- Library, Horizon Institute, Torquay Hospital
Dr Julian Elston
Research Fellow- Integrated Care Evaluation
Peninsula Medical School (Faculty of Health)
I am a researcher and Consultant in Public Health. I currently work as a Researcher-in-Residence at Torbay and South Devon NHS Trust (an Integrated Care Organisation), researching and supporting the evaluation of its new model of integrated care, particularly in relation to person-centred care (integrated care and social prescribing) and knowledge mobilisation (the Researcher-in-Residence).
I have worked in academia, the NHS and the voluntary sector. Prior to this post I was a Screening and Immunisation Lead for the South West Peninsula, overseeing the implementation, quality and governance of programmes.
My academic interests also relate to inter-organisational working, quality improvement, quality assurance and health inequalities.
I am a multidisciplinary, mixed-methods researcher drawing on a wide range of literatures, including health services, public health, sociology, economics and organisation theory. I have published primary and secondary research on a range of public health related topics (health services, health protection and health promotion).
My PhD was an evaluation of strategic health partnership in the NHS. It was a multiple case study using mixed methods to understand the function and impact of multi-agency health partnerships. Drawing on theories from sociology, economics, management, organisation theory and operational research, I developed an analytical framework combining three theories operating at the micro, meso and macro level (collaboration theory, resourced dependency theory, governance theory) to understand the factors that influence the implementation, development and functioning of partnerships.
2009 - Consultant in Public Health, Severn Deanery.
2005 - PhD in health services, LSHTM, University of London
1997 - MSc in Public Health, LSHTM, University of London
1986 - BSc (Hons) in Biochemistry and Biotechnology, University of Birmingham
I am a Fellow of the Faculty of Public Health
I have been teaching undergraduate medical students public health at the Universities of Plymouth and Exeter since 2006. This has included giving lectures and workshops on over 33 different topics, using a variety of teaching methods and approaches.
I enjoy teaching and strive to ensure that those whom I teach are enthused by my interest in and knowledge of public health. I am particularly keen for medical students to be able to locate clinical work in a broader context, so that they understand what drives demand for health care and recognise their wider role, such as in health promotion and health planning.
I have taught on MSc in Public Health at LSHTM, University of London as guest speaker on the Health Management module, whilst training as a Consultant in Public Health.
As a PhD student and Research Fellow, I was involved in organising and running the MSc in Public Health. This involved developing and delivering teaching sessions, tutoring students, reviewing the curriculum, setting exam questions, marking papers and attending a variety of teaching committees to discuss course evaluation and development.
I am also trained as an educational/academic supervisor for the Severn Deanery, supporting Specialist Registrars in Public Health become consultants.
My current research interests cover two areas.
Person-centred care – focusing on social prescribing and intermediate/integrated care (with a focus on multi-morbidity in older people), understanding for whom, how and in what circumstances these services improve patient experience and outcomes.
Knowledge mobilisation– particularly in relation to the Researcher in Residence model and how embedded researchers can build research and evaluation capacity and capability, facilitate the use of formal and local knowledge to co-produce evidence (with service users), innovate and to improve local services
Grants & contracts
- Jan 2020; Co-applicant and joint lead on NIHR 19-117 call: Peninsula Adult Social Care Research Collaborative (PARC): Building capacity and embedding research in practice using the Researcher-in-Residence model, £2,400,000 (pending)
Sep 2019; PI on the Devon STP Social Prescribing Evaluation and Research project (DeSSPER), £99,998
Nov 2018; Joint PI on the Evaluation of the implementation and effectiveness of Health Navigators’ telephone-based health coaching service, Devon CCG, £29,500
Apr 2018; Joint PI on Evaluating the new care model at Torbay and South Devon NHS FT Trust, £149,360
Jan 2017; Co-Applicant on the Evaluation of Urgent and Emergency Care Vanguard Initiatives in the Southern Cluster, £180,000
Oct 2008; Joint PI on Evaluating the cost-effectiveness of Down’s screening strategies using a decision analytic computer model, Fetal Anomaly Screening Programme (FASP) and Knowledge Transfer Partnerships, £93,059
Oct 2008; on Co-Applicant on Population screening for hypertrophic cardiomyopathy. A review of the literature, National Screening Committee, £19,843
Nov 2007; PI on the North Devon Acoustic Cueing Therapy Study (NDACTS), a pragmatic randomised cross-over trial, Northcott Devon Medical Foundation, £4,029
May 2000; PI on an Evaluation of strategic health policy partnerships (PhD Fellowship), North Thames Regional Health Authority, £120,000
Key publications are highlightedJournals
Asthana S, Gradinger F, Elston J, Martin S, Byng R. 2020 Capturing the role of context in complex system change: an application of the Canadian Context and Capabilities for Integrating Care (CCIC) Organisation in the English context. International Journal of Integrated Care; XX(X): X, 1–10. DOI PEARL
Elston J, Gradinger F, Asthana S, Lilley-Woolnough C, Wroe S, Harman H, Byng R. 2019 Does a social prescribing ‘holistic’ link-worker for older people with complex, multi-morbidity improve well-being and frailty and reduce health and social care use and costs? A 12-month before and after evaluation Primary Health Care Research and Development , DOI PEARL
Gradinger F, Elston J, Asthana S, Martin S & Byng R 2019 Reflections on the Researcher-in-Residence model co-producing knowledge for action in an Integrated Care Organisation: a mixed methods case study using an impact survey and field notes. Evidence & Policy: A Journal of Research, Debate and Practice 15, (2) 197-215 , DOI PEARL
Elston J 2013 'Partnerships' in Guest C; Ricciardi W; Kawachi I Oxford Handbook of Public Health Practice Third Edition Edited by Charles Guest, Walter Ricciardi, Ichiro Kawachi, and Iain Lang)
Elston J, Stein K. Public health implications of establishing a national programme to screen young athletes in the UK, British Journal of Sports Medicine, 2011, Jun;45(7):576-82
Bond M, Elston J, Mealing S, Anderson R, Weiner G, Taylor R, Stein K. Systematic reviews of the effectiveness and cost-effectiveness of multi-channel unilateral cochlear implants for adults. Clinical Otolaryngology. 2010 Apr; 35(2):87-96.
Bond M, Elston J, Mealing S, Anderson R, Weiner G, Taylor RS, Liu Z, Stein K. Effectiveness of multi-channel unilateral cochlear implants for profoundly deaf children: a systematic review. Clinical Otolaryngology. 2009 Jun;34(3):199-211.
Elston J, Honan W, Powell R, Gormley J, Stein K. Do metronomes improve the quality-of-life in people with Parkinson’s disease? A pragmatic, single-blind, randomised, cross-over trial. Clinical Rehabilitation, 2010;24 (6):523-32
Bond M, Mealing S, Anderson R, Elston J, Weiner G, Taylor RS, Hoyle M, Liu Z, Price A & Stein K 2009 'The effectiveness and cost-effectiveness of cochlear implants for severe to profound deafness in children and adults: a systematic review and economic model' Health Technol Assess 13, (44) 1-330 , DOI
Bond M, Elston J, Mealing S, Anderson R, Weiner G, Taylor RS, Liu Z & Stein K 2009 'Effectiveness of multi-channel unilateral cochlear implants for profoundly deaf children: a systematic review' Clinical Otolaryngology 34, (3) 199-211, DOI
Rogers G, Elston J, Garside R, Roome C, Taylor R, Younger P, Zawada A & Somerville M 2009 'The harmful health effects of recreational ecstasy: a systematic review of observational evidence' Health technology assessment (Winchester, England) 13, (6)
Taylor R & Elston J 2009 'The use of surrogate outcomes in model-based cost-effectiveness analyses: a survey of UK Health Technology Assessment reports' Health Technology Assessment 13, (8) , DOI
Elston J & Taylor RS 2009 'Use of surrogate outcomes in cost-effectiveness models: A review of United Kingdom health technology assessment reports' International Journal of Technology Assessment in Health Care 25, (01) 6-13 , DOI
Elston J, Stein S. A rapid needs assessment of the provision of Health Technology Assessment in the south-west peninsula. Journal of Public Health, 2007: 29;2:157-164
Abbott, S, Shaw S, Elston J. Comparative analysis of health policy implementation. The use of documentary analysis. Policy Studies 2004; 25(4): 259-266
Elston J, Fulop N. Perceptions of partnership. A documentary analysis of Health Improvement Programmes. Public Health 2002; 116, 207-213
Fulop N, Elston J, Hensher M, McKee M, Walters R. Lessons for health strategies in Europe: the evaluation of a national health strategy in England. European Journal of Public Health 2000; 10:11-17
Elston J, Gradinger F, Asthana S, Fox M, Dawson L, Butler D & Byng R 'Impact of “enhanced” intermediate care located in a health & wellbeing hub at the integrated care organisation (ICO) in Torbay and South Devon, uk', DOI PEARL
Gradinger F, Elston J, Asthana S, Lilley-Woolnough C, Myers C, Fox M, Butler D & Byng R 'Implementation and impact of co-locating the voluntary sector with a multidisciplinary, cross-sector community hub at the Integrated Care Organisation (ICO) in Torbay and South Devon, UK, DOI PEARL
Gradinger F, Elston J, Fox M, Myers C & Butler D 'Mrs Smith - Chapter 2: Vertical and horizontal integration and care model implementation in the Integrated Care Organisation (ICO) in Torbay and South Devon, UK - a workshop on leadership and co-production', DOI PEARL
Elston J, Martin S 2019. Using a novel approach to evaluate system sustainability - the Researcher-in-Residence model, Microsystem Festival, Jönköping, Sweden
Well-being Co-ordination (WBC) in Torbay and South Devon. A before and after study of impact. First International Conference on Social Prescribing, Manchester, 13 Jun 2018
Gradinger F, Elston J. Squaring the translational circle: co-producing knowledge for action using a researcher-in-residence model, Inaugural Implementation Science Conference, London, July 2018
Gradinger F, Elston J Implementation and impact of an integrated care model: applying a realist evaluation framework in a researcher-in-residence model. CARES International conference, London, 3-5 Oct 2016