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Breakout session 1.5

Using clinical networks to
drive quality improvement

                       Ian Golton
      Director, NHS Stroke Improvement Programme
                             and
Associate Director, Strategic Clinical Networks and Senates,
                 Yorkshire and the Humber




     Why?

                                                               1
Organisations join networks
                       because they can do what they
                       need to do more effectively
                       together than if they operate
                       alone.




“Networks bring together the providers of care and the
commissioners of care to work together to plan and
deliver high quality services for a specific population.
Networks aim to improve outcomes, improve patient
experience, improve the quality of treatment and care
[and] improve access to appropriate high quality
services”


“Networks should be established…bringing together key
stakeholders and providers to review, organise and
improve delivery of services across the care pathway”




                                                           2
Network ‘bread and butter’
• Promoting the idea of a ‘patient pathway’
• Helping different individuals, teams and
  organisations talk to each other
• Helping the interface with the ‘penumbra’ of non-
  specialist services
• Developing a collective voice and perspective,
  including a patient voice
• Providing expert advice to those who need it
• Helping the constituent parts to improve through
  idea sharing and mutual support




         How?

                                                      3
‘Bread and butter’ activities
•   Meeting each other
•   Talking to each other
•   Sharing information
•   Developing Clinical Leads
•   Special interest groups
•   Patient groups
•   Peer review/support visits
•   Joint projects
•   Coordinated voice to commissioners




            Minimum resources


•   Willingness
•   Time
•   Somewhere to meet and talk
•   Leaders




                                         4
What happened?




                 5
“Clinical networks are an NHS success story.
 Combining the experience of clinicians, the input
 of patients and the organisational vision of NHS
 staff, they have supported and improved the way
 we deliver care to patients in distinct areas,
 delivering true integration across primary
 secondary and often tertiary care.”



 Bruce Keough and Jane
 Cummings (TBC)




12 NHS | Presentation to [XXXX Company] | [Type Date]




                                                        6
7
Core Support Team Structure
The actual size of the
team will vary depending                                NHS CB LOCAL AREA
on the population served                                  TEAM MEDICAL
                                                            DIRECTOR
by the Clinical Senate but
core posts will exist in all
senates.                                SENATE CHAIR                         SCN CLINICAL DIRECTOR
                                                                                 (approx. 0.4 wte)



                                                          SCN & SENATE
                                                       ASSOCIATE DIRECTOR
                                                             BAND 9
                                                                                               PA
                                                                                             BAND 5




                               SENATE MANAGER                          NETWORK MANAGERS
                                0.5 wte BAND 8C                           3 x BAND 8Cs




                                  SENATE PA                    QUALITY                    NETWORK ASST 1 x
                                0.5 wte BAND 4         IMPROVEMENTS LEADS                     BAND 5 &
                                                           8 x BAND 6 - 8B                NETWORK ADMIN &
                                                                                         SUPPORT OFFICER 1x
                                                                                               BAND 4
 16




                                                                                                              8
To put it bluntly:

                    Resources




Workload




       Misconceptions:
       • Because there is one network support
         team there will only be 12 clinical
         networks
       • Each support team will only have 11
         posts
       • Priorities and activities will be
         centrally dictated
       • There will be no national support




                                                9
Guiding values:
•    A clear sense of purpose
•    A commitment to putting patients,
     clinicians and carers at the heart of
     decision making
•    An energised and proactive organisation
     offering leadership and direction
•    A focused and professional organisation,
     easy to do business with
•    An objective culture, using evidence to
     inform the full range of its activities
•    A flexible organisation
•    An organisation committed to working in
     partnership to achieve its goals
•    An open and transparent approach




    Progress to date:

    • All leads for the 12 Network Support Teams have
      been ‘appointed’
    • Most of the NST teams have been completed
    • Work plans are being discussed
    • Local and national events are underway
    • Various ‘working groups’ are looking at aspects of
      SCN functioning
    • More guidance being published




                                                           10
But, many questions still to be answered:
• How will it all work?
• How will the NHS work?
• How to protect the best of what we
  already have?
• How to reconcile local versus central
  priorities?
• Getting started with mental health,
  dementia, neurological conditions,
  maternity, children's services (plus
  building further diabetes and kidney care
  as part of CVD)
• Playing together nicely: SCNs, Senates,
  AHSNs, ODNs, CSUs, HWBs, LATS, CCGs,
  LPNs etc.




                                              11
Suggestions:
• Make contact with your local (new) Network
  Support Team
• Self-organise
• Demonstrate how a little can go a long way
• Have your ‘pitch’ ready for different
  audiences
• Be (somewhat) shameless in pursuit of
  funding
• Partner with charities
• Keep an eye on Academic Health Science
  Networks




                                               12
http://www.commissioningboard.nhs.uk/resources/networks-senates/




                                                                   13
Geographical Area                        Host LAT                                    Associate Director
    London      London                                   London                                      Lucy Grothier
                East of England                          East Anglia                                 Ruth Ashmore
Midlands & East East Midlands                            Leicestershire and Lincolnshire             Rebecca Larder
                West Midlands                            Birmingham, Solihull and Black Country      Danielle Taylor
                Cheshire & Merseyside                    Cheshire, Warrington & Wirral               Jan Vaughan
                Greater Manchester, Lancashire & South
                                                         Greater Manchester
    North       Cumbria                                                                              Janet Ratcliffe
                Northern England                         Cumbria, Northumberland, Tyne & Wear        Roy McLachlan
                Yorkshire & Humber                       South Yorkshire & Bassetlaw                 Ian Golton
                South East Coast                         Surrey & Sussex                             Deborah Tomalin
                                                         Bristol, North Somerset, Somerset & South
                South West Coast
    South                                                Gloucestershire                             Sunita Berry
                Thames Valley                            Thames Valley                               Aarti Chapman
                Wessex                                   Wessex                                      Lucy Sutton




                                                                                                                          14

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Breakout 1.5 Using clinical networks to drive quality improvement - Ian Golton

  • 1. Breakout session 1.5 Using clinical networks to drive quality improvement Ian Golton Director, NHS Stroke Improvement Programme and Associate Director, Strategic Clinical Networks and Senates, Yorkshire and the Humber Why? 1
  • 2. Organisations join networks because they can do what they need to do more effectively together than if they operate alone. “Networks bring together the providers of care and the commissioners of care to work together to plan and deliver high quality services for a specific population. Networks aim to improve outcomes, improve patient experience, improve the quality of treatment and care [and] improve access to appropriate high quality services” “Networks should be established…bringing together key stakeholders and providers to review, organise and improve delivery of services across the care pathway” 2
  • 3. Network ‘bread and butter’ • Promoting the idea of a ‘patient pathway’ • Helping different individuals, teams and organisations talk to each other • Helping the interface with the ‘penumbra’ of non- specialist services • Developing a collective voice and perspective, including a patient voice • Providing expert advice to those who need it • Helping the constituent parts to improve through idea sharing and mutual support How? 3
  • 4. ‘Bread and butter’ activities • Meeting each other • Talking to each other • Sharing information • Developing Clinical Leads • Special interest groups • Patient groups • Peer review/support visits • Joint projects • Coordinated voice to commissioners Minimum resources • Willingness • Time • Somewhere to meet and talk • Leaders 4
  • 6. “Clinical networks are an NHS success story. Combining the experience of clinicians, the input of patients and the organisational vision of NHS staff, they have supported and improved the way we deliver care to patients in distinct areas, delivering true integration across primary secondary and often tertiary care.” Bruce Keough and Jane Cummings (TBC) 12 NHS | Presentation to [XXXX Company] | [Type Date] 6
  • 7. 7
  • 8. Core Support Team Structure The actual size of the team will vary depending NHS CB LOCAL AREA on the population served TEAM MEDICAL DIRECTOR by the Clinical Senate but core posts will exist in all senates. SENATE CHAIR SCN CLINICAL DIRECTOR (approx. 0.4 wte) SCN & SENATE ASSOCIATE DIRECTOR BAND 9 PA BAND 5 SENATE MANAGER NETWORK MANAGERS 0.5 wte BAND 8C 3 x BAND 8Cs SENATE PA QUALITY NETWORK ASST 1 x 0.5 wte BAND 4 IMPROVEMENTS LEADS BAND 5 & 8 x BAND 6 - 8B NETWORK ADMIN & SUPPORT OFFICER 1x BAND 4 16 8
  • 9. To put it bluntly: Resources Workload Misconceptions: • Because there is one network support team there will only be 12 clinical networks • Each support team will only have 11 posts • Priorities and activities will be centrally dictated • There will be no national support 9
  • 10. Guiding values: • A clear sense of purpose • A commitment to putting patients, clinicians and carers at the heart of decision making • An energised and proactive organisation offering leadership and direction • A focused and professional organisation, easy to do business with • An objective culture, using evidence to inform the full range of its activities • A flexible organisation • An organisation committed to working in partnership to achieve its goals • An open and transparent approach Progress to date: • All leads for the 12 Network Support Teams have been ‘appointed’ • Most of the NST teams have been completed • Work plans are being discussed • Local and national events are underway • Various ‘working groups’ are looking at aspects of SCN functioning • More guidance being published 10
  • 11. But, many questions still to be answered: • How will it all work? • How will the NHS work? • How to protect the best of what we already have? • How to reconcile local versus central priorities? • Getting started with mental health, dementia, neurological conditions, maternity, children's services (plus building further diabetes and kidney care as part of CVD) • Playing together nicely: SCNs, Senates, AHSNs, ODNs, CSUs, HWBs, LATS, CCGs, LPNs etc. 11
  • 12. Suggestions: • Make contact with your local (new) Network Support Team • Self-organise • Demonstrate how a little can go a long way • Have your ‘pitch’ ready for different audiences • Be (somewhat) shameless in pursuit of funding • Partner with charities • Keep an eye on Academic Health Science Networks 12
  • 14. Geographical Area Host LAT Associate Director London London London Lucy Grothier East of England East Anglia Ruth Ashmore Midlands & East East Midlands Leicestershire and Lincolnshire Rebecca Larder West Midlands Birmingham, Solihull and Black Country Danielle Taylor Cheshire & Merseyside Cheshire, Warrington & Wirral Jan Vaughan Greater Manchester, Lancashire & South Greater Manchester North Cumbria Janet Ratcliffe Northern England Cumbria, Northumberland, Tyne & Wear Roy McLachlan Yorkshire & Humber South Yorkshire & Bassetlaw Ian Golton South East Coast Surrey & Sussex Deborah Tomalin Bristol, North Somerset, Somerset & South South West Coast South Gloucestershire Sunita Berry Thames Valley Thames Valley Aarti Chapman Wessex Wessex Lucy Sutton 14