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Dr. Sarah Barry
Adjunct Associate Professor, Public Health & Primary Care

Biography

Dr Sarah Barry, PhD is Assistant Professor of Health Services Management at the Centre for Health Policy and Management, Trinity College Dublin. Current and recent research projects include Health system foundations for effective Regional Integrated Care Organisations (RICOs) - co-producing evidence to inform the design of regional organisations to support integrated care in Ireland 2019-2021, Independent Evaluation of Primary Care Learning Sites for Health Service Executive- Implementation of Community Healthcare Networks, Safety Culture Implementation for the Health Service Executive, Understanding Change in Complex Health Systems - A review of the literature 2007-2017, Pathways to Universal Health Care in Ireland and the Resilience of the Irish Health System in the face of Economic Crisis.

Her research focusses on integrated care and policy implementation in the context of change and complex systems. She is particularly interested in knowledge making, sharing, transfer and learning at national, service delivery, regional and local levels. Sarah currently works on universal health care (UHC) implementation in collaboration with the Sláintecare Implementation Office of the Department of Health, the Irish National Programme for Integrated Care of Older Persons, and the National Strategy Office for Primary and Community Care. She has coordinated change programmes with a variety of organisations both overseas and in Ireland and has been a visiting lecturer at the Milltown Institute of Theology and Philosophy and at IBAT Business College Dublin. Recently Sarah worked with the Irish Government's Oireachtas All-Party Committee on the Future of Health Care in Ireland in developing the Sláintecare Report and recommendations.

Publications and Further Research Outputs

Peer-Reviewed Publications

Barry, S, Ní Fhallúin, M, Thomas, S, Harnett, PJ, Burke, S. , Implementing Integrated Care in Practice - Learning from MDTs Driving the Integrated Care Programme for Older Persons in Ireland, International Journal of Integrated Care , 21(1):15, ((1) ), 2021, p1 - 11 Journal Article, 2021 URL

Thomas,S, Johnston, J, Barry, S, Siersbaek, R, Burke, S., Sláintecare implementation status in 2020: Limited progress with entitlement expansion, Health Policy, 2021 Journal Article, 2021 URL

Unruh L, Allin, S, Marchildon, Burke, S, Barry, S, Siersbaek, Thomas, S, Selina, R, Andriy, K, Alexander, M, Merkur, S, Webb, E,Williams, GA., A comparison of health policy responses to the COVID-19 pandemicin Canada, Ireland, the United Kingdom and the United States of America , Health Policy, online 1 July, 2021 Journal Article, 2021 URL

Burke, Sara; Parker, Sarah; Fleming, Padraic; Barry, Sarah, Thomas, Steve, Building health system resilience through policy development in response to COVID-19 in Ireland: From shock to reform, The Lancet Regional Health - Europe, 10, (100223), 2021 Journal Article, 2021 URL

Embracing and Disentangling from Private Finance: The Irish System in, editor(s)Colleen Flood and Bryan Thomas , Is two-tier health care the future?, Ottawa, University of Ottawa Press, 2020, pp291 - 314, [Stephen Thomas, Sarah Barry, Bridget Johnston, Rikke Siersbaek and Sara Burke ] Book Chapter, 2020 URL

Barry, S., Sheehan, A., Kennedy, L.A., Crowley, G. , Evaluating Community Healthcare Networks Primary Care Development in Ireland focussing on Stakeholder Engagement, International Conference of Realist Research, Evaluation and Synthesis, Dublin Castle, Dublin, 24-26 March 2020, 2020 Conference Paper, 2020

Barry, S., Sheehan, A., Kennedy, L.A., Crowley, G., Evaluating Community Healthcare Networks Primary Care Development in Ireland focussing on Stakeholder Engagement, SPHeRE Network, 6th Annual Conference - Data to Policy, RCSI Dublin, 25 February 2020, 2020 Conference Paper, 2020

Burke Sar, McGettrick Grainn, Foley Kare, Manikandan Manjul, Barry Sarah, The 2019 neuro-rehabilitation implementation framework in Ireland: Challenges for implementation and the implications for people with brain injuries, Health Policy, 2020 Journal Article, 2020 URL DOI

Barry, S., Burke, S. , The Challenge of Co-Creating a Living Implementation Framework with Evaluation (LIFE) to Deliver Integrated Care at Whole of System Scale in Ireland, International Journal of Integrated Care, 20th International Conference on Integrated Care, Sibenik, Croatia, 27-29 April 2020, 2020 Conference Paper, 2020

Johnston BM, Burke S, Barry S, Normand C, Ní Fhallúin M, Thomas S., Private health expenditure in Ireland: Assessing the affordability of private financing of health care. , Health policy (Amsterdam, Netherlands), 2019 Journal Article, 2019 DOI

Harnett, P.J., Ní Fhalluín, M., Burke, S., Boyce, M. O'Shea, T., Williams, P., Thomas, S., The challenges of delivering universal and integrated care - evidence to inform policy implementation in Ireland and internationally, 19th International Conference for Integrated Care, San Sebastian, Spain, 1-3 April 2019, 2019 Conference Paper, 2019 DOI

Barry, Sarah, Contextual Analysis for Practical Action (CAPA) Understanding context for practical learning and implementing change in complex systems, Global Implementation Conference 2019, Glasgow, Scotland, 16-17 September 2019, 2019 Conference Paper, 2019

Barry. S., Harnett, P.J., Burke, S., Thomas, S., Evaluating the Implementation of Integrated Care for Older Persons as a path to Universal Health Care, International Journal of Integrated Care, 18th International Conference for Integrated Care, Utrecht, Holland, 23-25 May 2018, edited by Robin Miller & Viktoria Stein , 19, (00), International Federation for Integrated Care, 2018, pp00 - 00 Conference Paper, 2018

Steve Thomas, Sarah Barry, Bridget Johnston, Sara Burke, Ireland's health care system and the crisis: a case study in the struggle for a capable welfare state, Anais do Instituto de Medicina Tropical , 17 (Supplement), (1), 2018, p27 - 36 Journal Article, 2018 URL

Sara Burke,Sarah Barry,Rikke Siersbaek,Bridget Johnston,Maebh Ní Fhallúin,Steve Thomas, Sláintecare - A ten-year plan to achieve universal healthcare in Ireland, Health Policy, 2018, p1-5 Journal Article, 2018 DOI

Barry, Sarah; Burke, Sara; Tyrell, Ella; Thomas, Steve, Is someone going to saw off the plank behind me?' - Healthcare managers' priorities, challenges and expectations for service delivery and transformation during economic crisis, Health Systems and Policy Research, 4, (1:39), 2017, p1 - 7 Journal Article, 2017 DOI URL

Barry. S., Burke, S., Boyce., M., Eustace-Cook, J., Normand, C., Thomas, S., Implementing Universal Healthcare implies Integrated Care Design - findings from a systematic review of the organisational challenges of implementing UHC policy, International Journal of Integrated Care, 17th International Conference for Integrated Care, Dublin, Ireland, 8-10 May 2017, edited by Robin Miller & Viktoria Stein , 17, (5), International Foundation for Integrated Care, 2017, ppA477 - A477 Conference Paper, 2017 DOI

Barry SE, Burke S, Boyce M, Eustace-Cook J, Normand C, Thomas S., Implementing Universal Healthcare implies Integrated Care Design - findings from a systematic review of the organisational challenges of implementing UHC policy. , International Journal of Integrated Care. , 17, (5), 2017, ppA477- Conference Paper, 2017 DOI

Burke S, Normand C, Barry S and Thomas S, From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis., Health Policy, 120, (3), 2016, p235 - 240 Journal Article, 2016 URL URL

Barry, Sarah; Burke, Sara, Thomas, Steve, Patterns of Health System Response to Austerity - Outcomes, Challenges, Questions, HSRN Symposium 2015, Nottingham, UK, July 2015, 2015 Conference Paper, 2015

The impact of the financial crisis on the health system and health in Ireland in, editor(s)Maresso A, Mladovsky P, Thomson S, Sagan A, Karanikolos M, Richardson E, Cylus J, Evetovits T, Jowett M, Figueras J and Kluge H , Economic crisis, health systems and health in Europe: country experience, Copenhagen, Denmark, : WHO/ European Observatory on Health Systems and Policies, 2015, [Anne Nolan, Sarah Barry, Sara Burke, Steve Thomas] Book Chapter, 2015 URL TARA - Full Text

Fleming, Padraic; McGilloway, Sinead; Barry, Sarah, An evaluation of the development and implementation of personal budgets for people wth a disability in Ireland, 12th Annual Psychology, Health and Medicine Conference - Improving health and well-being: better futures for all, Stranmillis University, Belfast, Northern Ireland, April 2015, 2015 Conference Paper, 2015

Sarah Barry, Sara Burke, Maria Boyce, Jessica Eustace-Cook, Charles Normand, Steve Thomas , 'Mapping the organisational challenges of implementing universal health care/coverage policies for health systems in countries with a GDP per capita greater than $22,000 ', PROSPERO 2015, 2015, - Protocol or guideline, 2015 URL

Sara Burke, Charles Normand, Sarah Barry, Stephen Thomas, From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis, Health Policy, 12, 2015, p1-12 Journal Article, 2015 DOI

Fleming, Padraic; McGilloway, Sinead; Barry, Sarah, Individualized funding: The experiences, barriers and facilitators associated with implementing four pilot initiatives in Ireland, Claiming Full Citizenship: self determination, personalization, individualized funding, Vancouver, Canada, 15-17 October, Centre for Inclusion and Citizenship, The University of British Columbia, 2015 Conference Paper, 2015 URL

Burke, Sara; Thomas, Steve; Barry, Sarah, Measuring, mapping and making sense of Irish health system performance in the recession, BMC Health Services Research, 14 (Suppl 2) P12, 2014, p1-1 Journal Article, 2014 URL

The impact of the financial crisis on the health system and health in Ireland in, editor(s)Maresso A, Mladovsky P, Thomson S, Sagan A, Karanikolos M, Richardson E, Cylus J, Evetovits T, Jowett M, Figueras J and Kluge H, eds , Economic crisis, health systems and health in Europe: country experience,, Copenhagen, World Health Organization - European Observatory on Health Systems and Policies, 2014, pp1 - 42, [Nolan, Anne, Barry Sarah, Burke, Sara, Thomas, Steve] Book Chapter, 2014

Steve Thomas, Sara Burke, Sarah Barry, The Irish health-care system and austerity: sharing the pain, The Lancet, 383, (9928), 2014, p1545 - 1546 Journal Article, 2014 DOI

Burke, S., Thomas, S., Barry, S., Keegan, C., Indicators of health system coverage and activity in Ireland during the economic crisis 2008-2014 - From 'more with less' to 'less with less', Health Policy, 117, (3), 2014, p275-278 Journal Article, 2014

THOMAS, S., BURKE, S. & BARRY, S, The Irish health-care system and austerity: sharing the pain, The Lancet, 383, 2014, p1545 - 1546 Journal Article, 2014

Burke S, Thomas S, Barry S, Keegan C, Indicators of health system coverage and activity in Ireland during the economic crisis 2008-2014 - From 'more with less' to 'less with less'., Health policy (Amsterdam, Netherlands), 117, (3), 2014, p275-8 Journal Article, 2014 TARA - Full Text DOI

Case Study 1: The Economic Crisis and the Irish Health System: Assessing Resilience in, editor(s)Hou, Xiaohui Velényi, Edit V. Yazbeck, Abdo S. Iunes, Roberto F. Smith, Owen , Learning from Economic Downturns: How to Better Assess, Track, and Mitigate the Impact on the Health Sector, Washinton D.C., World Bank, 2013, pp156 - 160, [Burke, Sara, Barry, Sarah, Thomas, Stephen] Book Chapter, 2013

THOMAS, S., KEEGAN, C., BARRY, S., LAYTE, R., JOWETT, M. & NORMAND, C., A framework for assessing health system resilience in an economic crisis: Ireland as a test case, BMC Health Services Research, 13, (450), 2013, p1-8 Journal Article, 2013

Lessons from the European Union. Case Study 1: The Economic Crisis and the Irish Health System: Assessing Resilience. in, editor(s)X Hou, E Velenyi, AS Yazbeck, RF Iunes, O Smith , Learning from Economic Downturns, How to Better Assess, Track and Mitigate the Impact on the Health Sector, Washington, The World Bank, 2013, pp155 - 161, [Burke S, Nolan A, Thomas, S, Barry, S] Book Chapter, 2013 TARA - Full Text

Thomas, SteveKeegan, ConorBarry, SarahLayte, Richard, The Irish health system and the economic crisis, The Lancet, 380, (9847), 2012, p1056 - 1057 Journal Article, 2012

Barry, Sarah, An organisational learning approach to church governance - seeking coherence with hierarchical practice, structure and theology, Milltown Studies, 65, (1), 2011, p660 - 672 Journal Article, 2011

Barry, Sarah Hederman, Lucy Maclachlan, Mac McAuliffe, Eilish Normand, Charles, Organisational Learning and Accountability - opportunity for an Irish contribution?, Trócaire Development Review 2009, 2009, p159 - 175 Journal Article, 2009

Non-Peer-Reviewed Publications

Sarah Barry, Sharing the learning from the Nurture Programme: Infant Health and Wellbeing - Placing the learning in the context of international experience of change processes, Sharing the learning from the Nurture Programme: Infant Health and Wellbeing, RCSI Dublin, 4th March, 2020, Katherine Howard Foundation Invited Talk, 2020

Sarah Barry, Richard Dalton & Jessica Eustace-Cook, Understanding Change in Complex Health Systems -a review of the literature on change management and social care 2007 - 2017, 2018 Review, 2018 URL DOI TARA - Full Text

Fleming, Padraic; McGilloway, Sinead; Barry, Sarah, Individualised funding in Ireland: Identifying and implementing lessons from elsewhere, Frontline - the Irish voice of intellectual disability, (101), 2015, p1-3 Journal Article, 2015 URL

Research Expertise

Description

My research interests focus on the challenges of health system and organisational change in terms of policy translation, integrated care delivery, health and social care system reform. Currently I am progressing these interests through the follow research projects: Health system foundations for effective Regional Integrated Care Organisations (RICOs) - co-producing evidence to inform the design of regional organisations to support integrated care in Ireland 2019-2021, Independent Evaluation of Primary Care Learning Sites for Health Service Executive- Implementation of Community Healthcare Networks, Safety Culture Implementation for the Health Service Executive, Understanding Change in Complex Health Systems - A review of the literature 2007-2017, Pathways to Universal Health Care in Ireland and the Resilience of the Irish Health System in the face of Economic Crisis.

Projects

  • Title
    • Health system foundations for effective Regional Integrated Care Organisations (RICOs) - co-producing evidence to inform the design of regional organisations to support integrated care in Ireland 2019-2021
  • Summary
    • Health systems all over the world are struggling to provide equitable access to integrated, patient centred services that better meets the needs of individuals and populations. In Ireland, the way our health system is funded and structured creates particular barriers for people trying to access effective, responsive, quality care. The 2017 Oireachtas report, Sláintecare, set out a ten-year roadmap to deliver universal access to integrated care. In August 2018, the Department of Health published the Sláintecare Implementation Strategy which specified how Regional Integrated Care Organisations (RICOs) will be a central mechanism to funding and delivering healthcare regionally, based on population health needs, with a much stronger focus on prevention, better health outcomes, accessing care in the community. This research will be instrumental in influencing the design of RICOs and providing knowledge to enable those responsible for implementing Slaintecare (Sláintecare Implementation Office, Department of Health and HSE) to make evidence-informed decisions to deliver more effective, person-centred regional integrated care organisations (RICOs). This research will draw on international and national theory, evidence and experience to assist the Slaintecare Implementation Office work with key stakeholders to co-design the best implementation approach for RICOs. This research will be happening as the RICOs are at design and early implementation stage allowing evidence and knowledge learnt to actively feed into the realisation and development of RICOs. This learning will be useful for implementation of integrated care and major health system reform in the Irish context and internationally. The design and policy implementation process will be documented and a Living Implementation Framework with Evaluation (LIFE) will be devised in order to create a learning, iterative and collaborative practice of RICO implementation. The essence of this project is to use academic and real-world knowledge and evidence to bring about health system change in the public interest.
  • Funding Agency
    • Health Research Board
  • Date From
    • 01/09/2019
  • Date To
    • 31/08/2021
  • Title
    • International Literature Review - Understanding Change in Complex Health Systems
  • Summary
    • Review design, development, drafting and production; liaison with commissioners, collaboration with co-authors and supervision of research assistant
  • Funding Agency
    • Organisation Development and Design Services, HSE
  • Date From
    • 01/07/2017
  • Date To
    • 01/04/2018
  • Title
    • All Party Oireachtas Committee on the Future of Health Care in Ireland - Phase 1 Workshop Process and Report Design
  • Funding Agency
    • Government of Ireland
  • Date From
    • 01/11/2016
  • Date To
    • 31/01/2017
  • Title
    • All Party Oireachtas Committee on the Future of Health Care in Ireland - Phase 2 Technical Assistance and report Drafting
  • Summary
    • Technical Assistance including in-depth engagement and collaboration with the All-Party Oireachtas Committee on the Future of Health Care in Ireland, generation of international evidence, data generation, coordination and management, report drafting and completion
  • Funding Agency
    • Government of Ireland
  • Date From
    • 01/01/2017
  • Date To
    • 31/05/2017
  • Title
    • Mapping the Pathway to Universal Health Care in Ireland
  • Summary
    • The current Irish Government has committed itself to achieving universal access to health care, free at the point of delivery, by 2016. Yet, at the moment, timely access to essential healthcare in Ireland is often determined by ability to pay, such as with private insurance. Further, those without medical cards or GP visit cards face high charges for GP care and may put off seeking care when they need it. The benefits of universal health coverage for relieving the economic hardship from seeking care and ensuring prompt access are well recognised and there is a strong international push to achieve this, led by the WHO. In 2005, all WHO member states, including Ireland, committed to achieving universal health coverage. Nevertheless, in the current economic environment, with a 22% cut in the health budget over seven years, high indebtedness and increased demand for health and social care, achieving universal coverage is a challenge. While there is a government commitment to universalism, much government action since coming to power in 2011 has involved squeezing budgets and transferring the cost of care from the State to the people. This research adapts and applies to Ireland new international methods for assessing the progress made towards universal access to health care and measuring the gap with universalisation. It also appraises options for getting there, reviewing international case studies and assessing and modelling options according to key criteria such as cost, requirements and complexity. Finally the research identifies the challenges likely to be faced, by assessing international experiences and evaluates whether and to what extent the current systems of organisation have the necessary capacity and flexibility to deliver their stated objectives. This evidence will help inform decision making and progress Ireland towards universal access, free at the point of delivery, for all the population.
  • Funding Agency
    • Health Research Board
  • Date From
    • 01/10/2014
  • Date To
    • 31/08/2017
  • Title
    • Mapping the Pathway to Universal Health Care in Ireland - Leveraged Funding
  • Summary
    • Leveraged extra funding for research assistant post to support completion of component 3 of the Pathways research project
  • Funding Agency
    • Integrated Care Programme Older Persons, HSE
  • Date From
    • 01/09/2017
  • Date To
    • 01/06/2018
  • Title
    • Scoping review on safety culture methodologies in health and social care systems
  • Summary
    • A review of the literature and international best practice on methodologies to appraise, formulate policy, implement and evaluate safety culture in health and social care systems
  • Funding Agency
    • HSE
  • Date From
    • March 2019
  • Date To
    • July 2019
  • Title
    • Structured Population and Health-services Research Education (SPHeRE) Programme
  • Summary
    • A collaboration between TCD, RCSI, UCC involving all HEIs in Ireland for structured PhD education in population health and health services research including the establishment of a national SPHeRE network of policy makers, researchers, educators and advocacy groups
  • Funding Agency
    • Health Research Board
  • Date From
    • 01/09/2013
  • Date To
    • 31/08/2021
  • Title
    • Community Healthcare Networks - Learning Sites Evaluation
  • Summary
    • This project is a collaboration with the Centre for Effective Services and the HSE to evaluate the implementation, outcomes and system learning elements of first phase roll out of Community Healthcare Networks in the Irish setting
  • Funding Agency
    • HSE
  • Date From
    • October 2019
  • Date To
    • October 2020

Keywords

Brain Health in Ageing; Changing Culture in Healthcare; Chronic Health; Community Health; Community Healthcare Reform; Connected Health; Culture and health; Global Health; HEALTH CARE; HEALTH CARE FINANCING; HEALTH CARE ORGANIZATION; Health Care Policy; Health Care Reform; Health Services Delivery; HEALTH SERVICES RESEARCH; HEALTH-CARE PROVIDERS; Integrated Community Healthcare

Recognition

Representations

Represented Trinity College Dublin on the Special Policy Group, Royal College of Physicians of Ireland (RCPI). Produced 'Towards 2026: A future direction for Irish healthcare' in March 2017 2017

Memberships

International Foundation for Integrated Care January 2018

Implementation Network of Ireland and Northern Ireland September 2018