Clinical networks have proven to be a valuable tool in delivering effective service provision and commissioning. Peter Melton explains

My first experience of the power of clinical networking was when NHS Networks established a local out-of-hours GP co-operative in 1996.

The local GPs thought the service could be improved with regard to quality, staff and patient experience, accessibility and efficiency. They designed a new model, secured stakeholder support and implemented the new service in a way that delivered their key aims.

This network has evolved to include our local foundation trust and we are planning to provide integrated emergency care services from a new shared facility.

Learning from the success of this project, we established a locality commissioning pilot in 1997. The arrangements evolved into one of the first PCTs in April 2000. The PCT assumed care trust status on 1 September.

In 2002 we established regional and national networks of professional executive committee chairs to build working relationships between the committees, strategic health authorities and the Department of Health.

With the establishment of practice-based commissioning, we are currently formulating a partnership between practices that will serve a population of 40,000. This new partnership will be the commissioning body for that population and will align and integrate health and social care budgets. It will also provide integrated nursing services for its population and work to improve the health of designated vulnerable communities.

Lessons learned:

  • Clinical networks can be a powerful lever for effective provision and commissioning;

  • their initiation is haphazard;

  • their development is not systematically supported;

  • most networks emerge in an informal way but to be truly successful there comes a point when they need to be actively managed;

  • the NHS benefits most when we create a healthy challenge and scrutiny between provider and commissioner networks;

  • clinical networks transcend the established NHS structures and systems and can therefore more effectively deliver responsive, integrated and holistic services.

How do we use clinical networks to deliver world-class commissioning and Our NHS, Our Future?

  • We can no longer allow their formulation and development to occur by chance;

  • we need to develop complementary provider and commissioning clinical networks;

  • we need to assess our current baseline of clinical networks throughout the NHS;

  • we need to support the transition of informal networks into more effective managed networks;

  • we need networks at local, regional and national levels;

  • we need to systematically learn from our current networks;

  • we need to energise the development of PBC and support the networking of PBC;

  • we have many effective specialist regional provider networks. We need PECs to work together to ensure that we develop robust clinical commissioner scrutiny of these networks;

  • at national level, we have excellent clinical leaders who are leading new and innovative ways of working in their field of expertise. PECs need to work together to critically challenge some of the emerging ideas. They need to ensure a holistic view is taken, localism is not compromised and that the plans are responsive to emerging local priorities.

The NHS is moving away from traditional organisational models of provision and commissioning. As we go through this transition, we all share a collective responsibility to ensure we develop world-class networks – supported by NHS Networks – to deliver world-class commissioning.