Having trained in London as an undergraduate and post graduate, I moved to NHS Wales as associate medical director for information and research, professor at Aberystwyth University, and consultant gastro-hepatologist. Wales has an integrated care approach to health and social care which involves structural integration of primary and secondary care. During my career I have always developed IT and now machine learning systems to support patient care. In 2016 I moved to Australia as staff specialist in gastroenterology / hepatology and director of digestive health. Currently I chair the QH ESISS (Endoscopy system) committee, and sit on the AUSPEN council.