Update: Operational Delivery
Networks
Denise McLellan
Transitional Lead, Networks and
Senates, Midlands and East
November 2012
Context
• NHS CB recognition of the value of networks -The
Way Forward: Strategic Clinical Networks July
2012
• A range of networks :
– Operational Delivery Networks i.e. neonatal, adult
critical care, trauma burns
– Strategic clinical networks i.e. cancer, cardiovascular,
maternity and children and mental health, dementia
and neurological conditions
– Local networks, locally determined.
SCNs and ODNs
• Operational delivery networks are focussed on coordinating patient
pathways between providers over a wide area to ensure access to
specialist resources and expertise. Provider clinicians dominate their
membership, though work closely with patients and other stakeholders.
– In future they will be provider hosted and funded
• Strategic clinical networks define evidence based best practice pathways,
and operate as engines for change across complex systems of care,
maintaining and or improving quality and outcomes. They bring primary,
secondary and tertiary care clinicians together with partners from social
care the third sector and patients.
– In future they will be NHS CB hosted and receive national commissioning
funding for their core functions
– Criteria for SCNs set out in ‘The Way Forward’
Current Situation
• Existing provider delivery networks
– With national coverage: Critical Care, Adult, paediatric,
Neonatal, Burns, Trauma.
– Variable coverage: adult congenital heart disease,
paediatric congenital cardiac surgery, paediatric
neuroscience.
• Variable funding mechanisms and scope. Eg 11/12
baseline survey £8.5m on provider delivery networks,
with £4m on adult critical care. Trauma networks just
being established.
• Range per network £84k to £621k pa.
• Mainly PCT hosted
Proposal
• Move to align to senate geography -12 in England
• Include membership of ODN in commissioning
specifications for inclusion in 13/14 contacts.
• Over time funded through tariff
• Nationally set strategy coordinated through NHS
CB specialised commissioning programme of care
leads and clinical reference groups.
• Continued patient and family engagement
• Close alignment with SCNs , local senates, AHSNs,
LETB, research networks, HWBs, CCGs etc
Purpose of ODNs
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Ensure effective clinical flows
Facilitate system wide collaboration
Multi professional engagement
Consistent application of standards
Quality assurance
Capacity planning
Activity and quality monitoring
Benefits of ODNs
• Improved outcomes and efficiency
• Stronger collaborative provision
• Increased consistency of care and patient and family
experience
• Additional risk sharing opportunities
• More accurate costing, leading to better resource
utilisation
• Development of ‘prime contracting’ focus
• Increased speed of innovation adoption
• Rapid learning and development
• Improved system resilience including major incident
planning
Success factors for ODNs
• Improved access and egress to and from
services at the right time.
• Improved operating consistency.
• Improved outcomes.
• Increased productivity.
• Improved collaboration between providers in
a pathway.
Operating Principles
• Hosted by lead provider
• Chaired by experienced clinical leader
• Link member to relevant national Clinical
Reference Group
• Use NHS Change Model www.changemodel.nhs.uk
• In accordance with pathway in contract
specification
• Governance within host provider
Links to commissioning policy
development
• 60 National Clinical Reference Groups linked
to Specialised commissioning definition set
• CRGs support development of national
contracting products, quality monitoring tools,
developing clinical innovation
• Coordinated through Regional Programme of
Care Leads, within Regional Specialised
commissioning teams
Proposed funding mechanisms
• Long term- tariff funded. Providers will not be
able to provide these services without being
in an appropriate network and will need to
agree with each other how this is resourced.
• Transitional arrangement ( 13/14 and 14/15):
c0.1% CQUIN for relevant specialised services
will be retained by specialised commissioners
• Nationally 0.1% CQUIN worth c£9m compared
to current estimated £8.5m cost
Proposed contractual arrangements
• Local LAT Specialised Commissioning teams will agree a
host provider for each network and a locally agreed
quality and outcome related service specification.
• Host provider receives locally agreed CQUIN funds
• All relevant providers will have a service specification
requiring networked pathways through an ODN
approach
• Host provider may or may not be tertiary provider; may
be economies of scale to host more than one ODN
Accountability
• ODN hosted by and accountable to a lead
provider
• Governance arrangements agreed between
members, to include clear escalation and risk
management arrangements
• Subject to specification in the contract
• Annual report highlighting quality outcomes
to be produced
HR issues
• In future, staff will be employed by the host
provider, within provider determined structures
• TUPE principles apply.
• Specialised commissioning teams will negotiate
transfers with host providers within a national HR
framework
• National timescales apply ie staff to know
destination by December 12
• Further consultation with staff to follow
Next steps
• NHS CB sign off of ODN operating model ( by end
of November 12)
• Communications and engagement plan
• Organisational development arrangements
• Managing transition
• Local negotiation between specialised
commissioning teams and providers
• Development of national model specifications for
ODNs