Karen has a long history of supporting change in the public sector – firstly as an auditor and then as a consultant. She now works with healthcare and other public sector organisations on both strategic and operationally based assignments to deliver service improvement. Karen has a professional and academic interest in transformation within healthcare services and her doctorate explored how the field of child psychiatry responded to pressures for change. In recent years, Karen's focus has been on two key areas- projects seeking to reduce health inequalities and projects seeking to improve the healthcare estate.