About
I am an epidemiologist/clinical trials methodologist with more than 25 years working in clinical and health services research. I have a particular interest in using routinely collected health and social care data to inform and evaluate health and care services for older adults, particularly those with frailty and dementia, and to use data to highlight and address health inequalities and differences in care.
I am currently working on projects which use cohort data of older adults from the SAIL databank, the Royal College of General Practitioners Research and Surveillance Centre, NHS Digital Hospital Episode Statistics, South Central Ambulance Service, Discover-NOW (Imperial College Healthcare Partners/North-West London SDE) and the Wessex Secure Data Environment.
Research
Research groups
Research interests
- Use of health and social care ‘big data’ to characterise older people’s service use and outcomes, especially for people living with frailty or dementia.
- Development and assessment of interventions to improve care and quality of life for older adults.
- Methodological expertise: epidemiology, clinical trials of medicines and devices, feasibility studies, patient and public involvement and engagement with health services research.
Current research
1) Two complementary studies to further understanding of the current and future impact of frailty, and its implications for the health and social care workforce – the Frailty Dynamics project and the FLOWS project. The Frailty Dynamics project used data from England and Wales to describe frailty incidence, prevalence and severity transitions, identify risk factors and trajectories and associated service use and costs. This data was presented in stakeholder sessions involving the public, health and social care providers and commissioners, and used to develop and test a simulation model which can be used by commissioners to predict frailty patterns in their local populations and plan to address service needs. The FLOWS project (started October 2022) is adapting the simulation model produced in the Frailty Dynamics project to include the workforce required to prevent and manage frailty in the future through data gathering via a scoping review, a survey and analysis of community health, mental health and social care data.
2) Examining emergency and social care services for older people, in particular those with a diagnosis of dementia. – with South Central Ambulance Service, University of Portsmouth and Hampshire County Council Adult Social Care team. Improving recording of dementia in routine datasets, analysing patient flows and referrals between services, and informing and evaluating care interventions.
3) Understanding community pathways for older people with urgent care needs, involving analysis of pathway data from community and secondary care in the Wessex region.
Research projects
Active projects
Completed projects
Publications
Teaching
Teaching interests:
- Clinical research design, particularly epidemiology and clinical trials
- Using routinely collected health and care datasets
- Evidence-based practice
- Patient and public involvement and engagement
Current responsibilities:
- Seminar Lead on BSc Nursing dissertation module
- MSc dissertation supervisor
Biography
Carole joined Health Sciences in 2019, and is a Senior Research Fellow working on an NIHR funded Frailty Dynamics project. She is interested in the health and social care pathways and outcomes for older adults, especially for people living with frailty or dementia. Carole is passionate about the use of ‘big data’ to answer questions in this area, with the purpose of directly informing changes in services to benefit patients.
“Things get done only if the data we gather can inform and inspire those in a position to make a difference” – Mike Schmoker
Carole studied Biological Sciences at the University of Oxford, and Control of Infectious Diseases at the London School of Hygiene and Tropical Medicine. She completed her PhD at the University of Southampton, which examined the hospital outcomes of older people with cognitive impairment using a large secondary care dataset.
Carole has extensive experience in the design, conduct and analysis of quantitative and mixed-methods clinical research studies, including epidemiological studies and clinical trials. She has worked as an epidemiologist/clinical trialist for Epicentre/Médècins sans Frontières in Africa, running disease surveillance programmes and clinical trials for new treatments for infectious diseases. She has expertise in pharmacovigilance, including analysing large international and UK-based datasets of safety data for medicines prescribed in primary care.
Carole has also spent 10 years working with clinicians in the NHS to develop, obtain funding for, and deliver clinical research studies, and as a Senior Reseach Advisor in the NIHR Research Design Service. These have encompassed many clinical disciplines, including older people’s medicine, emergency care, respiratory conditions, gastroenterology and surgery, and involved working closely with commercial partners to develop and test new products intended for use in the NHS. All studies have involved patients and the public to inform the study design, particularly those aspects relating to participant involvement, and plans for dissemination.
Carole is also an experienced educator, having taught evidence-based medicine, research design and public engagement to post-graduate and medical students at the University of Portsmouth and Portsmouth Hospitals NHS Trust. She also contributed to the London School of Hygiene and Tropical Medicine’s distance learning MSc courses in Public Health and Clinical Trials for many years. She now contributes to undergraduate and postgraduate teaching within Health Sciences.