The MSK Clinical Networks Project

ARMA has a strategic partnership with the National Clinical Director for MSK disorders, and as part of this partnership ARMA is running a year-long project to research, and then begin to implement, the best ways of supporting the development of MSK clinical networks in England. Such networks have a key role in the new NHS landscape, especially in terms of driving up quality through the identification and dissemination of best practice.

Related pages:
FAQ on Clinical Networks
MSK Knowledge Network
CCGs joining the MSK Knowledge Network
MSK 2013 Seminar event
“Improving outcomes in MSK” lecture 2013
The Health and Social Care Network

Background

Currently, there is significant variation in the delivery of existing MSK services across England as evidenced by ARMA’s recent audit of MSK services, Joint Delivery?, the King’s Fund report Variations in Healthcare 2011 and Getting It Right First TimeImproving the quality of Orthopaedic Care within the National Health Service in England (Briggs, BOA, 2013).

A key aim of the MSK Clinical Networks Project is to identify the key elements of ‘what good looks like’ for MSK services by analysing existing successful networks. This should then lead to the design and delivery of MSK clinical networks that deliver real improvements in MSK services.

Clinical Networks

Clinical networks have been increasingly turned to in order to improve health and health services with the ultimate aim of ensuring that more people can be enabled to live better for longer.  Managed clinical networks were described by the NHS Executive in 2000 as “linked groups of health professionals and stakeholders [so they can] work together in a coordinated manner unconstrained by existing professional boundaries to finish with an equitable provision of high quality care.”

Since April 2013, NHS England has introduced strategic clinical networks for four key clinical areas: i) mental health, dementia, neurological conditions;
ii) maternity and children; iii) cancer; and iv) cardiovascular services.

 

Clinical Networks can take many forms. Here are the key elements of successful clinical networks based on existing evidence:

  • it was important to have a clinical champion;
  • it was critical to involve patients;
  • network protocols and other forms of communication – including leaflets which included ‘a patient story’ (a patient-recalled clinical experience) – improved communication between primary and secondary care;
  • the network aimed to improve equity of access to and standards of care.
  • the clinical lead ‘works across existing professional enclaves or with isolates’ using interpersonal relationships and contacts to gain information, understanding values and undertaking negotiations
  • having a clear and shared vision between individuals and organisations involved in the network
  • network cohesion was also facilitated through investment in communication, which energised participants, and helped clinicians and managers to make the essential step for ‘quality improvement in developing ‘the ability to see services from the patient’s point of view’.
  • Combination of clear national policy framework with resources/targets and local customisation
  • Strong research and evidence base
  • Service improvement agenda
  • Only one sector – no private or social care involvement, small voluntary sector
  • Highly graded staff with a large support team (so can be high staffing costs)
  • Strong clinician involvement
  • Effective small team based forms of leadership, including clinical managerial hybrids

 

In practice, both statutory and non-statutory networks have delivered major positive changes to services. For instance, the NHS London trauma network reduced fatalities by 20%, while the paediatric hepatology network set up by Dr Alastair Baker at King’s College Hospital, successfully worked with patients and providers to develop and provide highly specialised services delivered much closer to the patient and patient’s family.

The methodology adopted to structure the project is ‘appreciative inquiry’ which is a well-researched approach to change management which has been widely and successfully practised in the public, private and voluntary sectors.

 

More pages related to the MSK Clinical Networks Project:

 

Frequently Asked Questions

Please visit this page for our FAQ on Clinical Networks.