Care integration and service commissioning and procurement across the Kent and Medway Integrated Care System (1.8m population; £4bn pa). Chair of the Improving Outcomes Committee establishing system quality and programme improvement, and member of the Remuneration Committee. Previously Independent Clinician to the Governing Body of Clinical Commissioning Groups in Sussex.

Scholarship Fund Trustee

Advisor to pharmaceutical companies at Phase III development, approval and post approval evaluation (NICE). Advisory Board membership for market segmentation and entry strategies. Data Safety Monitoring Board Member. Site Principal Investigator for phase 3 trials.

Accredited Physician in Internal Medicine/Elderly Care with specialist interest in cardiovascular medicine and heart failure. Multiple lead roles in clinical and integrated pathway implementation. National lead in clinical standards and guideline development and implementation. National and international journal editorial positions; publications and conference presentation. National Clinical Excellence award. (2013)

Over 100 papers and conference abstracts including original research, clinical trials and opinion pieces on heart failure and cardiovascular medicine (and philosophy). National and international conference presentations. International guidelines (ICHOM)British Heart Foundation (BHF) Junior Research Fellowship 1991 - 1993: (MD - The Electromechanical Properties of Hypertrophied Human Myocardium: 1994)Editorial Board - and Journal reviewer: British Journal of Cardiology (2003 to date) and European Journal of Heart Failure (2004 to date; Lead Reviewer 2006, 2007). Peer reviewer to Acute Heart Failure and Multimorbidity NICE guidelines; Cochrane Review and NIHR application.Honorary Clinical Reader to Brighton and Sussex Medical School (2015 - 2020) and Course Director for MSc in Cardiology.National Investigation Programme member and lead with NICOR, BHF, DMSB member (Bevacizumab in Macular Degeneration; Spironolactone in CKD)Site Principle Investigator in National and Intentional studies

Judge for a section of the International Student Design Award

Independent Secondary Care Clinician to Horsham-Mid Sussex and Crawley CCG GB and thereafter Single STP Committee in Common 2016-2021. Providing independent medical advice to system reorganisation, service procurement, governance and commissioning.

Interim Board Advisor during major reorganisation. Involvement in organisational re-design, guidance methodology update and the development and launch of the NICE 5-year strategy. Advised on health inequalities. Member of NICE Strategy Board.

Chaired the production of several aspirational, measurable, outcome-orientated standards across a wide range of health and care conditions. Liaison with implementation team to embed in practice.

Guideline Development Group: Heart Failure, Myocardial Infarction, Safe Staffing.

Clinical advisory position. Lead in position papers on value and Heart Failure pathways. Selected member of PCBC review for two major Provider reconfigurations.

Leaad for the Kent Surrey and Sussex Enhancing Quality Programme in heart failure. Major improvement programme integrating acute and community pathways of care and embedding the national heart failure audit program in the region.