Clinical networksand Senates

Professor Sir John Burn MD FmedSciInterim Clinical Director

NHS Clinical Networks Northern EnglandThursday, 8th November 2012

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AHSN CCRN

Senate HWB

LETBNHS

Clinical engagement is critical to getting more for less

Chairs of the Clinical Innovation Teams and Network Leads meet monthly

Between 2008 and 2011over 1000 North East Clinicians helped develop our programme of activity

We can network

Examples: Bill Cunliffe –Planned CareLiz Kendrick- End of Life Care

Philosophy: Care is best delivered by networks of clinicians able to act together and transcend structural system boundaries, standardise care and drive innovation

Governance– Must embrace diversity from the large and highly

structured to the loose more local partnerships

Limits– Geographical– Organisational

www.theclinicalnetwork.org

Chief Executive

Nurse DirectorMedical Director

Domain 3Domain 1 Domain 4 Domain 5Domain 2

Lead Nurse Medical Lead

CCGs, Providers, Patients and Clinicians

National Level

Sub national commissioning sector

Sub sector level

National Clinical Directors

Strategic Clinical Networks

TheClinical

networks and

Senates

What we know

• The Way Forward• 4 x Strategic Clinical Networks• 8 staff• £10m core + £32m programmes• Senates• Cumbria, North of Tyne and Wear Local Area Team• Single operating model

Constructing “Clinical Networks Northern England”

‘Clinical Networks Northern England’ –

Direction

Development Delivery

managing the transition to ‘Clinical Networks – Northern England’

ProfessionalPragmaticPatient Centred

EngagementFinancial securityambition

Integrated teamShared facilitiesRegular interactions

THE CLINICAL NETWORK PROGRAMME

PLANNED CARE ACUTE CARE LTC’S

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operational NETWORKS

STRATEGIC CLINICAL NETWORK

STRATEGIC CLINICAL NETWORK

STRATEGIC CLINICAL NETWORK

Regional Networks End Of Life, Learning Disability,respiratory

Critical care, burnsNeonates, pathology

CNS DISORDERSMental health, dementia, neurosciences

STRATEGIC CLINICAL NETWORK

Issues still to resolve

• Operational networks • Programme budgets• Degree of flexibility• Senates• HR arrangements• Single operating model

Senate/Network footprint & interactions

•CCGs•FTs•NHS Commissioning Board

•Specialised Commissioning Hubs•Local Authorities•Health & Wellbeing Boards•Local Education and Training Boards (LETBs)

•Universities•Academic Health Science Networks (AHSNs)•Health Innovation and Education Clusters (HIECs)•Comprehensive Clinical Research Networks (CCRNs)•(CLAHRCs)Collab.s for Leadership in Applied Health Research & Care

• Commissioning Support• Quality Observatories• Public Health Observatories

Senates

• Has same footprint as networks• Under shared management• We think

• It needs a trusted chair• It should assemble for specific cases• Form should follow function

Building the Models…

‘Fast Focus Session’

Before we get to the event, we need to be able to describe each model taking into account;

• Number of Consultants and specialist staff

• Number of Beds (staffed)• Rotas and Job Plans• Patients (and admission

patterns• Services• Hospitals• The Network• Centres• PAUs• Population• Distance to travel

To start the event, we need two models demonstrating how the network could operate. These models are based on facts and show the network in two configurations – 3 centre vs 4 centre

Captain Kirk signs his PADD

The tricorder

What is your first response?

• “I bet it won’t work”• ….”it can’t can it?!”• ….”but that would affect my budget…”• …”it’s from Newcastle!”• ….”it’ll cause ethical problems”• ….”I hope it doesn’t work”

2001

Cui, Y., Wei, Q.Q., Park, H.K. & Lieber, C.M. Nanowire nanosensors for highly sensitive and selective detection of biological and chemical species. Science 293, 1289–1292 (2001).

“Devices based on nanowires are emerging as a powerful platform for the direct detection of biological and chemical species, including low concentrations of proteins and viruses.” 1st July 2006 Analytic Chemistry

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October 2012 £4m Nanomal grant with St George’s London to develop a point of care malaria test in 2

years

Langa Township August 2010

Warfarin project

Prof Ann Daly, Newcastle University

The cytochrome P450 CYP2C9 is responsible for the metabolism of S-warfarin.

Two known allelic variants CYP2C9*2 and CYP2C9*3 are associated with impaired hydroxylation of S-warfarin

> 5m people in Europe are prescribed the wrong warfarin dose

Aim: to develop a POC test to test for variantsfor use in clinics/GP surgery

•Integration is better than disintegration

•Standing still when all else changes equals moving backwards

•Have confidence in our professional skills

•Prove my business partners wrong-let’s put Q-Poc into practice in the north of England 1st