Improving access to routine healthcare among vulnerable communities in rural North Devon

As part of NHS England’s Innovation for Healthcare Inequalities Programme (InHIP), Health Innovation South West supported a new primary care outreach service, focused on routine assessments and colorectal cancer testing, in a local area of deprivation. The project tackles health inequalities by supporting those facing multiple challenges in accessing traditional healthcare. 

John Thornton, Community Development Officer, One Ilfracombe

Ilfracombe grapples with severe deprivation, with its electoral wards ranking in the top 10% most deprived areas in England.* Partnering with the local Integrated Care Board (ICB) One Devon, Health Innovation South West initiated a person-centred primary care outreach model at a community hub, addressing the healthcare needs of vulnerable individuals.

Unstructured, personalised drop-in sessions, led by GPs from a local practice, occur bi-monthly to provide earlier diagnosis of major illnesses and personalised care for underserved people, who face heightened mortality rates.

The service aims to offer:  

• Personalised routine GP care – including signposting for ongoing care if required.   
• Earlier identification of chronic disease such as diabetes mellitus, hypertension, chronic obstructive pulmonary disease and various cancers 
• Mental health/chronic disease reviews and management  

Faecal immunochemical testing (FIT) for colorectal cancer was introduced, an innovation that can reduce health disparities and save lives.

The project’s core was its person-centred approach, delivering accessible and comprehensive healthcare interventions delivered alongside additional services such as mental health, literacy, housing and rehabilitation services. Trust-building and relationship development were central to the project for attendees who often shared a distrust in the healthcare system. The joined-up approach of healthcare providers and additional services, coupled with drop-in sessions, fosters accessibility.

* Devon County Council Strategic Plan 2021-25 Tackling poverty and inequality – Strategic Plan (devon.gov.uk) 

• A total of 58 appointments were held. 31 individuals received personalised healthcare by a GP, with the majority (27 people) coming for follow-up sessions following their initial appointment. The majority of those were male, white British, and over 50.  
• 61.3% of the cohort received a blood pressure check, 12.9% a qFIT test, and 83.9% were referred to additional services. 
• An increasing uptake of FIT testing among vulnerable populations, thereby reducing colorectal cancer disparities, improving early cancer detection, and potentially saving lives and reducing long-term healthcare costs.  
• Earlier identification and treatment of mental health difficulties and chronic diseases such as cardiovascular disease.