cardiac and stroke network directors update 19 feb 13
TRANSCRIPT
National Update- Cardiac and Stroke Network Directors’ Meeting
19 February 2013 Denise McLellan
Transitional National Lead, Network and Senate Implementation
Overview • Network ‘essence’ • National Support work ongoing
Overview of Networks and Senates in the new NHS system
January 2013
NHS | Presentation to [XXXX Company] | [Type Date] 4
“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.”
Sir Bruce Keogh, NHS Medical Director and Jane Cummings, Chief Nursing Officer
Networks support local clinicians to deliver the Outcomes Framework in local systems
Domain 1 Preventing people from dying prematurely Domain 2 Enhancing quality of life for people with long term
conditions Domain 3 Helping people to recover from episodes of ill health or
following injury Domain 4 Ensuring that people have a positive experience of
care Domain 5 Treating and caring for people in a safe environment;
and protecting them from avoidable harm
What is a Clinical Network?
Secure alignment across system
Patient and public involvement
Improve Clinical pathways
Outcomes Framework
Formal leadership and governance
Clinical relationships
Use influence and intrinsic motivators
Not statutory body
Defined geography and focus
The parts and power of Networks Membership Network power is greater than the sum of its parts
All local NHS bodies are expected to want to be members
Network members
Network board
Network stakeholders
Network support team
Network members
Network board
Network stakeholders
Network support team
+ +
=
3) Skills required for change ‘…I have the skills, capabilities and opportunities to behave in the new way’
Networks work by aligning levers for influence
4) Role modelling ‘…I see leaders, peers and reports behaving in the new way’
2) Reinforcement mechanisms ‘…The structures, processes and systems reinforce the change in behaviour I am being asked to make’
1) Understanding and conviction ‘…I know what is expected of me, I agree with it, and it is meaningful’
Our shared purpose
Spread of innovation
Leadership for change
Engagement to mobilise
System drivers
Improvement methodology
Rigorous delivery
Transparent measurement
Networks use a consistent change model
www.changemodel.nhs.uk
NHS Outcomes Framework
Senates [12]
Strategic Clinical
Networks
Local Professional
Networks
Operational Delivery
Networks
Other Local
Networks “The conscious and guiding intelligence”
“Engines for change and improvement across complex care systems”
“Gathering frontline knowledge and expertise”
“Mapping patient pathways to ensure access to specialist support”
“15 AHSNs: Masters of science and evidence based practice”
Multi-professional
i.e. Cancer; CVD; Maternity and Children’s; Mental Health / Dementia / Neurological Conditions
i.e. Pharmacy; Eye health; Dental
e.g. Adult Critical Care; Neonatal Intensive Care; Trauma; Burns; Paediatric NM; Paediatric IC
e.g. Academic Health Science Networks, Research Networks
NHSCB Network Support Teams (AT-based)
Annual national priorities from the NHSCB Medical and Nursing Directorates All supported by Improvement Body and Leadership Academy
Different Types of Network
Strategic Clinical Networks • No set number, condition-specific focusing on Cancer;
Cardiovascular Disease; Maternity and Children’s; Mental Health/ Dementia and Neurological Conditions.
• Typical work plans: hyper acute stroke, specialist cancer care, psychological support, child to adult transition
• Host: NHSCB AT – 12 Network and Senate Support Teams • Annual accountability agreement and work plan with Area
Team Medical Director
“Engines for change and improvement across complex care systems”
• Cover: Pharmacy; Eye Health; Dental • Typical workplans: Community Pharmacy enhanced
services; glaucoma pathways, community dental specialists • Host: NHS CB Areas – 27 primary care teams • Annual Accountability agreement and workplan agreed with
Area Team Medical Director
Local Professional Networks
“Gathering frontline knowledge and expertise”
Operational Delivery Networks • e.g. Adult Critical Care; Neonatal Intensive Care; Trauma;
Burns; Paediatric Neuromuscular; Paediatric Intensive Care • Typical workplans: transfer protocols between specialist
neonatal intensive care units, plans for managing a surge in critical care demand
• Host: Local Provider (transitional CQUIN funding) • Annual contract / specification with NHSCB AT specialised
commissioning team
“Mapping patient pathways to ensure access to specialist support”
Other Local Networks • e.g. Academic Health Science Networks (15),
Comprehensive Local Research Networks • Typical AHSN workplans: Medicine safety, digital access,
dementia care; industry links • Host:
- Various AHSN: annually accountable to NHSCB - Research Network: DH NIHR annual agreement - Respiratory: locally accountable
“15 AHSNs: Masters of science and evidence based practice”
NHS | Presentation to [XXXX Company] | [Type Date] 16
What is a Clinical Senate? “The Senate, an assembly of some three hundred of Rome’s great and good, generally acknowledged - even by those not in it – to be both the conscience and the guiding intelligence of the Republic. Membership of this elite was determined not automatically by birth but by achievement and reputation… This gave to the Senate’s deliberations immense moral weight, and even though its decrees never had the technical force of law, it was a brave or foolish magistrate who chose to ignore them.”
Holland; Rubicon (London, 2003) p37
Clinical Senates • Both proactive and reactive, broad clinical advisory focus • Typical work plans: reconfiguration of hospital services;
7 day working across a system • Host: 12 NHSCB Area Teams, share support with SCNs • Annual work plans agreed by members and with Area
Team Medical Directors
“The conscience and guiding intelligence”
Geography of Senates 12 Senate areas, broadly based around major patient flows to tertiary providers
Links to other parts of the system
Aligned work plans to achieve improved outcomes
Networks work in partnership with other bodies: • Health Education
England • Senates • Public Health
England • Health and
Wellbeing Boards • New Improvement
Body • Leadership
Academy
Networks offer: • local clinical insight • a readymade set of
clinical relationships
• communication networks
• means of improvement (or ‘delivery vehicle’)
Other Bodies offer networks: • intersecting relationships • specialist knowledge and data • other channels and means of influence
Overview • Network ‘essence’ • National Support work ongoing
Senates • Senates: The Way Forward published 25 Jan
2013 • http://www.commissioningboard.nhs.uk/resources/
networks-senates/ • Next steps: model terms of ref, workplan template
and conflict of interest policy • National workshop for senate chairs and
managers in April 13 • [email protected]
National Implementation Group: overall coordination • Has been chaired by Mike Bewick, Regional Medical Director with regional and specialist contributors
• Now needs to move to delivery, led by Associate Directors and Area Medical Directors , with links to other key national bodies
• Will also be ADs ‘Shared work and communication’ group and ? Ones for individual networks managers/ Improvement leads
• [email protected] for details
Pharmaceutical advice to SCNs • Paper setting out options for SCNs has been
circulated • Area specialised commissioning teams will have
access to specialist cancer pharmacist • Hopeful that Area Teams will have a senior
pharmacist to advise • [email protected] • [email protected] ( JDs)
Rehab/therapy advice to SCNs • Small group plans to meet and make some
recommendations to SCNs • Wed 27 Feb 10—11- teleconference • [email protected] for info
Websites/ digital platforms • Various needs: archiving existing websites, links
to common material on NHS CB, ie for voice and insight work, sharing resources and good practice between networks, communication within Networks and support teams
• NIB will have some role; NHS Networks being explored as a temporary platform
• Need a volunteer to lead- Please?
Research Networks • Need to maintain close links • Paper highlighting their transition has been
circulated to ADs • [email protected] and
[email protected] • Agreed to keep channels open
Working with Pharma • Scoping meeting held 15 February 2013 • Potential Quick wins- induction, analysis sharing
of previous initiatives • Longer term- agreed pathway redesign, possibly
working with AHSNs • All work will need to be underpinned by good
governance arrgts • [email protected]
Links to specialised commissioning • Webex Friday 22 February 11.00-12.00- CVD
specific overview of programme of care commissioning managers, role of clinical reference groups and linking SCN and spec comm’g priorities
• [email protected] for dates/ dial in • [email protected] Internal
medicine POC lead but can link to others • [email protected] SCN AD lead
Network Leaders’ bookclub by webEx • Run by Prof Helen Bevan • Looking at academic literature on leadership in
network settings • Mon 11 March 11-12 tele conference: gazelles
and gorillas • All types of network/ members can join • First one on Nilofer Merchant :11 rules for creating
value in the social era ( 2012) e book • [email protected]
Accountability and Governance • Accountability and Governance Framework • Model accountability agreement, work plan
template, model terms of reference (E mailed to ADs)
• Draft workplans due end of Feb 13 to AT MD • [email protected] ; • [email protected]
Ensuring meaningful PPI • Review undertaken with those involved and a workshop on
15 January 2013- developing library of resources
• Request each SCN team to identify a PPI lead
• Key issues are legacy, quick wins moving forwards and developing new sustainable systems, aligned to NHS CB voice and insight arrangements and best practice
• Further all day workshop planned: Wed 27 Feb London
Information needs of networks • Helping SCNs be intelligent customers of a range
of intelligence sources • Ensuring info providers understand Network
needs • All day workshop planned • [email protected] [email protected] • [email protected]
Working with the Third Sector • Lessons from partnerships in the past and ideas
for the future • Planned meeting between Richmond Group of
Charities and Domain leads
Working with the NHS IQ, Improvement Body • National Improvement body priorities • Ongoing support to SCNs- what is needed? • Development days, tools and techniques, digital
platform • [email protected] • www.changemodel.nhs.uk
Join the largest single improvement event to date in the NHS www.changemodel.nhs.uk/changeday Pledge to do something as a network?
Other? • Are you aware of other pieces of work that would
be useful that you want to share? • What else do you think needs developing? • [email protected] • NHS CB resources for networks and senates- • http://www.commissioningboard.nhs.uk/resources/
networks-senates/