When Shifting the Balance of Power within the NHS: securing delivery was published in April 2001, it became clear that clinical service networks were embedded throughout the proposed new organisational structures for the NHS in England. A service network can be defined as a collaborative partnership of professionals (both commissioner and provider) working in a co-ordinated manner, unconstrained by existing professional and organisational boundaries to ensure patient-focused high quality, effective, equitable services. The modern NHS has sought to shift power away from the centre, in favour of patient-centred, locally focussed services.
Having comprehensive National clinical standards has been heralded as the best way to end the lottery of care in the NHS. National standards for NHS HIV services have been developed by MEDFASH over the last year and are available in draft form on the MEDFASH website. The final standards will be published shortly.
Last week in London, MEDFASH facilitated a seminar for professionals working in the NHS and the voluntary sector to come together to learn about how managed service networks can help them to provide better services. A well-developed HIV service network should increase uptake and access to services (particularly for target groups), by providing better information and advertisement of local services.
South West London has a well-developed HIV service network. This enables members of the network to share ideas for service development and improvement. They have developed a website which contains much relevant information about HIV treatment and care in South West London, and aside from quarterly meetings, represents the best way for all involved to keep up-to-date with one another.
In today’s British Medical Journal, Dr Hilary Thomas, a cancer specialist outlines how clinical service networks have offered “flexibility, inspiration, and mutual benefit” to those working in oncology. She emphasises “managed clinical networks are based on (such) teamwork, enabling doctors and managers to work together constructively. These networks link groups of health professionals and organisations from primary, secondary, and tertiary care, enabling them to work together in a coordinated way, unconstrained by professional and organisational boundaries to ensure equitable provision of high quality, effective services to patients”.
At the MEDFASH seminar last Friday, many healthcare professionals expressed concern that the resources required to support the development of a clinical service network will have to come from existing funds- it seems no additional funds are to be made available.
Peter Nieuwets, HIV commissioning manager for West Sussex said that he felt developing networks was important if we are to successfully manage shrinking funds available for HIV and GUM services in the future.
Anxieties about competing priorities were common; Dr Chris Carne from Addenbrookes hospital in Cambridge cautioned that involving clinicians in more meetings may have a knock-on effect on patient waiting lists.
Dr Lister, consultant GU physician at Queen Mary’s hospital, who has been involved from the start of the South West London HIV clinical services network, acknowledged that whilst service networks can deliver improvements in service delivery this is very much dependent upon resources.
HIV Services Networks Seminar, MEDFASH, 14 March 2003, London.
Thomas H Clinical networks for doctors and managers. BMJ 326:655, 22 March 2003.