Health Programme. Each webinar will feature health and care practitioners with experience of implementing people-centred integrated care for older people. Presenters from around the world will offer evidence, personal insights, practical tips and peer support as part of IFIC’s global community of practice. Each webinar will extend IFIC’s on-line knowledge tree by collating resources related to the specific topic.
Professor Anne Hendry
Clinical Lead for Integrated Care Senior Associate,
International Foundation for Integrated Care (IFIC)
Anne is a geriatrician, stroke physician and clinical lead for Integrated Care, has extensive experience of transforming health and social care for older people and adults with long term conditions across Scotland.
As a Senior Fellow with the International Foundation for Integrated Care, Anne now promotes the adoption and spread of innovation and good practice on population based, people centred and integrated care and facilitates special interest groups on Intermediate care, complexity, and palliative care.
Other work includes leadership development and knowledge exchange initiatives that link Scotland with other systems, participation in the European Innovation Partnership on Active and Healthy Ageing, and in Horizon 2020 funded research projects on chronic care and integrated care. Anne will lead the models of care Work Package in a new European Joint Action on Frailty.
She is honorary professor at the University of the West of Scotland, holds honorary appointments with the University of Glasgow and the University of Edinburgh’s Global Health Academy, is a trustee for two national charities and Board member of the ALLIANCE Academy.
Senior Programme Manager, NHS Lanarkshire and ADVANTAGE JA
Mandy is a registered nurse and an experienced innovator and change and improvement agent in health and social care across public, private and voluntary sectors. She supports the International Centre for Integrated Care as Senior Programme Manager for the European Joint Action on Frailty.
She previously worked as a leadership consultant with NHS Education for Scotland and established the national Leading Quality Network and national mentoring initiative. Her experience of managed clinical networks, QI collaboratives and leading a national cross sector improvement network developed skills to lead, manage and support transformational change.
She is passionate about involving people, carers and service users to ensure their lived experience shapes new ways of working. She is a (founding cohort) member of the Q Initiative, a UK-wide initiative led by the Health Foundation and supported and co-funded by NHS Improvement.
M: +44 7977 091548 T: @mandynetwork
Self Management and Co-production Hub,
Health and Social Care Alliance Scotland
As Programme Manager of the Self Management and Co-production Hub, Sara coordinate the ALLIANCE’s work to develop, deliver and evaluate a high quality programme of work to support the development and embedding of person centred approaches and third sector involvement within the planning and delivery of health, social care, and integrated services across Scotland. Central to this is ensuring a strong voice for disabled people, people living with long term conditions and unpaid carers. Sara’s work spans a broad agenda, including health and social care integration, self management, health literacy and Scotland’s House of Care. Before joining the ALLIANCE, Sara worked within Scottish Government as a social researcher supporting the Equality Unit alongside working with a variety of third sector organisations.
Regional ICP Business Manager
Directorate of Integrated Care
Health and Social Care Board in Northern Ireland
Sinead is the Regional ICP Business Manager in the Directorate of Integrated Care at the Health and Social Care Board in Northern Ireland. Master’s Degree in Health Psychology and has worked in the area of health and social care for the last 15 years, primarily in service improvement roles both in the voluntary sector and in the statutory sector. Currently works for the Northern Ireland Health and Social Care Board in the area of Integrated Care and particularly the establishment of Integrated Care Partnerships (ICPs). Sinead has a particular interest in collaborative working co-production and self-management.
Strategic Head of Community and Chronic Conditions Management
Hywel Dda University Health Board
Claire is Strategic Head of Community and Chronic Conditions Management. Claire is currently the Strategic Head of Community and Chronic Conditions Management in Hywel Dda University Health Board responsible for the strategic implementation of the Chronic Conditions Programme and leads and co-ordinates a range of activities that promote excellence in chronic conditions management practice through utilization of evidence and research. This requires Claire to manage on behalf of the Director of Primary, Community and Long Term Care a range of programmes including diabetes care, respiratory care, Technology Enabled Care and supporting projects to address commissioning, performance and services for chronic conditions management. Claire is also operationally responsible for the Hywel Dda Home Oxygen Service and the Education Programme for Patients and a Bevan Exemplar.
Dr Derick Mitchell
Dr Derick Mitchell is the Chief Executive of IPPOSI. Derick has over ten years’ experience of working in patient engagement, scientific communications, multi-stakeholder management and advocacy at both the national and European level. Derick leads IPPOSI’s participation in EUPATI – a unique initiative to develop an EU-wide Patient Training Academy. He is also a member of a number of national committees including the eHealth Ireland committee, the Medical and Life Sciences Committee of the Royal Irish Academy as well as the oversight group on implementation of the National Rare Disease Plan for Ireland. Derick has a PhD in Molecular Medicine from University College Dublin, as well as a BSc in Biotechnology from NUI Galway.
Head of Effective Prescribing and Therapeutics
Head of Effective Prescribing and Therapeutics, Scottish Government & previously Deputy Chief Pharmacist for Scotland. EU project coordinator for SIMPATHY, EIP AHA A1 action group coordinator for polypharmacy and prescription, and WHO lead for Polypharmacy for the Third Patient Safety Challenge, National Scottish lead for polypharmacy and Patient Safety Quality and Scottish Quality and Improvement Fellow.
NI pharmacists working with Older People (NIPOP)
In March 2012, Carmel was appointed as one of the first of five consultant pharmacist posts within NI. Since then she has implemented and evaluated innovative pharmacy models focusing on medicines optimisation for Older People. She currently sits as a member of the Joint Formulary Committee of the BNF, NI Regional Formulary Group, Parkinson’s Expert Reference Group, Regional Inpatient Falls Prevention Group, Northern Ireland Frailty Network and is involved with research in the area of Dementia and medicines management. Carmel also works with education, regulatory and professional bodies to promote pharmacy development and is founder of the NI pharmacists working with Older People (NIPOP) Network.
Redesign NHS Ayrshire and Arran
My current role involves leading on the redesign of pharmacy services which includes developing and implementing procedures for new ways of working to ensure efficient practice, patient safety and service improvements for patient.
I am currently leading the redesign to the care of the elderly pharmacy services. This encompasses pharmacy services in the hospital, care homes, care at home and integrated care services with links to community pharmacists too.
I am a qualified pharmacist independent prescriber and I work clinical sessions in the Emergency Department, University Hospital Crosshouse.
I received an ABPI Pharmacy award in 2006 for innovative pharmaceutical care provision in a Clinical Decisions Unit. I am a fellow of the Scottish Patient Safety Programme (Cohort 2).
I completed a Doctorate of Professional Practice from Robert Gordon University in 2016. My research assessed the impact of implementation of a hospital electronic prescribing and medicines administration (HEPMA) system specifically focusing on discharge communication and prescribing errors.
I am a Scottish Pharmacy Clinical Leadership Fellow (2018-2019) with a remit for integration of pharmacy services.
Pharmacy Service of Consorci Hospitalari de Vic
Pharmacist (Salamanca University, 2009). Specialist in Hospital Pharmacy (Virgen del Rocío University Hospital, Sevilla, 2015), having received the Best Resident Prize of its year. Board Certified Pharmacotherapy Specialist (American Pharmacist Association), master´s degree in Pharmacoeconomics (Granada University) and postgraduate diploma on Health Technologies Assessment by the University Pompeu Fabra, Barcelona.
Currently he works at the Pharmacy Service of Consorci Hospitalari de Vic (Barcelona), being responsible for providing pharmaceutical care to patients with multimorbidity in an intermediate care centre and a nursing home centre dependents of Vic General Hospital.
His main lines of work and research are specially focused on design and implementation of strategies for improving effective prescribing and medication adherence in patients with multimorbidity.
Dr. Lisa Garland Baird
Research and Analytic Unit
Canadian federal government at Veterans Affairs Canada (VAC)
Dr. Lisa Garland Baird works and lives with her family in Prince Edward Island, Canada.
She is a Registered Nurse who practiced as a home care nurse for fourteen years, providing direct nursing and palliative care, and in the development and implementation of home care nursing policies and programs in PEI. Concurrently, she was a nurse educator at the University of Prince Edward Island Faculty of Nursing teaching community health nursing and population health in both the classroom and clinical settings.
Dr. Garland Baird is currently employed with the Canadian federal government at Veterans Affairs Canada (VAC), where she is the national manager of a research and analytic unit exploring client experiences and outcomes to improve VAC’s national programs and policies for Veterans.
She received her PhD in Nursing from the University of Alberta, Edmonton, Alberta in 2018. Her dissertation research explored home care case managers’ integrated care of older adults with multiple chronic conditions in PEI.
She received additional research training as a Trans-disciplinary Understanding in Training on Research (TUTOR) Fellow (2016-2017), and a CIHR Community-Based Primary Health Care Research Trainee with the McMaster University Aging, Community and Health Research Unit (2013-2018). She received integrated care training from the International Foundation of Integrated Care’s Integrated Summer School on Integrated Care (2017) along with Dr. Giovanna Cruz!
She is a co-primary investigator with Dr. Grace Warner, Dalhousie University, Nova Scotia, Canada on a Canadian Institutes for Health Research (CIHR) funded Strategies for Patient Oriented Research (SPOR) Realist Review. Her presentation today will focus on this cross provincial research that is exploring the use of case management in primary care as a mechanism to link formal and informal health and social services for patients and family members in end of life care.
Dr Giovanna Cruz
Integrated Palliative & End of Life Care Service
Hospice Isle of Man
Dr Giovanna Cruz is a Research Fellow within the Integrated Palliative & End of Life Care Service at Hospice Isle of Man. She is an experienced researcher with a background in epidemiology and biostatistics. In her current role, she is engaged in health services research pertaining to the design of population-based approaches to integrated palliative and end of life care. She earned her PhD from the University of California, Berkeley. She has research experience in the molecular epidemiology of cancer and autoimmunity, life course epidemiology, vulnerable populations and health disparities. She has worked in academic, not-for-profit and in the health care consulting sectors
Palliative Care Nurse
Susanne Gray trained as a nurse in Romford, Essex. After a period working in the hospital where she trained and then in her first community nurse post in South London, Susanne returned to Scotland in 1994, working as a community nurse in a variety of areas in Glasgow most notable Possil Park. During this time she completed a post graduate diploma in cancer nursing at Glasgow University.
She became a Palliative Care Clinical Nurse Specialist in the community in NHS Lanarkshire in 1997 and stayed there until 2009. During this time she completed a master of nursing degree at Glasgow University and played a lead role in the development of the Lanarkshire Palliative Care Assessment Tool. Susanne moved to NHS Greater Glasgow and Clyde in 2009 to take up a role in Renfrewshire Health and Social Care Partnership. The emphasis within this role, which is Susanne’s current role, is service development and continuous improvement in community palliative care. Developments that Susanne has led on to date include introduction of Macmillan cancer information and support services based within libraries in Renfrewshire, the community palliative care kardex and most recently a redesign of community palliative care.
Hospice Isle of Man
Inés García- Sánchez
Inés García-Sánchez studied Medicine at the Public University in Madrid, Spain. She has a degree in Public Health from Spain’s Ministry of Education. She received postgraduate training in Public Health at the London School of Hygiene and Tropical Medicine in London, UK, and at the Centre for Disease Control in Atlanta, USA. She worked as primary health care physician for five years in Spain for the National Health Service in Madrid, and then moved to primary health care planning and public health for 10 years in Andalucía.
From there she has worked for the Regional Health Government in Andalucía, Spain, for over 15 years, as main researcher and coordinator for several health projects at European level.
From 2012-2016 she worked as an European Commission Policy Officer for the Innovation and Health and Consumers Unit at DG Health and Consumer, which lead the European Innovation Partnership on Healthy and Active Ageing. She coordinated the Action Group on prevention of frailty. From 2017 she has worked as the ADVANTAGE JA Deputy Coordinator.
Integrated Care Programme Older Persons
PJ Harnett has worked in a variety of roles in healthcare over the past 34 years before becoming the National Programme Manager for the Integrated Care Programme Older Persons. This included working in clinical practice, senior managerial and service improvement and development roles locally and nationally. Originally qualifying as a Mental Health Nurse he holds a Masters in Nursing, Masters in Healthcare Management and is currently undertaking a PhD in implementation of change in Healthcare systems with a specific focus on integrated care.
Public Health and European Commission
Mirca has 25 years of work experience in the design, implementation and evaluation of European and International programmes/projects on Health, Social and Governance Issues. She is collaborating with the Public Health Agency of the Emilia Romagna Region, providing technical assistance for the design and implementation of European projects, including the Joint Action on Frailty-Advantage and the coordination of the Sunfrail project on Frailty and Multimorbidity.
For the European Commission (DG Santé), she’s providing technical support for the design and implementation of the EU Joint Action Chrodis Plus on Chronic Diseases.
She also has worked with other Italian Region on the design and implementation of regional health and social services and with Formez PA and the Italian Ministry of Health, providing technical assistance and training on Public Health Services planning, monitoring and evaluation.
For the European Commission she has collaborated as Health Expert for strategic planning in Primary Health Care, Reproductive Health and Hospital sector development, and as Expert Evaluator of Project Proposals in the field of Public Health, Chronic/Non-Communicable Diseases, Sexual Reproductive Health Rights and Governance.
Rujia Ali Shahul Hameed PBM
Senior Nurse Manager
Continuing & Community Care,
Community Health Team Central Health,
Tan Tock Seng Hospital
Adv. Diploma in Critical Care Nursing Singapore, Specialist Diploma in Coronary Care (Primary Care), Yorkshire University UK,
Bachelor Science Degree Business and Management, University of Bradford UK, Masters Community Leadership Social Development Singapore University of Social Sciences
Volunteers with Women’s Integration Network (WIN) Council Singapore 3rd vice chairman and Chairman for Women Executive committee (WEC) Singapore
under People’s Association (PA) The Frontier Community Centre
Dr Janet Bettger
Health Services Researcher and Implementation Scientist
Duke University, US
As a health services researcher and implementation scientist, she designs and studies new models of care to prevent functional decline particularly after an injury or hospitalization for an acute event or surgery. She deeply values interdisciplinary team science and enjoys building networks of partners to spread and scale effective interventions.
Intermediate Care & Rehabilitation Services
North Ayrshire Health and Social Care Partnership
Emma has worked for NHS Ayrshire and Arran as a Physiotherapist for 12 years in a variety of teams and settings, moving into a Leadership role 5 years ago as Team Leader for Intermediate Care and Enablement Services. Emma’s current role as Service Manager for Intermediate Care and Rehabilitation Services for the North Ayrshire Health and Social care Partnership was a natural progression from that post.
Emma is passionate about improving how we support people to be as healthy and independent as they can be and empower them to take control of how we interact with them wherever possible. In 2016, Emma completed a Masters in Research, and her thesis entitled “Exploring the Construct of Healthcare Expectations” further developed her interest in how practitioners have conversations about patient expectations.
Prof Áine Carroll
Healthcare Integration and Improvement
University College Dublin
Áine is Professor of Healthcare Integration and Improvement at University College Dublin and a Consultant in Rehabilitation Medicine at the National Rehabilitation Hospital in Dublin. She is co-Director of IFIC Ireland and a Senior Associate of IFIC. Prior to this, she was National Director of the Clinical Strategy and Programmes Division in the Health Services Executive. During her tenure, Professor Carroll established the Integrated Care Programmes for older persons, chronic disease, children and patient flow to promote coordinated care and team work across services and specialties, ensuring that care is provided effectively and seamlessly to patients as they move through the system. Áine is acknowledged Internationally for her expertise in large-scale change and implementation. An experienced Improvement advisor, she has provided advice, guidance and training on quality improvement and change to leaders of healthcare systems across the world. She is passionate about Person Centred Coordinated Care and Implementation Science.
Self Management Team and the Health and Social Care Alliance Scotland
Marianne is Development Officer within the Self Management Team and the Health and Social Care Alliance Scotland. Marianne works to support increased knowledge and sustain good practice about self management across health, social care and the 3rd sector. Supporting the spread of social innovation approaches to influence service redesign and change and working in partnership with key stakeholders to spread self management approaches.
Dr. Michelle Nelson
Collaboratory for Research and Innovation (Sinai Health System)
Michelle is a Research Scientist in the Collaboratory for Research and Innovation (Sinai Health System) & Assistant Professor, IHPME, University of Toronto. Her research focuses on the organization and delivery of patient/family centred rehabilitation and community reintegration services. She leads the IFIC Special Interest Group ‘ Partnering with Volunteers and the Voluntary Sector for Integrated Care’.
Health and Social Care Academy programme Manager
Health and Social Care Alliance Scotland
Sarah manages the Health and Social Care Academy a programme of the Health and Social Care Alliance Scotland, which works with people who use health and social care services to influence positive and significant change. The Academy provides a space for radical and emergent ideas and looks at relational, rather than organisational aspects of change. Sarah is passionate about social change and was involved in promoting the recovery agenda for substance misuse in the Scottish Government and developing the understanding of the wider community around issues associated with homelessness and social exclusion whilst working at Cyrenians. She is a strong advocate of being led by the voice of lived experience and believes in social enterprise as a business model to promote sustainability and social impact.
Assistant Professor in Practice of Pharmacy
School of Pharmacy and Pharmaceutical Sciences,
Trinity College Dublin
Cristina Arnal Carda
Hospital a domicili Integral Geriatria (HaDo) Parc Sanitari Pere Virgili, Barcelona
Lead for Intermediate Care H@H Services
Researcher and Project Manager,
Uxío Meis is researcher and project manager at ACRA, focusing his research in long-term care needs, health policy planification and health economics. Uxío holds a BA in Political Science at University of Santiago de Compostela and a Master’s in Public Policy at Universität Pompeu Fabra in Barcelona. Before joining ACRA, he was researcher in the Centre for Research in Health and Economics of the Universität Pompeu Fabra in Barcelona carrying projects of pharma economics and long-term care needs.
Nurse Consultant Palliative Care
Hospice Isle of Man
Cheryl is a senior nurse with over 20 years nursing experience in palliative care, ten of those as a specialist palliative care nurse and more recently as a nurse consultant. In this new post Cheryl contributes to develop an evidence-based and comprehensive palliative care service that is fully integrated across Isle of Man whilst leading the development of advance care planning.
She was a member of the National Clinical Guideline Committee (NCDG) which published clinical guidelines for care of dying adults in the last days of life and was instrumental in establishing the need for new end of life guidance and the development and implementation of the policy and guidance in the Isle of Man. Her interest in ethical issues led her to obtain an MA in Ethics of Cancer and Palliative Care after completing her BSc (Hons) in Cancer and Palliative Care.
Cheryl she also a member of the International Foundation for Integrated Care (IFIC) and National Nurse Consultant Group in Palliative Care (NCG).
Isle of Man
Educated at Manchester University and Cranfield Institute of Technology, Chris gained a broad spectrum of experience in both systems and general management before co-founding PDMS Limited (PDMS) in 1993 on the Isle of Man.
In its 25 years, PDMS has completed a myriad of software projects for Public and Private Sector clients on the Isle of Man, in the UK, and further afield internationally ranging from ship registries to NHS databases to citizen-centric platforms. The First Point Community Portal, which aims to help people with additional needs receive better care in an emergency, was developed by PDMS uniquely in partnership with the Third and Public Sectors to empower the individual and provide peace of mind to the person and their loved ones.
Chris has for many years also been involved in a number of groups set up to provide advice on government policy in relation to IT, Communications, e-Commerce, and Health and Social Care. Presently, Chris sits on the Tech UK Central Government Council, the Advisory Panel for the Isle of Man Independent Health and Care Review, and other committees designed to coordinate the roles of the Public and Private Sector into better services for the citizen.
Isle of Man Community Platforms
With an MBA from the Isle of Man International Business School (awarding body Liverpool John Moore’s University), a BA Hons degree from the University of Wales Lampeter, and a management background in the Third and Private Sector, within PDMS Lorna manages technology-based services that help to connect and support the Isle of Man Community. Her principal focus has been on lessening the labour market skills gap through facilitating work experience, mentoring, and apprenticeship programmes suited to the needs of local employers, education, and students. In addition to this, Lorna has overseen the development of the First Point Community Portal, which supports an independent lifestyle for platform users.
Lorna’s involvement in local groups such as the Isle of Man Constabulary’s Police Inclusion Scrutiny Group and the Isle of Man Chamber of Commerce, along with her 10 years of experience in the Third Sector, allow her to better understand the needs of businesses and organisations serving the Island’s community and their service users.
Professor D. Robin Taylor
Consultant Respiratory Physician
Professor D. Robin Taylor currently works for NHS Lanarkshire as a consultant respiratory physician. He returned to Scotland in 2013 after 25 years in New Zealand where he was Professor of Respiratory Medicine at the University of Otago. He is widely published in the area of asthma management and airway biomarkers.
In 2015 he was commissioned by NHSL to develop and implement the Hospital Anticipatory Care Plan to improve end-of-life care in acute medical and surgical wards across Lanarkshire hospitals. In recognition of this work, he was awarded the William Cullen Prize by the Royal College of Physicians of Edinburgh in 2017.
More recently he has undertaken a programme of consultant coaching and training on the topics of prognostic conversations, avoiding futile treatments harms reduction and anticipatory care planning. He is an Honorary Fellow of the University of Edinburgh and teaches undergraduates on the same themes. He has published a short book for patients and families “Coping with Crisis”
Older People and Frailty
Healthcare Improvement Scotland
Graham is the Clinical Lead for Older People and Frailty with Healthcare Improvement Scotland. He is a geriatrician working in NHS Lanarkshire where he has worked for over 10 years. He has had clinical experience in Acute and Community care. He has ongoing research in the organisation of services for older people and Hospital at Home in particular.
Professor Martin Vernon
National Clinical Director for Older People
NHS England and Improvement.
Martin qualified as a medical doctor in 1988 in Manchester. He trained as a Geriatrician and General Internal Physician in the North West and London before becoming a NHS Consultant in Manchester in 1999 where he continues to practice medicine. He has a MA in Medical Ethics and Law from King’s College London and continues to teach these subjects.
Martin has held many senior NHS leadership roles including Clinical, Divisional and Associate Medical Director. He has been Clinical Champion for older people and integrated care In Greater Manchester and British Geriatrics Society Champion for End of Life Care. He was also a standing member of the NICE Indicators Committee.
Martin holds an honorary academic post at Salford University and was appointed as Visiting Professor at the University of Chester in 2016.
In 2016 he was appointed National Clinical Director for Older People at NHS England and Improvement. He has led multiple national workstreams including development of the NHS Long Term Plan Ageing Well Programme published in 2019.
ADVANTAGE JOINT ACTION (JA)
Almudena Albertos is a project manager of ADVANTAGE JOINT ACTION (JA) at the Foundation for Biomedical research of the University Hospital of Getafe (Madrid), where coordinates the daily tasks of the JA like financial and communication activities. Almudena is working as project manager of European research projects for ten years. Previously, the managed projects have been related to health area particularly to cardiovascular research, primary care and public health in the Institute of Health Carlos III and Spanish National Center for Cardiovascular Research. She has a degree in Economics from the Universidad Complutense of Madrid.
ADVANTAGE JOINT ACTION (JA)
Cinzia Giammarchi is the project manager of the ADVANTAGE JOINT ACTION (JA) for the Marche Region (Italy), where she coordinates all tasks in regards to Communication and Dissemination. Cinzia has been working in European research projects in the health and social areas for the last ten years, concerning in particular public health aspects such as ageing. Previously she worked in the health sector in England in the Chelsea and Westminster hospital and then in Bristol PCT. Cinzia graduated in Translation and Interpreting from Bologna University, in “Social and Health Systems and Public Sector” (Faculty of Economics) at the University Politecnica delle Marche – UNIVPM (Ancona, Italy) and has a II degree Master in “Management of the health sector” from UNIVPM.
Juan Manuel Espinosa
Senior Advisor on Aging
Regional Ministry of Health and Families of Andalusia
Juan Manuel Espinosa, MD and specialist in Family and Community Medicine as well as PhD in Medicine. He has been primary care physician at the Andalusian Healthcare Service for more than 37 years. Currently he is senior advisor on aging at the Regional Ministry of Health and Families of Andalusia.
Dr Espinosa has been Coordinator of Strategies and Comprehensive Healthcare Plans of the Regional Ministry of Health and Families of Andalusia and has participated in the development of different comprehensive healthcare plans and strategies, including the Andalusian Comprehensive Healthcare Plan for People with Dependency and their Caregivers, the Andalusian Alzheimer’s Plan and the Andalusian Comprehensive Action Plan for People with Disabilities.
He is member of different scientific societies (Andalusian Society for Family and Community Medicine-SAMFYC; Spanish Society for Family and Community Medicine-semFYC) and collaborator in different teaching activities in residency programs including specific courses on “Care for elderly people” and “Palliative Care”. He was the Chair of the Andalusian Society for Family and Community Medicine for six years.
He has contributed to the development and implementation of the last version of the Health examination for people aged over 65 years program that aims to determine the level of autonomy, detect any health problems at an early stage in people aged 65 and over, and implement promotion and prevention measures, that according to available studies, enhance health and quality of life of people aged 65 and over, while maintaining their independence for longer.
Dr Espinosa has led the development of the “En buena edad” platform (www.enbuenaedad.es), that aims to promote healthy aging (ERDF funded) and is part of the Andalusian team within the ADVANTAGE joint action on managing frailty (funded by the EU Health program).
West of Scotland: Living Well in Communities Team
Michelle is an improvement advisor within ihub’s Living Well in Communities team. Working with health and social care services to enable more people with complex care needs to live well in their community for longer.
The role of improvement advisor is diverse. Within the Team, Michelle is the improvement lead for West of Scotland and lead programmes with the following themes to fruition:
- improve support for people with long term conditions, people with frailty and people nearing the end of their life,
- enable people to die well in the place of their choice, an
- maximise the impact of preventative and anticipatory care to reduce pressures on carers, hospitals and community services.
Michelle has many different roles including clinical governance, commissioning, operational service management, and audit and management accounting. While working across all manner of sectors and settings one thing stands out from my experience – people and relationships are everything. Fascinated by the psychology of change and the behavioural science that can help people take up new practice.
Michelle gets a lot of joy and feels very privileged working with people that give tirelessly to support people get the care they need in communities and homely settings. Works with an enthusiastic team, who have a multitude of varied skills and experiences. Has a real passion for the work she does and an awareness that although there may be challenges ahead, by working together with our partners and communicating clearly these can be overcome.
Prof Anne Hendry
Anne is a geriatrician and was clinical lead for integrated care and for the Reshaping Care for Older People programme in Scotland. As a Senior Associate with IFIC, Anne coordinates the Integrated Care Matters webinars, leads Work Package 7 for Advantage JA and is the lead for the Intermediate Care SIG and contributes to knowledge exchange on integrated care across the globe.
National University of Ireland
Duygu is a postdoctoral researcher at the National University of Ireland Galway with a PhD degree in Public Health Nursing. Her research background includes frailty, ageing, intermediate care, quality care metrics, and occupational health and safety. She has publications and research interest in Delphi methodology, model based interventions, experimental study design, systematic reviews, and meta-analyses. She currently works in the EU ADVANTAGE Joint Action for frailty prevention and is involved in the “Frailty at population level” and “Models of Care” work packages. She has been contributing to the planning and administration of the “Intermediate care and transitional care for older people living with frailty” Delphi study and the “Effectiveness of transitional care interventions for older adults” systematic review since January 2019.
Researcher in Residence embedded
Integrated Care Organisation, Torbay
Felix is a Researcher-in-Residence embedded from 2016-2021 at the Integrated Care Organisation at Torbay, co-producing with system stakeholders evaluation and research around person-centered, coordinated care for older people in the community. He has experience in public involvement, conducting action-based, participatory, ethnographic and mixed methods research. Felix is a social scientist and his work is informed by a bio-psycho-social model of health. His work won a prize at the 1st Annual Implementation Science Research Conference, and Felix and the health&wellbeing team were finalists at the Health Services Journal (HSJ) Awards 2018, in the category Primary and Community Care Services Redesign.