Dr Ronan Fenton: Improving and transforming everyone’s health and care

#NarrowingTheGapMSE

Dr Ronan Fenton is the System Medical Director, for Mid and South Essex Integrated Care System

People across mid and south Essex unfortunately to do not have the same experience of health and care. This can be for a variety of reasons such as lack of transport, fear, cultural reasons, language barriers or learning difficulties.  These factors can result in people not accessing the care they need to either prevent them getting ill or preventing long-term conditions getting worse. 

As an ICS, Mid and South Essex Integrated Care System (MSEICS) and its partners recognise these barriers in our communities, so we’ve three challenges that we need to consider in delivering health and care.

We need to:  

• Deliver better health and wellbeing for everyone 
• Deliver better quality of health services for all individuals 
• Ensure sustainable use of health and care resources 

To be able to deliver on these challenges we need to target our health and care where we can make a difference. 

Stewarding our health and care resources  

We’ve an innovative game-changing approach that places multi-professional clinical leadership at the helm called Stewardship. It brings together people, we call stewards, from the coalface of services with people with lived experience related to their own specialty care area. They’ll have the responsibility to re-shape how health and care services deliver value for our residents. 

In the first phase of the programme six stewardship teams, with around ten people in each. They’ve already started to define their care areas in terms of the resident population who may need health and care resources, the level of shared resources within their care area, current service activity, level of disease and the outcomes.

The first six care areas include:

• Ageing well
• Cancer care
• Cardiac care
• Respiratory care
• Stroke care
• Urgent and emergency care

The second phase, which was recently been set up, covers:

• Mental Health and Learning Disabilities
• Children and Young People
• Dermatology
• Ophthalmology
• Musculoskeletal
• Diabetes

Our stewards have access to data, knowledge, resources and skilled workforce. This ensures that we can focus our collaborative efforts to better understand our populations and identify and target the inequalities causing poorer health within our local priority areas. This approach also talks to people from communities, to help provide insight and advice, so we can effectively re-prioritise how resources are used.

Cancer Pathways

For our cancer group, our Stewards have been tasked with delivering improvements in primary and secondary cancer care, to enhance individual experience and outcomes for our existing cancer patients. Simultaneously, we’re working with multiple agencies to improve early detection and diagnosis of cancer and address inequalities and lifestyle factors, which detrimentally impact the cancer health of our wider population.

This presents a wide-ranging remit and involves implementing multiple strategies, whilst taking responsibility for the totality of cancer care resources, so we can optimise our cancer health performance and drive health standards.

Integrated and joined up approach

We’re working to integrate and ensure a joined up approach to our cancer pathways covering primary, community and secondary provision. Working closely with the Trust, we are aligning strategies and that patients travel seamlessly between the three care areas.  We’re also examine how to align the approaches to care and best practice, initially for five key development pathways, covering:

• prostate,
• lower GI,
• gynaecological,
• breast and skin

The stewards have already played a vital role as they were involved in the successful mid and south Essex bid for implementing one of three national prostate case finding pilots, alongside the Marsden and the Christie.

They’ve also been an integral part in developing an approach to quickly triage dermatology patients under investigation. This ensures that those without cancer are removed quickly and notified in a timely manner. Therefore, they can direct patients with cancer to the correct service provision. This approach will be extended to other areas.

In addition, the stewards have been reviewing the Rapid Diagnostic Service as it’s the front door service that will enable timely diagnosis of symptoms and rapid referral for people who do and don’t have cancer.

Also, they are researching and evaluating the effective Cancer Care Reviews in primary care after treatment and discharge, ensuring patients get the vital psychosocial support they need after diagnosis.

Grants to help reduce health inequalities

Microgrants

If you are part of a community of voluntary organisation, you apply for a new micro grant programme to help address health inequalities and the wider determinants of health within your local area. 

Essex Community Foundation Grant

There’s funding available, from the Essex Community Foundation (ECF), to support marginalised communities and address health inequalities for people who have mental health problems. If you are a charity community group working within the mid and south Essex footprint.

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