Hepatitis C Managed Care Network Process of development, strengths and challenges Justin Schofield, Hepatitis C MCN Manager

Background Evolved from Board’s Hepatitis Treatment & Care subgroup –Specialist Care ─ Voluntary Sector –Public Health ─ Pharmacy –Service managers Two years pump-priming funding (Scottish Executive) –Recruit MCN manager –Develop network Phase I Action Plan

Steering Group Membership Health Board –Public Health Consultant –Pharmacy –MCN Manager Specialist Care –ID / GI / Hep Consultants –Clinical Nurse Specialists –Psychologist –Service Managers –Pharmacists Social Care –BBV Social Worker Primary Care –CHCP Director –GPs Voluntary Sector –2 x vol sector support services –Patient representation Specialist Virology Centre –Virologist Scottish Prison Service –Prison healthcare staff

Govt. via CMO NHS GGC MCN Steering Group Audit & Effectiveness sub Prison Outreach sub Patient Involvement sub Viral Hepatitis Nurses Group Organisational Structure

Strengths Play to providers strengths & interests –South Asian patients –co-infection issues Multi-site & multi-agency working –testing & supported referral in community addiction settings –prison peer support and treatment Reduction of duplication –Network-wide clinical audit –Shared patient information resources

Strengths 2 Primary prevention + treatment and care Professional development –Internal Nurses group have educational programme Multi-site / agency research –External Annual info & update event open to health & social care professionals ‘Quick reference guide for GPs Info sent to health professionals with HCV test results

Challenges Managed care network↔Clinical focus Standardised protocols↔Clinical autonomy

Challenges Managed care network↔Clinical focus Standardised protocols↔Clinical autonomy Partnership working↔Organisational identity Meetings & paperwork↔Avoiding bureaucracy

Challenges Managed care network↔Clinical focus Standardised protocols↔Clinical autonomy Partnership working↔Organisational identity Meetings & paperwork↔Avoiding bureaucracy Targets & vision↔Development time Existing allies↔Potential converts

Challenges Managed care network↔Clinical focus Standardised protocols↔Clinical autonomy Partnership working↔Organisational identity Meetings & paperwork↔Avoiding bureaucracy Targets & vision↔Development time Existing allies↔Potential converts Meaningful public & patient involvement ↔Tokenism & perceptions of need

Key Facilitators National policy context (Phase I Action Plan) –Enables buy-in –Corporate agendas –Associated funding MCN Guidance: MEL (1999) 10 –Definition, core principles, framework for development Local champions –Drive process –Engage with colleagues at all levels of organisation

Further information & guidance NHS National Library for Health –Health Management Specialist Library: MCNsHealth Management Specialist Library: MCNs Scottish Government –Introduction of MCNs within the NHS in ScotlandIntroduction of MCNs within the NHS in Scotland –Promoting the development of MCNs in NHS ScotlandPromoting the development of MCNs in NHS Scotland –Strengthening the role of MCNsStrengthening the role of MCNs Care Services Improvement Partnership –Clinical Networks in Maternity ServicesClinical Networks in Maternity Services Clinical Governance Bulletin –Vol 3, Number 6: Clinical NetworksVol 3, Number 6: Clinical Networks n.b. view as slideshow to access web links