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“Just what we needed” - Dartford, Gravesham, & Swanley Community HealthPathways

Published on 15 Feb, 2023 | Return|

Since embarking on their HealthPathways journey last year, the Dartford, Gravesham, & Swanley (DGS) HealthPathways team has been working hard to prepare for launch. The new HealthPathways team share their thoughts about why HealthPathways is needed, and their plans for their implementation.


The DGS team - from left to right: Joe O’Toole, Coordinator; Dr Liz Lunt, Clinical Editor; Dr Zuby Chile, Clinical Editor; Dr Purnima Sharma, Clinical Editor; Moyra Costello, Programme Manager; Dr Sarah MacDermott, Senior Clinical Editor and Clinical Lead

Health service provision in the region, just east of Greater London, is challenged by inequality and a significant variation in life expectancy across the area. The desire to join up health services is seen by the Dartford, Gravesham and Swanley Health and Care Partnership as key to shaping health and care services for local people.

The drivers for starting HealthPathways in Dartford, Gravesham, & Swanley (DGS) were threefold, says Moyra Costello, Programme Manager of DGS Community HealthPathways.

HealthPathways is a structured and systematic programme with a regular review cycle, and a clear way to provide feedback on the content. The information is user-friendly and intuitive,” she says.

"Key clinical stakeholders reviewed HealthPathways and decided it was just what we needed locally. Local clinicians had been strengthening links between primary and secondary care, especially during COVID. HealthPathways offers the opportunity to work together to reduce variation in access to care, but also to maximise the best use of clinician time – to avoid wasting primary care clinicians’ time searching for information and improve referral quality once received by secondary care.” 

Reflecting on their motivations for starting a HealthPathways programme, other project members have echoed these sentiments.

“The landscape had changed significantly post-pandemic with a demand that seemed impossible to meet and a real need for a better way of promoting self-care and diverting as many patients as possible into non-health care alternatives and getting all organisations to sign up to a single way of doing things in a system.”
Dr Steve Fenlon, former Chief Medical Officer and now Chief Operating Officer of Dartford and Gravesham NHS Trust

“I really like the ‘automated’ approach to best practice, limiting variation in care and enabling us to evolve and adapt the pathways over time. I had also heard great things about the project elsewhere (King’s Fund) so was very keen to become a part of that.”
Dr Sarah MacDermott, former GP Member of K&M Governing Body and now  Senior Clinical Editor and DGS GP

Overcoming challenges

Moyra expects that clinical time and user engagement, as well as critical mass of resources, will be the main challenges initially.

“The DGS Health and Care Partnership (HCP) team has provided powerful momentum behind transformation of local healthcare pathways. However, the size of DGS as the smallest HCP in Kent and Medway means that both clinical and transformation teams are very lean, which makes securing resources for implementation challenging. HealthPathways is not only web-based but intuitive, and so the hope is that this will maximise user engagement once the word gets out,” she says.

To address these challenges, the HealthPathways team developed a Communications and Engagement Plan in consultation with the wider project group. The plan included a phased introduction approach for their HealthPathways programme, with an initial focus on face-to-face user engagement. This included a clinical group workshop and a GP engagement ‘curry evening’ with HealthPathways demonstrations.

“We must work closely together and join clinicians and teams together so everyone understands the capabilities and challenges of others to devise the best care given the straitened circumstances we find ourselves in. I strongly believe we must enable patients to take more responsibility for their care and be able to engage more proactively in improving their own outcomes and controlling the inputs to their health,” says Dr Fenlon.

Inequity of access to services

One of the key issues DGS is faced with is the wide variation in deprivation - from some of the most affluent areas in the United Kingdom to areas with significant deprivation. As a result, health outcomes vary widely. In addition, primary and community health provision is under-developed as a legacy of years of under-investment.

“Although HealthPathways is not going to directly address the funding shortfalls, it is being implemented alongside transformation work in respiratory and diabetes pathways, as well as a system-wide Acute Frailty Network programme. As such it has the potential to maximise the impact of new solutions to joint working and the referral routes that will become available,” Moyra explains. 

“In addition, it provides a place where developments can be shared and owned by local clinicians, with the feedback facility being an integral part of how HealthPathways works.”

Dream team

Moyra is excited about the core team that has been set up to develop the DGS HealthPathways programme. As programme manager, Moyra is an Executive Director who has previously worked on the North West London Integrated Care Pilot, and has experience in other Integrated Care Organisations. Team co-ordinator Joseph O’Toole has a comprehensive grasp of local referral systems and mechanisms.

“We are lucky to have superb local clinical ownership and commitment,” she says.

“Our Executive Sponsor is Dr Tom Clarke, the Chief Medical Officer of Dartford and Gravesham Trust, who has recently taken over from Dr Stephen Fenlon, the previous CMO and now Chief Operating Officer of the Trust. Along with Dr Sarah MacDermott, the co-chair of the DGS Clinical and Professional Group, they form a powerful clinical leadership coalition.”

“We are also extremely fortunate to have as clinical editors four very highly regarded local primary care clinicians - alongside Dr Sarah MacDermott (Senior Clinical Editor), the other three clinical editors are drawn from different primary care networks (PCNs) and roles. Dr Liz Lunt is a local PCN Clinical Director and Chair of the local Primary Care Leads forum. Dr Purnima Sharma is a local GP and the GP trainee lead for DGS. Dr Zuby Chile is a local GP and community education facilitator (CEF) lead.” 

Launch celebrations

Several months into establishing their HealthPathways programme, the team has made significant progress on their first suite of pathways. They are planning to celebrate the launch this month (February 2023), just at the end of winter when pressures on the system are less than around the Christmas and New Year period. 

“This offers the best opportunity to run successful communication events which will reach a wider audience,” says Moyra.

“We are looking forward to watching our HealthPathways programme develop, and to seeing wider engagement from clinicians as it grows,” she says.

More information

To find out more about the work of the Dartford, Gravesham, & Swanley HealthPathways Community team, please email HealthPathways Programme Manager Moyra Costello at moyra.costello1@nhs.net

If you have any other questions about this update, please have a chat with your lead writer.

Find out more about HealthPathways

If you’d like to know more about HealthPathways, or if your health jurisdiction hasn’t yet joined the HealthPathways Community, please:

  • See HealthPathways Global for an overview 
  • Email info@healthpathwaysglobal.org or phone:
    • Within the United Kingdom: +44 20 3519 1964
    • Within Australia: +61 7 3559 2744
    • Within New Zealand: +64 3 595 2830