Medicine

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Trinity Biomedical Sciences Institute
Trinity College
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PI:  Dr Sara Burke, Centre for Health Policy and Management (CHPM), Trinity College Dublin with CHPM staff members Professor Steve Thomas, Dr Sarah Parker, and Veronica Segerstrom.  

Collaborators: 

  • Economic & Social Research Institute 
  • The European Observatory on Health Systems and Policies 
  • Department of Health 
  • Health Service Executive 

Funding: Health Research Board (HRB) and Department of Health (DOH) Evidence for Policy (EfP) Programme 

Objective: The Health Systems in Transition report, published by the European Observatory on Health Systems and Policies, aims to present a definitive overview of the current state of the Irish health system including ongoing policy and reform changes. The report has the potential to inform and shape both public and policy interest, and knowledge, as Ireland is implementing its policy of universal health care, Sláintecare.  

Key components: 

  1. Co-design: The report follows a template provided by the Observatory to facilitate international comparison and is written in collaboration with Professor Anne Noland and Dr Sheelagh Connolly of the Economic & Social Research Institute. The Department of Health and the Health Service Executive support the project in an advisory capacity and the final report will have been peer reviewed by international experts. 
  1. Policy translation: As a definitive source text of the health system, the HiT report will collate information to improve the general knowledge of the complete health system, ongoing reforms, and policy initiatives, while identifying areas where improvements are needed, and existing evidence gaps will also be collected. 

Impact: 

  • Aims to inform the general knowledge and understanding of the health system 
  • Provides a blueprint snapshot of the complete health system in 2025  
  • Contributes to international knowledge and comparison of healthcare delivery 

Project title: Optimising PrEP Delivery in Ireland: A Digital-Hybrid Model for Value-Driven Healthcare

PI: Dr Irina Kinchin, Centre for Health Policy and Management (CHPM), Trinity College Dublin

Collaborators:

  • Health Service Executive (HSE) Sexual Health Programme
  • SH:24 (UK-based digital sexual health service provider)
  • Clinical experts, policymakers, and community representatives

Funding: Health Research Board (HRB) and Department of Health (DOH) Evidence for Policy (EfP) Programme

Objective: This project aims to co-design and evaluate an integrated digital-hybrid model for delivering HIV Pre-Exposure Prophylaxis (PrEP) in Ireland. The model seeks to enhance accessibility, efficiency, and value for money in healthcare by combining online services with traditional in-person care.

Key components:

  1. Co-design: Collaborate with stakeholders (patients, clinicians, policymakers) to develop a user-centric PrEP service model.
  2. Pilot: Test the hybrid model in two clinics (Dublin and Cork) to assess feasibility, cost-effectiveness, and user/provider experiences.
  3. Policy translation: Generate evidence to inform national digital healthcare strategies and scalability to other services (e.g., contraception, chronic disease management).

Innovation:

  • Integrates Ireland’s nationally funded home STI testing service (SH:24) with clinical pathways.
  • Addresses systemic challenges in PrEP access, clinic capacity, and workforce productivity post-COVID-19.
  • Emphasizes equity, user experience, and staff retention.

Impact:

  • Aims to reduce HIV transmission by improving PrEP accessibility for at-risk groups.
  • Provides a blueprint for digital-hybrid care in Ireland’s health system, aligning with Sláintecare reforms.
  • Contributes to international best practices in value-based healthcare delivery.

Keywords:
PrEP, HIV prevention, digital health, hybrid care, health policy, value for money

Research Leader Award – November 2020- October 2025

The RESTORE research programme examines the key challenges facing the Sláintecare reform programme and evaluates strategies to facilitate its effective and thorough implementation in a complex adaptive system. It reviews the causality of how shocks to the system (such as COVID and the 2008 financial crisis) challenge or even facilitate reform. In particular, it evaluates public sector staff engagement over time as both a sign of resilience and a precondition for the implementation of effective change. The proposed research combines both qualitative data from stakeholder and key informant interviews, with quantitative data from surveys of health sector staff, alongside a review of key system metrics and the progress of reform. It will develop evidence-based strategies for policy makers in government to manage the competing tensions between system performance and reform to achieve universal care through enhanced resilience.

RESTORE project Components:

  1. Evaluating Health System Resilience
  2. Evaluating the challenges to large-scale reform and proposing strategic direction
  3. Assessing Staff Engagement Trends
  4. Building Resilience Theory

PI: Professor Steve Thomas

Centre Researchers: Dr Mary Guy, Dr Liz Farsaci, Catherine O’Donoghue and Dr Arianna Almirall-Sanchez

Find out more

 

Challenge

In Ireland we don’t know how many children have life-limiting conditions and need palliative care. We have UK-based estimates which are out-of-date and not detailed enough to help plan palliative services. We don’t know how many children miss out on palliative care referral because some clinicians view it as end-of-life care, or because the definition of life-limiting changes over time with improvements in life-expectancy for some conditions. There are concerns that children with life-limiting conditions have lengthy hospital stays and have difficulty accessing palliative care across the country. This project will gather and examine information to address these knowledge gaps and to improve how children’s palliative care is planned and delivered in Ireland.

Research Project aims and methods

Our team includes parents of children with life-limiting conditions, children’s palliative care policymakers, planners, providers, and researchers. We will discuss different definitions of life-limiting conditions and palliative care need. We will examine national datasets on hospital stays, deaths, children’s palliative care activity and others to learn about children who are at different stages (dying, unstable and receiving emergency care, deteriorating and receiving intensive care) of their illness. We will look at how complex these children’s needs are, and how they use hospitals. We will compare the geographic location of children’s palliative care services with where children with life-limiting conditions live. We will use all this information to guide and improve children’s palliative care policy, planning, and service delivery, supporting our goal of universal access to palliative care in Ireland.

Public, patient and personal involvement (PPI)

The Family Engagement Committee at LauraLynn, Ireland’s Children’s Hospice, is our PPI co-applicant for this project.
This group of parents have children who have, or have had, direct experience of children’s palliative care in Ireland. Our PPI co-applicant was involved during the project proposal stage and will take part in the project advice team. This is the team that includes all our co-applicants and collaborators and will meet at key points in the project, provide general oversight for project progress and assess what are the key messages from the analysis. In this sense, our PPI co-applicant will have involvement at all stages in the project.

Timeline

March 2023 – March 2025

Research Team

We are a collaboration of researchers, knowledge users, PPI, and data controllers. The project is managed by Drs Samantha Smith (Lead Researcher) and Joanne Balfe (Lead Knowledge User) and supported by the project advice team which includes representatives from the Children’s Palliative Care Strategic Advisory Group, our PPI representative, the Department of Health, national and international palliative care researchers, and data controllers.

Researchers
Dr Samantha Smith, Centre for Health Policy and Management, Trinity College Dublin
Dr Peter May, Centre for Health Policy and Management, Trinity College Dublin
Dr Tara Delamere, Centre for Health Policy and Management, Trinity College Dublin
Prof Lorna Fraser, King’s College London
Prof Suzanne Guerin, University College Dublin & Research at LauraLynn
Dr Helen Coughlan, St Vincent’s University Hospital

Knowledge Users & PPI
Dr Joanne Balfe, LauraLynn & Tallaght Hospital
Ms Orla Murphy, PPI Representative
Ms Avril Easton, Irish Hospice Foundation
Mr Maurice Dillon, Health Service Executive
Mr Tyrone Horne, HSE Cork University Hospital
Dr Mary Rabbitte & Dr Emer Brangan, All Ireland Institute of Hospice and Palliative Care
Dr Fiona McElligott, Temple Street Hospital
Dr Mary Devins, Crumlin Hospital
Mr Paul Rowe, Department of Health

Data Controllers
Ms Sinead O’Hara, Healthcare Pricing Office, HSE
Dr Cliona McGarvey, National Office of Clinical Audit

Funding & Support

This project is funded by the Health Research Board with additional co-funding from the Irish Hospice Foundation and LauraLynn Ireland’s Children’s Hospice

For Further Information Contact:

Email: ssmith1@tcd.ie

The Palliative Hub

This HRB funded study led by Dr Lorna Roe, will explore the care of older adults living with frailty and cognitive impairment for the first time. It's widely acknowledged that services and supports are inadequate, and the needs of older adults are poorly understood. The study "The Frail Brain and the Frail Body: Impact of FRAILty and COGnitive impairment on trajectories, patterns and costs in care in old age (FRAIL-COG)" will use data from The Irish Longitudinal Study on Ageing (TILDA) to examine the health trajectories of older adults living with concurrent frailty and cognitive impairment, and model how these trajectories determine the use and cost of health and social care; hours of informal care provided and the degree of functional decline. FRAIL-COG will provide valuable insights into the complex needs of older adults and identify gaps in service provision. The Health Service Executive (HSE) are knowledge partners in this project, ensuring a clear route for dissemination which will inform future service planning.

To find out more about this project, please email Dr Roe: loroe@tcd.ie

PI: Dr Lorna Roe

PI:  Dr Katharine Schulmann, Research Fellow, with support from Veronica Segerström, Research Assistant, and Co-PI Sara Burke, Associate Professor and Director CHPM  

Collaborators:  

Acquired Brain Injury Ireland (ABI) with main collaborator Grainne McGettrick.  

Funding:  

Acquired Brain Injury Ireland

Objective:  

To examine the role of the ABI case manager and their contribution to the rehabilitation pathway within Ireland’s healthcare system. 

Key components:  

Acquired Brain Injury Ireland’s (ABII) Case Managers are skilled professionals trained to guide and support brain injury survivors and their families over the course of their rehabilitation and recovery. Case managers connect the person with brain injury to a range of services delivered in a variety of settings (hospital, home/community rehabilitation, transitional living accommodation). According to ABII, they play a critical function in preventing often lengthy and unnecessary stays in hospital and inappropriate placement in nursing homes for people recovering from brain injury. Case managers’ primary goal is to ensure that people are supported to live independent lives to the extent possible and desirable. 

To support the expansion of case management services to people living across the country, ABII commissioned the CHPM research team to conduct a piece of research on the role of the ABI case manager with the overarching aim of gathering evidence for advocacy/lobbying purposes. Designated a Section 39 Organisation, ABI Ireland has been lobbying the HSE for additional investment to expand access to ABI case management nationwide. The organisation has approached CHPM for a two-pronged piece of research:   

1) Qualitative research exploring the case manager role, its definition and scope, and  barriers and facilitators,  

2) Cost benefit/health economics analysis of the case manager role. 

 

Research design: 

  • Define the role and scope of the ABI case manager and their specific input into the service users’ rehabilitation pathway;  
  • Map out the scope and span of the relationships with various key stakeholders;  
  • Understand the evolution of the case manager role in ABI Ireland in the context of being a specialist role;  
  • Provide an analysis of the value of the case manager’s role from a health economics perspective.  

The report includes findings and recommendations that will be used to support the expansion of case management services to people living across the country through ABI Ireland’s ongoing lobbying and advocacy work. It builds on previous collaboration between the Centre and ABI Ireland, found here The 2019 neuro-rehabilitation implementation framework in Ireland: Challenges for implementation and the implications for people with brain injuries - ScienceDirect