Perinatal Mental Health Clinical Networks A common template

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Perinatal Mental Health Clinical Networks A common template? East Midlands Clinical Network

Perinatal Mental Health Clinical Networks A common template? East Midlands Clinical Network

(Managed) Clinical Network Organisation that promotes integrated clinically/cost effective care for conditions that: •

(Managed) Clinical Network Organisation that promotes integrated clinically/cost effective care for conditions that: • involve different professions, organisations and levels of service provision • most severe conditions, uncommon and critical, mass only possible at supra-locality level • less severe are common and morbidity sufficient for local provision • suitable for “hub & spoke” design • need integrated care pathways • need specialist knowledge and skills not widely available

(Managed) Clinical Network • • • need different resources and service organisation National drivers

(Managed) Clinical Network • • • need different resources and service organisation National drivers and Quality standards owned and shared by all members Multi disciplinary and multi professional involves expert patients audit and outcomes

Clinical Network • • Improvement and change Reduction in unwarranted variation in quality of

Clinical Network • • Improvement and change Reduction in unwarranted variation in quality of care Equity of access Promotes development and improvement of services

Clinical Network • • Visible Accountable Governance Authority Source expert advice Major role in

Clinical Network • • Visible Accountable Governance Authority Source expert advice Major role in strategic planning Supports implementation

Clinical Network • • • Funded Clinical leads (professions/topics) Manager and admin support TOR

Clinical Network • • • Funded Clinical leads (professions/topics) Manager and admin support TOR Infrastructure – Wider stakeholder group – Clinical advisory group – Executive • Work plan • Longevity

Membership • Representatives of all professions/managers and planners involved in pathways • Representative of

Membership • Representatives of all professions/managers and planners involved in pathways • Representative of geography • Authority of their host organisation • Responsibility to disseminate to host organisations

How? Workplan 1 st year 1. Compilation of standards, guidelines, best pratice and national

How? Workplan 1 st year 1. Compilation of standards, guidelines, best pratice and national drivers 2. Informs first broad pathway 3. Mapping birthrates, population Services specialised - AMH – Primary care Maternity & children – 3 rd sector Gap analysis & needs assessment Identify barriers to access Local variation 4. Survey views/experience of key stakeholders including patients

5. Engage with stakeholders (iterative) identify senior/key movers & shakers 6. Establish internal structure

5. Engage with stakeholders (iterative) identify senior/key movers & shakers 6. Establish internal structure executive board advisory group (size proportional to function) equitable mix of clinicians and regional/ national planners and strategists Publish Disseminate Launch

Year 2 and subsequently Focus and prioritise Accountable T & F working groups and

Year 2 and subsequently Focus and prioritise Accountable T & F working groups and small number of standing groups Annual reports Early – pathways patient journeys interface other services education and training Added value data/benchmarking

Challenges • Maintaining momentum profile engagement • Avoiding domination of one profession/interest group •

Challenges • Maintaining momentum profile engagement • Avoiding domination of one profession/interest group • Managerial vs. Clinical vs. Network • Focus and priorities vs. broad perspective • Frequency and membership of meetings • Protocols vs. flexibility • Pushing on open doors vs. tackling difficult issues • Time frames • Consensus vs. ‘tell them what to do’ • Resistance to change • Data • Outcome measures • Money

Success • • Must succeed to continue Evidence of work done Change and impact

Success • • Must succeed to continue Evidence of work done Change and impact Evidence of improved outcome

NHS England 2011/12 NHS ‘reforms’ Network Review 12 x Strategic Clinical Networks each x

NHS England 2011/12 NHS ‘reforms’ Network Review 12 x Strategic Clinical Networks each x 4 cancer, CVS, maternity and children, MH, dementia and neurological conditions Continual change and reorganisation 2015 Implementation arm of NHSE policy Rise of managerialism national control

2016 National Perinatal Mental Health Plan + money 360 million + included 12 x

2016 National Perinatal Mental Health Plan + money 360 million + included 12 x Perinatal MH Clinical Networks access and waiting times ‘evidence based pathways’ BUT few networks match the template 2017 Review (again)

RCPsych CCQI 2007 Perinatal Quality Network UK Success Impact Quality improvement Added value Consensus

RCPsych CCQI 2007 Perinatal Quality Network UK Success Impact Quality improvement Added value Consensus owned and shared Involvement of services

MCN Essential • Seamless integrated care • Equity of access and quality standards •

MCN Essential • Seamless integrated care • Equity of access and quality standards • Ensure continued improvement