Background The NHS in England is evolving, with an increasing focus on long-term conditions, prevention and multimorbidity, and an overall purpose of providing coordinated, person-centred care. There are new structures and commissioning arrangements designed to deliver this vision and incentivise integrated working. In this landscape, clinical networks have a key role to play in terms of facilitating joined-up working and patient involvement, and contribute to healthcare improvement by providing a space for exchanging information and spreading good practice. There is a large and growing interest by commissioners and clinicians in a “networks approach” to improving care for people with RMDs in particular. Since 2013, ARMA has been working in partnership with NHS England and key NHS stakeholders to develop clinical networks in the area of RMDs.
Objectives To improve outcomes in the care of RMDs by bringing together knowledge and people through the creation of clinical networks, supported by national groups of experts in key priority areas.
Methods ARMA convened a set of meetings involving key ARMA member organisations to shape the project and secure the buy-in of all key stakeholder groups. Between April and November 2013, ARMA adopted an appreciative inquiry methodology to conduct research into existing networks and examples of good practice in multidisciplinary care for RMDs. This took the form of a large number of one-to-one interviews with clinicians from different professional backgrounds across England as well as desk research. The findings were shared and discussed with a large number of stakeholders from across the RMD community in England, including patients, clinicians, commissioners and NHS managers, at a seminar in November 2013. The outcomes of this seminar were used to inform the next stage of the project, described as: 1. Convening National Working Groups (NWGs) of experts on priority areas, 2. Developing clinical networks locally and regionally, 3. Producing a set of resources to support network development and inform the commissioning of RMD services
Results The 2013 seminar agreed 5 priority areas which every MSK clinical network needs to address, in addition to any specific priorities which it may have identified in its locality or region. It also produced a shared vision for good RMD care, and identified key elements of successful clinical networks. The seminar identified 9 key stakeholder groups which each clinical network should aim to include, described as the “MSK 9”, including people living with RMDs, General Practitioners, rheumatology and orthopaedic consultants and AHPs. By December 2014, all NWGs had begun functioning, a number of clinical network “frontrunners” had been identified and a resource pack was being developed in partnership with the NHS Confederation, which represents the health and social care system in England. Government has formally expressed its support for the ARMA project and for the first time NHS England has approached us with the aim of providing additional resourcing for it.
Conclusions Clinical networks are a demonstrably effective way of improving outcomes for people with RMDs, whose main strength lies in their ability to transcend specific NHS structures and hierarchies. This also makes them highly adaptable and easily transferable to health systems across the world. The ARMA project is therefore a good model for many other countries.
Effective Networks for Improvement, Health Foundation, March 2014
Disclosure of Interest None declared
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