“Delivering care in the best possible way for every individual.” Dr Toby Garrood, Joint Medical Director.
Dr Toby Garrood is the Joint Medical Director of South East London Integrated Care System (ICS), a post he shares with Dr Jonty Heaversedge. Here he tells us about his role and thoughts on the ICS.
All members of the board have a responsibility to uphold the aims of the ICS – making sure our residents are leading their healthiest possible lives and getting the best health outcomes for our communities. We also have to ensure that we are addressing inequality in our communities, making sure we’re getting value for money and also getting as much value out of the health and social care system as we can.
Specifically, our role as medical directors is really to focus on health outcomes – making sure that we’re doing as much as we can to help people stay well and delivering the best possible experience. Part of this is trying to really understand an individual’s experience, whether you’re accessing health care for the first time or whether you’re a long-term patient.
Delivering care in the best possible way for every individual
One of the key things in being part of an ICS is that all those individuals and organisations involved in the provision of healthcare are working together. The idea is that we remove as much competition between providers as we can, so we are more connected around patient care and experience.
One of the most important principles is keeping care as close to home as possible. This means delivering as much care as we can within communities and only bringing patients to hospital when absolutely necessary. We aim to deliver care in the best possible way for every individual – so from the moment you go to your GP to when you are referred to a hospital specialist or to see a physio for example, we will aim to make sure your journey through the system is joined up, and uses resources in the best possible way.
Keeping people well and preventing them from becoming unwell
I think the most exciting thing for me is the preventative side of things – keeping people well and preventing them from becoming unwell. This involves looking at what we call key determinants of health – those really important things which in the long-term affect our health outcomes. Part of this means focusing on the ‘vital five’ – blood pressure, BMI, mental health, smoking and alcohol.
Cancer screening is also really important, and part of encouraging people to get screening involves understanding the barriers they may face. Some people are simply reluctant patients, and some are frightened of seeking healthcare. We need to do more to understand the individual and their community to make sure we are delivering care in the most appropriate way for them.
A really simple, but important, point is making sure we are clear and consistent in our messages, and signposting people to the right place for information and support.
Better understanding of communities
Vaccinations is another key thing for me. We’ve learned a lot from the pandemic about some of the trust issues that particular communities have around healthcare and it’s really important that we learn from that and understand how best to address the issues which they think are important, not just what we think is important. So much of our work is about better understanding of communities.
Aligned on the important things
We are still a very young organisation, but I think one of the big successes so far has been seeing how we can work together. At many of our meetings we have representatives from our boroughs, from our primary care providers, from large and smaller hospitals, and colleagues from our mental health trust. It’s a huge step to be sitting around the same table having discussions around common goals.
We are absolutely aligned around the same priorities: recognising the importance of children and young people’s mental health, primary care access, key health determinants and prevention of ill health.
There is a real buzz around this new system, and fewer barriers. I feel like we have much more freedom to do absolutely what is best for the individual and make best use of all the fantastic resources we have.
Capturing the expertise and talent in the VCSE sector
One final thing I would like to stress is that until I took this role, I hadn’t fully grasped the extraordinary diversity of skills in the VCSE (voluntary, community and social enterprise) sector. They have massive amounts of expertise around communities, and are very, very dedicated to supporting local people. It’s a huge resource which we hope we can make the most out of, and also support them to deliver what is most important to their communities.