SCN & Senates : Whole System,

Integrated Approaches to Change

Jan Vaughan

Associate Director for Cheshire and Merseyside

7th May 2014

“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 Keogh, Medical Director and Jane Cummings , Nursing Director

NHS | Presentation to [XXXX Company] | [Type Date] 2

The Way Forward: Strategic Clinical

Networks (July 12)

• Essential to support improvement of outcomes for patients

• NHS England is the host for Strategic Clinical Networks from 1st April 2013

• Four initial areas operating throughout the country:

cancer

cardiovascular

maternity and children

mental health, dementia and neurological conditions.

Geography of Strategic Clinical Networks

12 SCN areas, broadly based around major

patient flows to tertiary providers

5

Cheshire and Merseyside Strategic Clinical Network Oversight Group

Cancer Cardiovascular Disease (CVD)

Maternity, Children and Young People

Mental Health; Dementia;

Neurological Conds. CARDIAC

STROKE

DIABETES

KIDNEY HEART

FAILURE

REHAB

NHS England

MATERNITY

CHILDREN & YOUNG PEOPLE

MENTAL HEALTH

NEUROLOGICAL CONDITIONS

DEMENTIA

COMMON CANCERS

RARE & SPECIALISED

CANCERS

Alignment with the New System

SCNs will need to develop close relationships with stakeholders including:

• Patients and the public

• Commissioners and providers

• Clinical Senates

• Health and Well Being Boards

• Academic Health Science Networks

• NHS Improvement Body

• Third sector organisations

• Professional organisations

• Education and training bodies... and more

Our purpose is:

• To identify innovation, encourage early adoption of evidence and

best practice that can produce a substantial improvement in health

outcomes across all 5 domains

7

How do they add value?

• By bringing together clinical expertise to drive changes to clinical practice and the required organisational change to enable those changes which may include service reconfiguration

• By ensuring that clinical expertise is not just medical and stretches across primary, secondary and tertiary care

• By ensuring that clinical expertise is based on:

o New evidence o Neglected evidence o Reinterpreting old evidence using revised conceptual framework o Guidance such as NICE and SIGN modified by any additional

evidence o Audits of clinical practice

• By ensuring that this leads to the identification of innovation, early adoption of evidence and best practice that can produce a substantial improvement in health outcomes

Benefits to Commissioners

• Collective effort & engagement to bring about the changes that are

needed to improve health care

• An NHS England funded support team to support each SCN to

prioritise its advice, be transparent in its work, ensure a document

trail, that different views are brokered to achieve consensus, that

advice is issued for commissioners and that it is acted on to make a

difference for patients

• Systematic, methodological approach to review

• Increased opportunities for education, learning, sharing best

practice

Benefits to Commissioners

• Strategic approach – contribution to the wider planning process (both two and five year plans)

• Advice on which outcomes for the condition areas should be focused on to deliver improvements and suggestions on what actions, models of care may be needed

• Combined efforts for common themes such as end of life, rehabilitation, transition

• Conduit to domain leads and national clinical directors

• Interpretation of national guidance and policy based on local needs, commissioner plans and priorities

Strategic Clinical Networks Going

Forward

• Two year plans (April 2014 - March 2016), which will also support commissioners five year strategies

• Support NHS England Area Teams and Clinical Commissioning Groups with quality and Call to Action and contributing to the Area Teams assurance process

• Focus on 3-4 transformational change programmes in each geography

• Ambition to align at least 1 priority across all of England’s Strategic Clinical Networks

• Projects relate to condition or cross cutting focus; not focused on areas of improvement other structures are leading on e.g. NHS Improving Quality is supporting the move to seven day services

• Real focus on momentum – delivery of tangible milestones for patients and to be held to account for delivery

• Conclusion of some areas of legacy work i.e. vascular surgery reviews

2012/13

12

LAs

FTs

SHAs

Links

PCTs HWBs

CCGs

Networks

31st March 2013

13

LAs

FTs

SHAs

Links

PCTs HWBs

CCGs

Networks

2013/14

14

LAs

FTs HWBs

CCGs

NHS England PHE

SCNs Senates

Healthwatch

2015/16

15

LAs

FTs HWBs

CCGs

NHS England PHE SCNs

Senates Healthwatch

Clinical Senates

Clinical Senates are non-statutory entities for active

engagement and involvement of the breadth of health

and wider care professionals, including those who

sometimes go unheard. To support the integration of

services, they will include public health specialists and

social care experts. Senates will also include patients

and public to ensure their experiences inform advice

that senates will provide.

Bruce Keogh, Medical Director and Jane Cummings , Nursing Director

NHS | Presentation to [XXXX Company] | [Type Date] 1

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Clinical Senate

The story so far……

Clinical Senates

• Futures forum discussions

• Established to provide robust, independent, credible clinical advice to commissioners of health and social care

• Activities include providing strategic advice on complex commissioning decisions such as large scale reconfiguration, major service changes or integration proposals

• Informed by patients, carers and public

• Strong links with national medical directors and clinical leads

• Will take on the functions previously performed by NCAT

• Developing at different paces in each area

• Appointed a Chair in April – Prof Martin Lombard

NHS | Presentation to [XXXX Company] | [Type Date] 19

“If everyone is moving forward

together,

then success takes care of itself”

Henry Ford

NHS | Presentation to [XXXX Company] | [Type Date] 20

Thank you for listening