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My academic research is developed through a portfolio of collaborative projects spanning five interconnected areas:
Long-Term Care (LTC) - Health and social care systems - Ageing, disability and socio-economic inequalities - Microsimulation and public policy - and Population health and prevention.
Below, I highlight current and selected past projects within each research area.
Download my full CV here
Long-term Care: Financing, Markets and Reform
A major strand of my research focuses on the economics of long-term care (LTC), including how care is financed, how care markets operate, and how alternative policy reforms affect public expenditure and the distribution of costs across individuals and families. This research combines policy evaluation, microeconometric analysis and microsimulation, with applications to both England and Italy. It has contributed to policy debates on the funding of care, the role of housing and private wealth, care market structure and provider behaviour, and the future sustainability of LTC systems.
Financing and Reform: I have worked extensively on the design and distributional consequences of alternative systems for financing long-term care. In England, this research includes work on the costs and distributional impacts of LTC funding reforms, the interaction between long-term care and State Pension reforms through the Care and State Pension Reforms (CASPeR) project, and earlier modelling of future demand, expenditure and alternative funding arrangements through Modelling Ageing Populations to 2030 (MAP2030). This work contributed evidence to the Commission on Funding of Care and Support (Dilnot Commission) and subsequent parliamentary inquiries on social care funding. More recently, I have extended this research to Italy, including ex-ante analysis of LTC needs, expenditure and reform options and work on the integration of long-term care financing with the Italian social protection and pension system with INPS, CNA pensionati, Network per la Non Autosufficienza, Regione Emilia Romagna among others.
Housing Wealth and Deferred Payment Agreements: A related strand of my research examines the role of housing and private wealth in financing long-term care. I currently lead research for the UK Department of Health and Social Care on Deferred Payment Agreements (DPAs) in England, investigating their uptake and the extent to which housing equity can be used to meet care costs while protecting individuals from having to sell their homes during their lifetime. This builds on earlier work examining the inclusion of housing wealth in means tests for publicly funded care.
Care Markets and Providers: Another major component of my research investigates how the structure of care markets affects prices, supply and quality. My work has examined local market concentration and the prices paid by Local Authorities, the role of care-home chains and private equity ownership, and the relationship between corporate structures, market concentration and quality. This research aims to provide evidence on how commissioning, provider characteristics and market structure shape the functioning and resilience of the care-home sector.
Technology and care: My current research also examines the role of assistive and digital technologies in long-term care, particularly in care homes. I lead an NIHR Economics of Health and Social Care Systems Policy Research Unit project investigating whether and how assistive technologies used in care homes may help reduce avoidable hospital admissions, and where important gaps in the existing evidence remain. This work includes mapping the availability, use and documentation of assistive technologies across English nursing homes.
Health and Social Care Systems: Organisation, Integration and Evaluation
A second major strand of my research examines how health and social care services are organised, integrated and delivered, and whether changes in organisational arrangements translate into better outcomes and more effective use of resources. My work combines quasi-experimental methods, administrative data and mixed-method evidence to evaluate large-scale policy reforms and new models of care, with a particular focus on the English health and social care system.
Health and social care integration: I have been extensively involved in the evaluation of policies designed to improve coordination between health and social care. This includes the national evaluation of the Vanguard New Care Models programme in England, research comparing the Vanguard programme with the earlier Integrated Care Pioneers, and work examining whether integration initiatives produce sustained changes in hospital activity and service use. More recent research has focused specifically on the integration of health and care services for older people living in care homes.
Primary care organisation and commissioning: Another strand of my research investigates changes in the organisation, commissioning and contracting of primary care services. In particular, I have studied the introduction of Primary Care Networks (PCNs) in England, including variation in their size, composition and organisational characteristics, as part of a wider programme of research on primary care commissioning and contracting.
Evaluating health and social care systems: My current research builds on this work to examine the performance, organisation and sustainability of health and social care systems more broadly, including how digital and assistive technologies are changing the organisation and delivery of care and supporting access to services. I am a Co-Investigator in two major NIHR Policy Research Units, working in multidisciplinary teams to provide evidence addressing policy priorities in health and adult social care.
Ageing, disability and socio-economic inequalities
A longstanding strand of my research examines how ageing, disability and care needs interact with income, wealth and socio-economic inequalities. My work has focused particularly on the measurement and economic consequences of disability, the additional costs associated with disability and care needs, and the extent to which public benefits and other forms of support compensate for these costs. This research combines applied microeconometric methods with longitudinal and household survey data to study inequalities in needs, resources and living standards across the older population.
Disability, care needs and the costs of living: A central part of my research investigates how disability and care needs can be measured and incorporated into assessments of living standards. This includes methodological work on the measurement of latent disability and research estimating the additional costs faced by people with disabilities. A particular focus has been on developing disability-adjusted measures of economic well-being that allow more meaningful comparisons of living standards between people with different levels of disability and care needs.
Disability benefits and public support: My research also examines how effectively public support reaches people with disability and care needs and whether existing benefit systems adequately compensate for the additional costs they face. This work includes research on disability-related benefits in the UK, their targeting across socio-economic groups, and the relationship between eligibility, receipt, care needs and economic resources.
Ageing and inequalities: More broadly, I study how health, disability and economic inequalities evolve at older ages and how differences in needs interact with income, wealth and access to formal and informal support. This strand of research considers both individual inequalities and their geographical and socio-economic dimensions, contributing to a better understanding of who is most exposed to the economic consequences of ageing and increasing care needs.
Microsimulation, distribution and public policy
A longstanding strand of my research develops and applies microsimulation methods to assess the distributional and long-term consequences of public policies. My work spans static, dynamic and spatial microsimulation, with applications to pensions, long-term care, taxation and social protection. A particular focus is on understanding how policy reforms affect different population groups over time and across geographical areas.
Pensions, ageing and life-course redistribution: My research uses dynamic microsimulation to examine the long-term distributional implications of pension systems and reforms, including pension adequacy, redistribution across population groups and the implications of differential mortality. This work includes the development and application of CAPP_DYN, a dynamic microsimulation model designed to analyse the evolution of individual and household economic outcomes over the life course.
Tax-benefit policies and distributional analysis: A related strand of my work uses microsimulation to assess the effects of taxes, cash transfers and social protection policies on household incomes, poverty and inequality. This research focuses on both the aggregate budgetary consequences of policy reforms and their heterogeneous effects across individuals, households and socio-economic groups.
Spatial microsimulation and local policy analysis: More recently, my research has extended microsimulation methods to small-area and spatial analysis. This includes the development of AMARTYA, a microsimulation framework for constructing representative synthetic populations at fine geographical levels and assessing the local distributional implications of public policies. This approach makes it possible to move beyond national averages and explore how needs, resources and policy effects vary across territories.
Population health, prevention and behaviour
A further strand of my research examines how public policies and environmental changes influence health-related behaviours and population health. Using quasi-experimental and applied microeconometric methods, this work evaluates policy interventions and natural experiments in areas including alcohol policy, active travel and the COVID-19 pandemic, with a particular interest in heterogeneous responses across population groups.
Public health policies and behaviour: My research has examined how population-level policy interventions affect health-related behaviours, including the effects of alcohol pricing and promotion policies. This work uses natural experiments and quasi-experimental designs to identify behavioural responses to policy changes and how these vary across socio-economic and demographic groups.
Environment, active travel and health: I have also investigated how changes in the local environment can influence health-related behaviours, including research evaluating the effects of cycling infrastructure on commuting and active travel.
COVID-19 and population health: During the COVID-19 pandemic, I contributed to research examining mortality, policy responses and their consequences for population health, including work specifically focused on older people and care-home populations.
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