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Managed Clinical Networks

Managed Clinical Networks. Dr A Hendry Lanarkshire Stroke MCN . “We shall never have all we need. Expectations will always exceed capacity. The service must always be changing, growing, and improving- it must always appear inadequate.” Aneurin Bevan 1948.

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Managed Clinical Networks

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  1. Managed Clinical Networks Dr A Hendry Lanarkshire Stroke MCN

  2. “We shall never have all we need. Expectations will always exceed capacity. The service must always be changing, growing, and improving- it must always appear inadequate.” Aneurin Bevan 1948

  3. Health and Community Care Policy • NHS Acute Services Review 1998 • Community Care : A Joint Future 2000 • Partnership for Care 2003 • Delivering for Health 2005 • Changing Lives : 21st C Social Work review 2006 Collaboration partnership integration redesign networks

  4. Managed Clinical Networks Linked groups of health professionals and organisations working together unconstrained by organisational or professional boundaries to ensure equitable,high- quality and effective services

  5. Education and training – staff and service users Continuing Professional Development for staff Quality assurance programme Audit as integral part Research & development Value for money Structure & relationships Distributed leadership Participation Multidisciplinary approach Service improvements Communication strategy MCN core principles

  6. Whole system burden of stroke • Health and Care burden • 6% of NHS and Social Services expenditure • Economic impact • Over 25% of strokes occur in people of working age • Emotional and Family impact

  7. System wide solution needs to address entire stroke journey • Health promotion • Primary prevention • Management of acute stroke • Rehabilitation • Secondary prevention • Discharge planning • Long Term support and care • Housing, adaptations, transport, leisure • Re-engagement in employment and community

  8. Disconnected services • Stroke units • Early supported discharge • Generic rehabilitation • GP hospitals • Community hospitals • Day hospital services • TIA clinics • Stroke liaison nurses • Primary care teams • Smoking cessation clinics • Lifestyle initiatives

  9. Network of Stroke Stakeholders • Patients and carers • Stroke teams/nurse • Early supported discharge • Primary care teams • Pharmacy services • Social work/homecare • CHS/VSS clubs • Public health practitioners • Health promotion • CHD/diabetes services • Care homes/liaison • Community hospitals

  10. MCN Champions • Vision • Creativity • Ability to challenge practice • Prepared to negotiate boundaries • Willing to embrace change in culture • Perseverance

  11. Henry Beecher 1813- 1887 “The difference between perseverance and obstinacy is that one comes from a strong will, and the other comes from a strong won’t.”

  12. Stroke MCN Evolution • Terms of Reference • Structure, Roles & Relationships • Benchmark and review processes • Redesign services • Evaluate Outcomes / experience • Adapt Adapt Adapt to organisational changes

  13. IndependentEvaluation : JIT 2006 Success factors Supportive framework MCN connected existing structures Distributed leadership Nurtured collaboration and partnership working Creativity and service redesign promoted Momentum and focus maintained despite Serial wider organisational changes Relocation of teams Reprovision of services

  14. Steering group : strategy & action plan 4 Working groups : evolving work programmes • Patient and carer information and support • Patient / carer co-chair • Multidisciplinary documentation • Education, training and development • Health promotion /secondary prevention • GenericHealth Improvement across MCNs • Protocols and evaluation • Clinical Effectiveness group

  15. Quality Improvement • Agree Standards • Measure Performance • Feedback Performance locally • Celebrate and share success • Learn from challenges • Support Improvements

  16. Quality Assurance Framework • Standards • Rationale • Criteria • Qualitative Quantitative Lanarkshire Stroke QAF rolled out across Scotland

  17. ALL SITES % Stroke patients admitted into Stroke Unit <24hrs

  18. ALL SITES Average LOS (days)

  19. National Stroke standards Criteria met by NHS Board 04/05

  20. Stroke MCN Impact • Redesigned journey of care • Improved process and efficiency • Better quality, experience and outcomes • Patient and carer focus • Change culture and leadership nurtured • Stakeholder learning opportunities • Culture of education, research and development • Recruitment and retention opportunities • Enhanced service profile

  21. Collaborations with academic, regional and national partners • NHS Education for Scotland • Health QWest • University of Glasgow • Glasgow Caledonian University • Bell College • University of Stirling • Stroke MCNs across Scotland • NHS Quality Improvement Scotland • DoH NHS Networks Board • DoH Northern Ireland

  22. Trondheim Stroke Unit Sep 2004

  23. Statutory, Private contractor and Voluntary Sector Partnership • NLC and SLC Social Work Services • NLC and SLC Leisure Services • Lanarkshire Care Homes • Community Pharmacy Services • Scottish Ambulance Service • Big Lottery Fund • Chest Heart and Stroke Scotland

  24. Stroke Support Service Stroke Support Team

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