Dr. Sara Burke

All over the world, health systems are responding to the major shock of the COVID-19 pandemic. The virus is causing urgent and fast-paced change in the delivery of health and social care as well as highlighting pre-existing deficiencies and inequalities in the health system and broader society. In Ireland, COVID-19 is occurring during the second full year of Sláintecare's implementation - Ireland's 10-year plan for health reform to deliver universal access to timely, integrated care. This research will coproduce a Living Implementation Framework with Evaluation (LIFE) linking evidence, policy and practice that feeds into real-world Sláintecare implementation. In partnership with senior leadership in the Sláintecare Programme Implementation Office, the Department of Health and the HSE, the researchers will scope, document, measure and analyse the Sláintecare relevant COVID-19 responses using qualitative and quantitative methods. The LIFE will initially take the form of a live spreadsheet which contains the COVID-19 responses most relevant to Sláintecare. For each response, 3-4 indicators will be collected which enables monitoring overtime. The spreadsheet will be accompanied by a series of rapid reviews, narrative descriptions of multiple case studies, research papers, stakeholder engagement and formative feedback. These collectively make up the 'LIFE', informing dialogue with the project partners, which is happening in real time (living), influencing health policy and system decision-making and implementation as the project progresses. The LIFE will inform health system reform in Ireland in the months and years after the emergence of COVID-19 as well as contributing to international health systems and policy research.

This research aims to address the critical need for an updated Health Systems in Transition (HiT) profile for Ireland, reflecting significant changes since the last report in 2009, including economic fluctuations, demographic shifts and the impact of the COVID-19 pandemic. Recognising the evolving landscape of Ireland's health system, particularly in light of the Sláintecare reform plan and recent global health challenges, this project seeks to produce a comprehensive HiT report in advance of Ireland holding the presidency of the European Union Council between July and December 2026. Collaborating with the Department of Health and the European Observatory on Health Systems and Policies, the multidisciplinary team will leverage national and international data to provide an in-depth analysis of Ireland's health system dynamics, policy initiatives and outcomes. Through a structured approach encompassing research (WP1), quality assurance (WP2), identification of data and evidence gaps (WP3) and extensive stakeholder engagement (WP4), this study will offer valuable insights for policy-making and implementation both in Ireland and internationally. This work stands to significantly inform and influence health system reforms and research directions in the Irish context and serves as a model for integrating academic research with practical policy development.

Ireland"s national Stroke Strategy emphasises the importance of enhancing the secondary prevention of stroke and ensuring national, equitable, patient-centred delivery of services. The INsPIRE Programme aims to provide evidence to inform policy on the effective promotion of physical activity (PA) in community settings to improve health outcomes for stroke in Ireland. In particular, the programme will update existing international evidence on the clinical and cost effectiveness of PA interventions in stroke, map existing secondary prevention stroke services and leverage an existing study evaluating a PA programme for people poststroke (the ExWell Stroke study). This will provide critical implementation data on feasibility, referral pathways, uptake, engagement, and programme retention. These data will be used alongside existing effectiveness and cost-effectiveness evidence from the evidence synthesis to inform health economic modelling exploring costs to develop a budget impact analysis. This evidence will be used to undertake a GRADE Evidence to-Decision Framework for developing policy recommendations based on the RE AIM and CFIR implementation frameworks. Public and Patient Involvement is interwoven throughout each element of the programme and will be coordinated specifically in a dedicated work package to maximise its impact. The work will be conducted across five work packages: " WP1: Evidence synthesis on the clinical and cost-effectiveness of different approaches to community-based PA interventions following a stroke " WP2: Mapping and implementation of PA for stroke in Ireland " WP3: Cost and budget impact analysis of a stroke exercise programme in Ireland " WP4: Policy recommendations " WP5: Public and patient involvement and knowledge translation The INsPIRE team includes experienced multidisciplinary clinical, evidence synthesis, implementation science, health economics, and health policy researchers and key knowledge users and public and patient stakeholders. The proposed programme will significantly inform and influence policy for exercise-based secondary prevention of stroke in community settings in Ireland.

I an a Co-Director of SPHeRE - Ireland"s national research training programme for population health, policy and health services research (PHPHSR) and is funded by the Health Research Board in Ireland. SPHeRE means `Structured Population health, Policy and Health-services Research Education". The SPHeRE concept captures our approach to the inter-relationship of research, translation and practice. Our aim is to improve the health and wellbeing of groups or populations through high-quality research, and stakeholder engagement, addressing current and emerging issues in population health, health policy and health systems. Our vision is to embed a culture of research in population health, health policy and health systems, grounded in principles of scientific inquiry and inclusion. The programme The programme is `structured" because we want all our scholars to receive the same training, regardless of their previous experience. This is because improvements in population health and health service delivery can"t be achieved without co-operation across disciplines. SPHeRE connects scholars from diverse backgrounds and gives them a common language to work together. We aim to develop the research leaders of tomorrow: a cadre of networked academics with a common training but diverse skills. We match excellent scholars with the best supervisors to carry out research of strategic importance to the Irish population. To do this we have developed a wide network of academics from disciplines such as biostatistics, economics, nursing, psychology, medicine, occupational therapy, sociology, speech and language therapy, management, geography and physiotherapy. Our scholars bring a diverse range of life experiences to each class and many have worked as clinicians, managers or policymakers in the Irish health system. Their research is conducted to the highest standards and has been widely published in prestigious international journals. Every year we showcase their research at our annual Network Conference and work to connect their findings with policymakers.