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

2. (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

3. (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

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

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

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

7. 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

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

9. Publish Disseminate Launch
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

10. 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

11. 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

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

13. 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
Implementation arm of NHSE policy
Rise of managerialism national control

14. 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
Review (again)

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

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